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Öğe A Rare Presentation of Coeliac Disease; Intractable Itching with Recurrent Heart Attack and Dermatitis Herpetiformis(Bilimsel Tip Yayinevi, 2021) Alan Yalim, Sumeyra; Dumanoglu, Betul; Poyraz, Merve; Alpagat, Gulistan; Baccioglu, Ayse; Kalpaklioglu, Ayse FusunCoeliac 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.Öğe Allergic Contact Dermatitis due to Medical Mask; A Case Report(BILIMSEL TIP YAYINEVI, 2020) Alpagat, Gulistan; Dumanoglu, Betul; Poyraz, Merve; Alan Yalim, Sumeyra; Baccioglu, Ayse; Kalpaklioglu, Ayse FusunAllergic contact dermatitis occurs as a result of delayed hypersensitivity reaction caused by various exogenous substances. Here, a case of allergic contact dermatitis due to medical mask use is presented. A 39-year-old female patient was admitted to Allergy outpatient clinic with complaints of red and itchy maculopapular lesions, and small blisters on the cheeks, nasolabial folds, chin and neck under the chin that started three days ago. She had no chronic illness, massive sunshine exposure, history of systemic and topical medication intake and cosmetic use. The patient has been using washable masks for the whole COVID-19 pandemic period, however she used medical masks instead of washable ones 15 days ago once and for the last two days before the beginning of her complaints. Even though there was no reaction in her first contact, the above dermatitis lesions restricted to mask area developed 24-48 hrs after starting to use it for the second time. Allergic contact dermatitis was diagnosed due to skin lesions suitable with dermatitis and occurrence of the reaction after the second contact to a suspicious substance. She was recommended to stop using medical masks, and a treatment of oral antihistamine and topical steroid was prescribed. After her complaints resolved completely, a challenge with a different brand of medical mask was performed, and no reaction was observed. As a result, this case implicates that allergic contact dermatitis may occur due to using medical masks, and it is important to use masks with standardized approval since they are essential in preventing airborne infections including corona virus.Öğe Amoxicillin/Clavulanic Acid-Induced Symmetric Drug-Related Intertrigious and Flexural Exanthema(Springernature, 2023) Alpagat, Gulistan; Baccioglu, Ayse; Dumanoglu, Betul; Yalim, Sumeyra Alan; Kalpaklioglu, Ayse Fusunbeta-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.Öğe Anaphylaxis After Consumption of Guar Gum-Containing Food: A Report of Two Cases(Springernature, 2022) Dumanoglu, Betul; Alpagat, Gulistan; Poyraz, Merve; Yalim, Sumeyra Alan; Baccioglu, AyseGuar gum is a food additive that acts as a thickening agent. Although the relationship between guar gum and occupational rhinitis/asthma has already been established, only very few cases of anaphylaxis were associated with guar gum ingestion. We present two examples of anaphylaxis induced by guar gum. Both cases were successfully treated with adrenaline. Moreover, serum-specific immunoglobulin E (IgE) with the culprit agent was detected in blood samples. To the best of our knowledge, here we present the first case of class 6 guar gum-specific IgE-positive anaphylaxis. This report aims to raise awareness of rare food additive allergies such as guar gum.Öğe Evaluation of systemic inflammation markers in patients with rhinitis(Springer Heidelberg, 2024) Yalim, Suemeyra Alan; Kalpaklioglu, Ayse Fuesun; Baccioglu, Ayse; Poyraz, Merve; Alpagat, Gulistan; Dumanoglu, BetulBackground: Rhinitis affects the majority of the population. It may generate localized nasal mucosal inflammation via allergic (AR) or nonallergic (NAR) processes, but it is unknown if this might also result in systemic inflammation, which can raise morbidity and death. Using current serum inflammatory markers, we sought to investigate systemic inflammation in patients with chronic rhinitis. Methods: In this retrospective case-control study, we included 439 patients with newly diagnosed AR (n = 179), NAR (n = 157), and 103 healthy individuals. Inflammation-related blood parameters were collected as lymphocyte/monocyte ratio (LMR), neutrophil/lymphocyte ratio (NLR), eosinophil/neutrophil ratio (ELR), and systemic immune inflammation index (SII). Results: All groups were similar in terms of age, gender, and body mass index. Neutrophil counts were significantly higher both in AR and NAR groups compared to controls (4.51 +/- 0.09, 4.54 +/- 0.1 vs. 3.73 +/- 0.1, p < 0.001). NLR (1.91 +/- 0.56, 1.89 +/- 0.61, 1.61 +/- 0.59, p < 0.001), LMR (5.76 +/- 0.17, 5.93 +/- 0.17, 5.1 +/- 0.15, p = 0.005), ELR (0.1335 +/- 0.007, 0.0999 +/- 0.006, 0.12 +/- 0.009, p = 0.003), SII (533.3 +/- 16.6, 558.1 +/- 20.9, 479.9 +/- 22.2, p = 0.035), and CRP (1.44 +/- 0.09, 1.67 +/- 0.09, 0.87 +/- 0.04, p < 0.001) were significantly higher in AR and NAR groups than the controls, respectively. SII (r = 0.146, p = 0.007) and ELR (r = 0.254, p < 0.001) were correlated with the presence of asthma. Conclusion: We found that systemic circulation of inflammatory cells was significantly increased in rhinitis with/without allergy compared to the control group. This study showed that not only AR, but also NAR triggers a systemic increase of inflammation which supports the link between rhinitis and comorbid conditions such as asthma. Therefore, effective treatment may be suggested for local inflammation and its systemic manifestations.Öğe Hypereosinophilia of undetermined significance in a rheumatoid arthritis patient(Wiley, 2022) Dumanoglu, Betul; Alpagat, Gulistan; Poyraz, Merve; Baccioglu, Ayse; Kalpaklioglu, Ayse Fusun[Abstract No tAvailable]Öğe Starting as cold-induced anaphylaxis but following as urticaria(Wiley, 2022) Poyraz, Merve; Alpagat, Gulistan; Dumanoglu, Betul; Yalim, Sumeyra Alan; Baccioglu, Ayse; Kalpaklioglu, Ayse Fusun[Abstract No tAvailable]
