Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item A Case Report of Latent Autoimmune Diabetes Arising After Isotretinoin Treatment: Real Association or Coincidence? A Hypothesis on Pathophysiology(2021) Bozkus, Yusuf; 34259153Background: Latent autoimmune diabetes in adults (LADA) is the most common form of adult-onset autoimmune diabetes. Isotretinoin is a very effective treatment for severe acne. There are various reports on the effect of isotretinoin on autoimmunity. We present a case of LADA, probably related to isotretinoin treatment. To the best of our knowledge, this case was the second case of LADA that occurred after isotretinoin treatment. Here we discuss a hypothesis on the pathophysiology of how isotretinoin can induce LADA. Case Presentation: A 55-year-old female was diagnosed with type 2 diabetes mellitus (T2DM) one month after the end of a nine-month isotretinoin treatment period. At the time of diagnosis, the patient's fasting blood glucose level was 257 mg/dL and HbA1c level was 10.3%. Then, she was followed-up for T2DM for two years. Since the patient did not comply with classical T2DM characteristics and C-peptide level was 0.4 ng/ml (0.78-5.18), autoantibody test was performed. The patient was found positive for anti-glutamic acid decarboxylase antibody (>2000 IU/mL). Her oral antidiabetic drug treatment was discontinued and insulin degludec and insulin aspart therapy was started. Three months after this adjustment, HbA1c level decreased to 7.2%. Except 25-hydroxycholecalciferol which was low (10.9 ng/mL), all other laboratory parameters were within normal range. Conclusion: Isotretinoin is known to have some immunomodulating effects. There are some case reports on the relationship between isotretinoin and autoimmune diseases. The negative immune enviromnent that developed due to the long-standing moderate-severe VitD deficiency may have taken a turn toward autoimmunity upon isotretinoin treatment. This hypothesis on how isotretinoin can cause autoimmtme diabetes needs to be validated.Item Higher mean platelet volume is accompanied with hyperthyroidism in patients with Graves' disease(2020) Bagir, Gulay Simsek; Ertorer, Melek Eda; 0000-0001-7357-8709; ABI-3705-2020Purpose: Graves' disease (GD) is an autoimmune disease that is the most common cause of thyrotoxicosis. Thyrotoxicosis can cause a decrease in platelet survival time. Inflammation is an important stimulus for platelets and mean platelet volume (MPV) could be used a diagnostic marker which is an important determinant of platelet activity. In this study we aimed to evaluate whether MPV would be a useful inflammatory marker for evaluation of disease activity in patients with Graves' disease. Materials and Methods: Two hundred twenty-nine patients (GD patients (Group 1); n=102 and patients with euthyroid nodular goiter (Group 2); n=127) were included in this retrospective study. Serum TSH, fT3, fT4 and MPV levels were recorded at presentation and at first euthyroid period under ATD treatment in GD patients and at presentation in patients with euthyroid nodular goiter. Results: The mean age was 40.3 +/- 13.5 in Group 1 and 50.2 +/- 11.6 in Group 2. Mean initial MPV level did not differ between groups; 8.3 +/- 1.2 fL and 8.3 +/- 1.1 fL, respectively (p=0.9). We found that mean initial MPV was higher than the first euthyroid period MPV in Group 1; Graves' group (8.3 +/- 1.2 fL vs 8.0 +/- 1.3 fL, p=0.02). Conclusion: Higher initial MPV levels in Graves patients and significant drop following the restoration of hyperthyroidism may be due to hypermetabolism of hyperthyroidism.Item Vitamin D deficiency is related to thyroid antibodies in autoimmune thyroiditis(2014) Unal, Asli Dogruk; Tarcin, Ozlem; Parildar, Hulya; Cigerli, Ozlem; Eroglu, Hacer; Demirag, Nilgun Guvener; 26155169Introduction: It has been known that vitamin D has some immunomodulatory effects and in autoimmune thyroid diseases, vitamin D deficiency was more prevalent. In this study, our aim was to investigate the relationship between thyroid autoantibodies and vitamin D. Material and methods: Group 1 and 2 consisted of 254 and 27 newly diagnosed Hashimoto's thyroiditis (HT) and Graves' disease (GD) cases, respectively; age-matched 124 healthy subjects were enrolled as controls (group 3). All subjects (n = 405) were evaluated for 25OHD and thyroid autoantibody [anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-tg)] levels. Results: Group 2 and group 1 patients had lower 25OHD levels than group 3 subjects 14.9 +/- 8.6 ng/ml, 19.4 +/- 10.1 ng/ml and 22.5 +/- 15.4 ng/ml, respectively (p < 0.001). Serum 25OHD levels inversely correlated with anti-tg (r = -0.136, p = 0.025), anti-TPO (r = -0.176, p = 0.003) and parathormone (PTH) (r = -0.240, p < 0.001). Group 2 patients had higher anti-tg and anti-TPO levels than group 1 and 3 (p < 0.001). Conclusions: In this study, we found that patients with autoimmune thyroid disease (AITD) present with lower vitamin D levels and GD patients have higher prevalence. Since we found an inverse correlation between vitamin D levels and thyroid antibody levels, we may suggest that vitamin D deficiency is one of the potential factors in pathogenesis of autoimmune thyroid disorders