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    A Rare Presentation of Coeliac Disease; Intractable Itching with Recurrent Heart Attack and Dermatitis Herpetiformis
    (Bilimsel Tip Yayinevi, 2021) Alan Yalim, Sümeyra; Dumanoğlu, Betül; Poyraz, Merve; Alpagat, Gülistan; Baççıoğlu, Ayşe; Kalpaklıoğlu, Ayşe Füsun
    Coeliac disease (CD) is a systemic disease of the unwarranted immune reaction to gluten and is associated with a 10% increased risk of cardiovascular disease. Here we present a patient with recurrent myocardial ischemia and intractable itching who was eventually diagnosed with CD. A 53-year-old man presented to the allergy department due to intractable itching that was resistant to antihistamine therapy. In addition, despite successful percutaneous intervention with stent implantation to the right coronary artery, there was an ST segment elevation with myocardial infarction (MI) in the lower wall that had occurred three times. After dermatitis herpetiformis was reported as a result of the biopsy performed from the lesions, duodenal biopsy confirmed the diagnosis of CD. Diagnosis of CD with atypical presentation can be difficult. Cardiovascular risk is increased in patients with celiac disease compared to the normal population. Itching is an important symptom that needs to be evaluated in detail, even without the typical gastrointestinal manifestations of CD.
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    Amoxicillin/Clavulanic Acid-Induced Symmetric Drug-Related Intertrigious and Flexural Exanthema
    (Springernature, 2023) Alpagat, Gülistan; Baççıoğlu, Ayşe; Dumanoğlu, Betül; Yalım, Sümeyra Alan; Kalpaklıoğlu, Ayşe Füsun
    beta-Lactams, particularly penicillins, may cause several allergic reactions. We described symmetric drug-related intertriginous and flexural exanthema (SDRIFE) illness in this case, a rare instance of systemic contact dermatitis caused by amoxicillin/clavulanic acid that needs to be considered in the differential diagnosis. A 65-year-old male patient was admitted to our Allergy Outpatient Clinic because of increased blue-purple pigmentation on the flexural surfaces of the hip, forearm, axilla, and posterior face of the neck. The patient was receiving a combination of angiotensin receptor blocker (ARB) and hydrochlorothiazide diuretic medication for hypertension. The patient used an antibiotic containing amoxicillin three months ago; As a result, there was localized redness, itching, and black spotting without any systemic symptoms. Similarly, the patient reported that when he used amoxicillin for an upper respiratory tract infection eight months ago, he experienced similar side effects within 20 days and recovered when he applied corticosteroid ointment.Due to the symmetrical site involvement following the consumption of penicillin group antibiotics with a five-month gap and subsequent comparable reactions in our patient, SDRIFE was taken into consideration. The results of the skin punch biopsy identified Baboon Syndrome (SDRIFE). Treatment with topical corticosteroids and antihistamines began. Clinically speaking, SDRIFE is distinguished by significant erythema of the gluteal/perianal area and/or V-shaped erythema of the inguinal/perigenital area, symmetric involvement of at least one other intertriginous or flexural area, and the absence of systemic signs or symptoms. The possibility that the medication may have contributed to the patient's erythematous eruption in the flexural regions should be taken into account, and the patient should be advised to stop taking the medication and not use it again.
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    Characteristics of Adverse Reactions and Compliance in Patients who Underwent Allergen-Specific Subcutaneous Immunotherapy; Ten-Year Real-Life Data
    (Bilimsel Tip Yayinevi, 2022) Baççıoğlu, Ayşe; Kalpaklıoğlu, Ayşe Füsun; Poyraz, Merve; Alan Yalım, Sümeyra; Dumanoğlu, Betül; Alpagat, Gülistan
    Objective: Allergen-specific subcutaneous immunotherapy (SCIT) is known as the best therapeutic method that may alter the natural course of allergic diseases, compared to pharmacological and avoidance options. However, some problems such as adverse reactions (ARs), inconvenience, and high costs of a prolonged course of therapy may prevent patients from completing the therapy. The objective of this study was to evaluate the evidence for the potential barriers against the benefits of SCIT in adult patients. Materials and Methods: An observational study between 2009 and 2019 was performed at the Allergy Clinic of a tertiary hospital. The data of 166 adult patients who underwent SCIT for allergic rhino-conjunctivitis (ARC), and/or asthma or hymenoptera venom anaphylaxis using conventional schedules with standard allergen extracts were evaluated. Results: SCIT indications were ARC (63%), ARC and asthma (19.3%), and venom anaphylaxis (17.5%). The standardized allergen extracts used were grass pollen (59%), house dust mite (19.9%), and hymenoptera venom (17.5%). The frequency of SCIT-related ARs was 7.4% per injection, and 42.2% per patient. Local ARs were more frequent than systemic ARs (SAR)s. The majority of the SARs were composed of anaphylaxis and generalized urticaria, which were mostly of moderate severity with no deaths. SARs were more common in women, in patients with high injection numbers, and in patients under SCIT with cat allergen or multiple allergens. Most of the SARs occurred immediately after injection, and in the initial phase, whereas the delayed-type of SARs was common in patients with pollen SCIT. Three patients under cat SCIT discontinued treatment due to SARs of immediate and moderate/severe type. Ratios of SARs of venoms were insignificantly higher than aeroallergens. SARs with house dust mite SCIT were rare. Rates of patients' compliance to SCIT were similar between the allergen extracts, with an average of 70%. The most common causes of non-compliance were non-adherence, leaving the current residence, difficulty in obtaining the allergen extracts, and ARs. The frequencies of local and moderate ARs were higher in compliant patients, whereas systemic and severe ARs were higher in non-compliant ones. In the regression model, it was found that ARs increased and patient compliance decreased as the number of injections increased. Conclusion: This study in the real-life setting for a decade showed that less than half of the patients that underwent SCIT had developed ARs, which were generally local and of moderate severity. In conclusion, these results indicated that each allergen of SCIT had different characteristics of ARs, and the moderate incidence of ARs was not a problem regarding compliance with SCIT. Therefore, SCIT may be preferred in indications of allergy, and has a tolerable balance of ARs and safety.
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    Hypereosinophilia of undetermined significance in a rheumatoid arthritis patient
    (Wiley, 2022) Dumanoğlu, Betül; Alpagat, Gülistan; Poyraz, Merve; Baççıoğlu, Ayşe; Kalpaklıoğlu, Ayşe Füsun
    [Abstract No tAvailable]
  • [ X ]
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    Relation of vitamin D levels in patients with allergic and non-allergic rhinitis
    (Wiley, 2021) Kalpaklıoğlu, Ayşe Füsun; Alpagat, Gülistan; Baççıoğlu, Ayşe; Alan, Yalım Sümeyra; Dumanoğlu, Betül; Poyraz, Merve
    [Abstract No tAvailable]
  • [ X ]
    Öğe
    Starting as cold-induced anaphylaxis but following as urticaria
    (Wiley, 2022) Poyraz, Merve; Alpagat, Gülistan; Dumanoğlu, Betül; Yalim, Sümeyra Alan; Baççıoğlu, Ayşe; Kalpaklıoğlu, Ayşe Füsun
    [Abstract No tAvailable]
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    The Effect of Internet Addiction on Asthma Control and Medication Adherence
    (Bilimsel Tip Yayinevi, 2022) Kalpaklıoğlu, Ayşe Füsun; Baccıoğlu, Ayşe; Dumanoğlu, Betül; Poyraz, Merve; Yalım, Sümeyra Alan; Alpagat, Gülistan
    Objective: Internet addiction has recently become a prevalent health problem. Although many studies indicate a link between internet addiction and various diseases, no studies have examined its consequences on asthma control or medication adherence. The purpose of this study was to determine how internet addiction affects asthma control and medication adherence. Materials and Methods: Study participants were grouped as asthmatics and healthy controls whom were aged between 18 and 77. Asthma control test (ACT) and medication adherence report scale (MARS-5) were fulfilled by asthma patients, whereas short version of Young Internet Addiction Test (s-IAT) was applied to all participants. Pulmonary function test was performed to all subjects. Results: Forty-nine healthy volunteers and 54 asthmatic subjects were enrolled. Age and gender profiles within the study groups were similar. There was no significant difference in means of problematic and pathological (s-IAT >= 31) s-IAT scores between asthma and control groups (24.1% and 20.4%, p=0.41), as well as between asthma patients with controlled and uncontrolled ACT scores (24.1% and 24%, p=0.99), and those with and without medication adherence (16.7% and 27.8%, p=0.50). s-IAT scores were found to be linked to higher educational level (p=0.01, r=0.37), and better FEV1 (p=0.04, r=0.27) in asthmatic patients. In addition, MARS-5 was correlated with older age (p=0.02, r=0.29), and low FEV1 (p=0.01, r= -0.35). Conclusion: Internet addiction did not seem to directly affect asthma control or medication adherence. However, it appeared to be associated with a high level of education and FEV1.
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    Vitamin D Levels in Patients with Allergic and Non-Allergic Rhinitis
    (Bilimsel Tip Yayinevi, 2022) Kalpaklıoğlu, Ayşe Füsun; Alpagat, Gülistan; Baççıoğlu, Ayşe; Alan Yalim, Sümeyra; Dumanoğlu, Betül; Poyraz, Merve
    Objective: Allergic and non-allergic rhinitis are quite similar from a clinical viewpoint and allergen sensitivity seems to be the important relevant difference between them. However, the role of vitamin-D (vit-D) as an immunomodulator hormone and on rhinitis phenotypes is not clear. We aimed to investigate the relation between vit-D levels and patients with rhinitis as allergic (AR) and non- allergic (NAR). Materials and Methods: This was a retrospective research of 228 patients whom were diagnosed at a tertiary hospital between 2012 and 2016. Rhinitis was diagnosed as AR if nasal symptoms were accompanied with skin prick test (SPT) positivity, and NAR if they were relevant with negative SPT. The clinical history of the patients and the symptoms were recorded. Serum total IgE tests were performed using an allergen detection system (UniCAP, Phadia, Uppsala, Sweden), and vit-D levels were measured with the 25-hydroxy-vit-D (25-OH vit-D) kit in the Elecsys 2010 analyzer (Roche Diagnostics, Germany). Results: A total of 228 patients (AR=170 and NAR=58) with a mean age of 31.06 +/- 11.58 yrs were included. The mean age and ratio of female gender were significantly higher in NAR (p=0.03), whereas obesity was significantly higher in AR patients (p=0.01). Duration of rhinitis in NAR was longer than in AR (p=NS). Serum total IgE levels were significantly higher in AR than NAR, whereas mean levels and ratio of vit-D deficiency were similar between the groups. Levels of vit-D were significantly lower in females than males only in the AR group (p<0.001). Patients with NAR had mostly severe vit-D deficiency (<10 ng/mL), and those with AR had mostly non-severe vit-D deficiency (11-19 ng/mL). There was no relationship between vit-D deficiency and allergen sensitization, but there was a negative correlation of vit-D levels and female gender in the AR group (p<0.001). Conclusion: The present study showed no association between serum vit-D level and allergen sensitization in adult patients with allergic and nonallergic rhinitis.