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    Acromegaly with No Evidence of Pituitary Adenoma or Ectopic Source
    (Galenos Yayincilik, 2017) Sari, Isilay Kalan; Demirci, Huseyin; Durmaz, Senay Arikan
    Acromegaly is caused by the uncontrolled hypersecretion of growth hormone (GH) and secondary increases of insulin-like growth factor-1. More than 95% of patients with acromegaly have a growth hormone-secreting pituitary adenoma. Ectopic GH or growth hormone releasing hormone (GHRH)-secreting tumors are rare cause of acromegaly. Pituitary adenomas that cause the hypersecretion of GH are nearly always visible on magnetic resonance imaging. Rarely, patients without an ectopic source may have normal pituitary imaging. In managing this rare circumstance, exploring pituitary or medical treatment with a somatostatin analog might be useful. We describe a patient with acromegaly with no pituitary adenoma and no evidence of ectopic source, who was treated with long-acting octreotide.
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    Atypical Diabetic Ketoacidosis: Case Report
    (Aves, 2015) Demirci, Huseyin; Cosar, Ramazan; Ciftci, Ozcan; Sari, Isilay Kalan
    Background: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus and can lead to death if untreated. It is a complex metabolic state characterised by hyperglycaemia, acidosis and ketonuria. Bonsai is one of the herbal incense products that contains synthetic cannabinoid and can be easily accessible via the internet in many countries. It cannot be detected in blood and urine studies using conventional methods. Synthetic cannabinoid abuse is associated with severe side effects, including tachycardia, high blood pressure, acidosis, excess sedation and coma. Case Report: A 17-year-old male patient was brought to the emergency department with sudden onset of dyspnoea. Laboratory investigations revealed hyperglycaemia, acidosis and ketonuria. He was admitted to the intensive care unit with a diagnosis of diabetic ketoacidosis. He was not considered a typical case of diabetic ketoacidosis because of the tendency to hypokalaemia, persistent tachycardia and bronchoscopic findings. We learned from his friends that he had used cannabis for a week and used bonzai on the day that he was brought to the emergency service. Conclusion: Diabetic ketoacidosis with prolonged acidosis and tendency to hypokalaemia are investigated for the consumption of synthetic cannabinoids.
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    Klinefelter Syndrome with Portal Vein Aneurysm: Case Report
    (Gazi Univ, Fac Med, 2018) Sari, Isilay Kalan; Cosar, Ramazan; Yilmaz, Sevda; Demirci, Huseyin
    Klinefelter syndrome (KS) is the most common chromosomal disorder in men characterized by clinical features of hypogonadism and infertility. About 90% of cases have classically 47, XXY karyotype and the remaining have additional X or Y chromosomes, high grade aneuploidies or X chromosome structural abnormalities. Portal vein aneurysms are very rare. Reported cases are increasing due to use of modern imaging techniques in clinic practise. Here we report a 19-year-old man with KS who was admitted with complaints of abdominal pain, nausea and vomiting. Further investigations revealed 23 mm anechoic, saccular expansion in the left branch of the portal vein. It is well known that KS is associated with venous thromboembolic diseases including portal venous thrombosis, but association with portal vein aneurysm has not been previously reported.
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    Scleredema Diabeticorum in a Patient with Type 2 Diabetes Mellitus
    (Galenos Yayincilik, 2016) Sari, Isilay Kalan; Durmaz, Senay Arikan; Bozdogan, Onder; Kocak, Mukadder
    Scleredema is a rare skin disease and clinically presents as diffuse, painless induration and thickening of the skin. Scleredema diabeticorum is usually slowly progressive and characterized by insidious onset and tends to be persistent. This type of scleredema primarily affects middle-aged and obese adults. Typically, affected area is the upper part of the body including the posterior neck, interscapular region and the chest. It usually develops in subjects with diabetes mellitus of long duration and poor metabolic control. We discussed a case of scleredema in a 54-year-old woman with a history of diabetes mellitus.