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Öğe Characteristics of Turkish patients with elderly onset psoriatic arthritis A retrospective cohort study(Lippincott Williams & Wilkins, 2017) Kobak, Şenol; Yıldız, Fidan; Karaarslan, Ahmet; Semiz, Hüseyin; Orman, MehmetPsoriatic arthritis (PsA) is a chronic inflamatory disease characterized with axial and peripheral joints involvement. It rarely affects patients older than 65 years old. The purpose of this study is to compare and evaluate the demographic, clinical and laboratory features of elderly-onset psoriatic arthritis (EOPsA) and young-onset (YOPsA) patients. A total of 180 patients diagnosed with PsA according to CASPAR criteria and followed-up in single center were included in this study. The patients with initial symptoms started after age 65 were accepted as EOPsA. Demographic, clinic, and laboratory data and the medications which the patients received were recorded and retrospectively evaluated. Nineteen (10.5%) of 180 patients were diagnosed as EOPsA, and 161 (89.5%) patients were evaluated as YOPsA. The mean patient age was 42.1years for the YOPsA group and 68.3 years for the elderly onset group. Mean duration of disease was 5.6 years for the early onset group and 1.3 years for the elderly onset group (P=.001). Fourteen (73.3%) of 19 EOPsA patients were female and 5 of them were male. Higher rates of fatique, pain scores, comorbid diseases, and acute phase reactants elevation were detected in EOPsA patients comparing to YOPsA (P=. 000, P=.000, P=.001, and P=.001, respectively). YOPsA patients have more dactilitis, nail involvement, elevated PASI scores, and smoking habitus when compared with EOPsA patients (P=.019, P=.03, P=.005, P=.004, respectively). In terms of the treatment options chosen, there was no significant difference in the use of nonsteroidal antiinflammatory drugs (NSAIDs), corticosteroids (CS), methotrexate (MTX), and sulfasalazine (SSL), but there was a more frequent use of anti-tumor necrosis factor-alpha in the YOPsA group. YOPsA and EOPsA patients may presented with different clinical and laboratory features. EOPsA patients are characterized with higher rates of fatigue, pain scores, comorbid diseases, and acute phase reactants and less dactilitis, nail involvement, and anti-TNFalpha usage.Öğe Coexistence of sarcoidosis and adult onset still disease(Elsevier Espana Slu, 2019) Semiz, Hüseyin; Kobak, ŞenolSarcoidosis is a chronic, inflammatory disease with unknown cause characterized by non-caseating granuloma formations. It can be presented with bilateral hilar lymphadenopathy, skin lesions, eye involvement and locomotor system findings. Adult onset Still disease (AOSD) is a chronic inflammatory disease which presents with fever, arthritis and typical skin rashes. The disease is rare and can be mis-diagnosed due to the absence of typical clinical and laboratory findings. The association of sarcoidosis and AOSD has not been previously reported in the literature. Herein we reported the development of AOSD in a patient followed by the diagnosis of sarcoidosis. The patient did not respond to high-dose corticosteroids and methotrexate therapy, and the disease was under control with anti-IL-6 (Tocilizumab) drug. (C) 2017 Elsevier Espana, S.L.U. and Sociedad Espanola de Reumatologia y Colegio Mexicano de Reumatologia. All rights reserved.Öğe Coexistence of sarcoidosis and gouty arthritis(Elsevier Espana Slu, 2019) Semiz, Hüseyin; Kobak, ŞenolSarcoidosis is an inflammatory disease with unknown cause characterized by non-caseating granuloma formations. It may present with bilateral hilar lymphadenopathy, skin lesions, the involvement of eye and symptoms on the locomotor system. Gouty arthritis is an autoinflammatory disease characterized by hyperuricemia, recurrent arthritis attacks and the deposition of monosodium urate crystals in the joints and the surrounding tissues. We reported the coexistence of sarcoidosis and gouty arthritis in this paper. (C) 2017 Elsevier Espana, S.L.U. and Sociedad Espanola de Reumatologia y Colegio Mexicano de Reumatologia. All rights reserved.Öğe Coexistence of sarcoidosis and hashimoto thyroiditis(Pagepress Publ, 2018) Semiz, Hüseyin; Yalcin, Mehmet Akif; Kobak, ŞenolSarcoidosis is a chronic, inflammatory disease with unknown cause characterized by non-caseating granuloma formations. It can present with bilateral hilar lymphadenopathy, skin lesions, eye involvement and locomotor system findings. Hashimoto thyroiditis is an organ-specific autoimmune disease characterized by increased autoantibody synthesis. Sarcoidosis can involve different endocrine glands. Thyroid gland involvement may lead to increased thyroid function disorders and autoantibodies. Herein, we report an 80-year-old female patient with sarcoidosis and Hashimoto coexistence.Öğe Concomitant autoimmune diseases in patients with sarcoidosis(Bmj Publishing Group, 2017) Kobak, Şenol; Sever, Fidan; Semiz, Hüseyin; Orman, Mehmet NurullahSarcoidosis is a chronic granulomatous disease characterized by non-caseating granuloma formation. It can mimic many rheumatic diseases and/or may be coexist with them. There are limited data in the literature about the association of sarcoidosis with autoimmune diseases.Öğe Concomitant autoimmune diseases in patients with sarcoidosis in Turkey(Turkish League Against Rheumatism, 2020) Yıldız, Fidan; Kobak, Şenol; Semiz, Hüseyin; Orman, MehmetObjectives: This study aims to determine the frequency and characteristics of autoimmune diseases associated with sarcoidosis patients. Patients and methods: The study included 131 sarcoidosis patients (36 males, 95 females; mean age 46.1 years; range, 20 to 82 years). Demographic, clinical, laboratory and radiological data of patients were evaluated retrospectively. The characteristics of autoimmune diseases associated with sarcoidosis (sarcoidosis-overlap group) patients and isolated sarcoidosis (isolated sarcoidosis group) were analyzed and compared. Results: Concomitant autoimmune diseases were detected in 15 (11.5%) (5 males, 10 females; mean age 50.8 years; range, 26 to 58 years) of the 131 patients with sarcoidosis and their mean disease duration was three months (range, 1 to 30 months). When compared with isolated sarcoidosis patients, more hand finger joint involvement, rheumatoid factor (RF) positivity, higher erythrocyte sedimentation rate (ESR) and less nonsteroidal anti-inflammatory drugs (NSAIDs) usage were found in the sarcoidosis-overlap group (p= 0.035, p=0.049, p= 0.015, p=0.018, respectively). There were no statistically significant differences between the two groups when evaluated for demographic, clinical parameters and disease-modifying antirheumatic drugs usage. Conclusion: Concomitant autoimmune diseases in patients with sarcoidosis may be rarely seen. These patients are characterized with more hand finger joint involvement, RF positivity, higher ESR and less NSAIDs usage. Multicenter, prospective studies involving large numbers of patients are needed to understand whether the association of sarcoidosis-autoimmune diseases is based only on coincidence or on a common etiopathogenesis.Öğe Elderly - onset sarcoidosis: a single center comparative study(Ediciones Doyma, S.L., 2020) Kobak, Şenol; Yıldız, Fidan; Semiz, Hüseyin; Orman, Mehmet AkifObjectives: Sarcoidosis rarely affect patients older than 65 years old. The purpose of this study is to compare and evaluate the demographic, clinical and laboratory features of elderly-onset (EOS) and young-onset sarcoidosis (YOS) patients. Methods: One hundred and thirty one patients diagnosed with sarcoidosis according to clinical, radiologic and histopathological evaluation were included in this study. The patients with initial symptoms started after age 65 were accepted as EOS. Results: Twenty (15.3%) of 131 patients were diagnosed as EOS, and 111 (84.7%) patients were evaluated as YOS. Fifteen of 20 EOS patients were female and 5 of them were male. Average duration of the disease was determined as 38.4 months for YOS and 22.5 months for EOS (p = 0.556). Delay of the diagnosis was 12 months for YOS while it was 3 months for EOS (p = 0.001). Higher rates of fatique, comorbid diseases and more hydroxychloroquine (HQ) use were detected in EOS patients comparing to YOS (p = 0.010, p = 0.003 and p = 0.039 respectively). Conclusions: EOS patients are characterized with higher rates of fatique and comorbid diseases, less inflammatory sign and delayed diagnosis, and less DMARDs use. © 2018 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de ReumatologíaÖğe Elderly - onset sarcoidosis: a single center comparative study(Wiley, 2017) Kobak, Şenol; Yıldız, Fidan; Semiz, Hüseyin; Orman, Mehmet[No Abstract Available]Öğe Elderly - onset sarcoidosis: a single center comparative study(Bmj Publishing Group, 2017) Kobak, Şenol; Sever, Fidan; Semiz, Hüseyin; Orman, Mehmet AkifSarcoidosis is a chronic granulomatous inflamatory disease characterized with non-caseified granuloma formation. It is rarely affects patients older than 65 years old.Öğe Hyponatremia as presentation in a patient with neurosarcoidosis(Elsevier Doyma Sl, 2017) Akyıldız, Ekin; Yalçın, Murat; Sever, Fidan; Semiz, Hüseyin; Kobak, ŞenolSarcoidosis is an inflammatory disease with unknown cause characterized by non-caseating granuloma formations. It may present with bilateral hilar lymphadenopathy, skin lesions, eye and musculoskeletal system involvement. Hypercalcemia and hypercalciuria are important electrolyte imbalances resulting from sarcoidosis and sometimes they may cause nephrolitiasis and kidney failure. Hyponatremia, although being quite rare, has been found in some patients with sarcoidosis. Herein, we have reported a patient with neurosarcoidosis who presented with hyponatremia and responded well to corticosteroid treatment. (C) 2016 Elsevier Espana, S.L.U. and Sociedad Espanola de Reumatologia y Colegio Mexicano de Reumatologia. All rights reserved.Öğe Malignancy in patients with sarcoidosis(Ediciones Doyma, S.L., 2021) Kobak, Şenol; Yıldız, Fidan; Semiz, Hüseyin; Orman Mehmet AkifThe relationship between sarcoidosis and malignancy is not clear yet. We retrospectively evaluated 131 sarcoidosis patients followed-up at the single Rheumatology center. The incidence of malignancies was investigated in this cohort. A total of 6 (4.6%) patients with malignancy were identified in our cohort of 131 patients with sarcoidosis. Hodgkin lymphoma (HL) was detected in three patients, followed by one patient with breast cancer, one patient with thyroid cancer and one patient with testicular cancer. All patients had chronic sarcoidosis with pulmonary involvement, and only 1 patient had acute sarcoidosis with Löfgren's syndrome. HL developed concomitantly with sarcoidosis in one patient while other two patients developed disease before and after sarcoidosis diagnosis. Two patients with solid tumors developed malignancy years before sarcoidosis diagnosis, while one patient developed thyroid cancer during sarcoidosis follow-up. All 6 sarcoidosis–malignancy patients survived after six year years follow up. We found low incidence of malignancy in patients with sarcoidosis in our small cohort. The sarcoidosis–malignancy relationship can only be a coincidence and/or can be explained by a common pathogenesis. New prospective studies involving large patients series are needed in this regard. © 2019 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de ReumatologíaÖğe Malignancy in patients with sarcoidosis: a retrospective cohort study from Turkey(Bmj Publishing Group, 2018) Kobak, Şenol; Yıldız, Figen; Semiz, Hüseyin; Orman, Mehmet AkifThe relationship between sarcoidosis and malignancy is not clear yet. There is debate with different speculations in the literature in this regard, that this association may be just a coincidence and/or common pathogenetic link. Objectives: The goal of our study was to evaluate the incidence and characteris-tics of malignancy in patients with sarcoidosis follow-up in a single centre.Öğe Sarcoidosis presenting as penile mass(Medknow Publications & Media Pvt Ltd, 2017) Semiz, Hüseyin; Kobak, ŞenolSarcoidosis is an inflammatory disease with unknown cause characterized by noncaseating granuloma formations. It may present with bilateral hilar lymphadenopathy, skin lesions, eye, and musculoskeletal system involvement. Rare involvement of the genital organs (prostate, testis, epididymis) has also been reported. However, penile involvement is observed quite rare. In this paper, we report a patient with penile mass who was diagnosed with sarcoidosis on the basis of the laboratory, radiological, and pathological investigations.Öğe Serum adipokine levels in patients with sarcoidosis(Springer London Ltd, 2020) Kobak, Şenol; Semiz, Hüseyin; Akyıldız, Mühittin; Gökduman, Ayşe; Atabay, Tennur; Vural, HüseyinBackground Sarcoidosis is a chronic inflammatory disease characterized by non-caseating granuloma which etiology is unknown yet. Adipokines are different proteins synthesized by adipose tissue that have an influence on angiogenesis, hemostasis, lipid metabolism, and immune system regulation. Adipokines may play a role in the pathogenesis of sarcoidosis. Objectives To evaluate the serum adipokine levels in patients with sarcoidosis and to determine a possible correlation with clinical and laboratory signs of disease. Methods Forty-four biopsy-proven sarcoidosis patients followed at a single center and age- and sex-matched 41 healthy volunteers were included in the study. Demographic, clinical, laboratory, and radiological data were recorded and body mass index (BMI) was calculated in all patients. Routine laboratory tests (blood glucose, liver, and kidney function test) were measured. Serum adiponectin and leptin levels were measured by ELISA method. Results Among 44sarcoidosis patients, 13 (29.5%) were male and 31 (70.5%) were female. Twenty-one (47.7%) patients had erythema nodosum, three (6.8%) had uveitis, 40 (90.9%) had arthralgia, 32 (72.7%) had arthritis, 15 (34.1%) had enthesitis. Laboratory evaluation showed increased serum ACE level in 24 (54.5%) patients, increased serum calcium level in 11 (25%) patients, increased serum D3 level in 5 (11.4%) patients, and increased ESR and CRP levels in 22 (50%) and 23 (52.3%) patients, respectively. Compared with the control group, serum adiponectin levels were significantly higher in patients with sarcoidosis(p = 0.007). Serum adiponectin level was associated with arthralgia and ankle joint swelling (p = 0.007, p = 0.006 respectively). Serum leptin levels were similar in sarcoidosis patients and controls (p = 0.327). There was no relationship between serum leptin level and disease features (p > 0.05). Conclusions In this study, high serum adiponectin level was detected in patients with sarcoidosis while serum leptin level was similar in the sarcoidosis and control group. Adiponectin, an anti-inflammatory protein, may play a role in the pathogenesis of sarcoidosis. Studies are needed to shed light on this topic.Öğe Ustekinumab-induced sarcoidosis in a patient with psoriatic arthritis(Bentham Science Publ, 2020) Kobak, Şenol; Semiz, HüseyinBackground : Psoriatic Arthritis (PsA) is a chronic inflammatory disease that may affect different joints. Sarcoidosis is a Th-1 cell -related chronic granulomatous disease characterized by non -caseating granuloma formation. The coexistence of both the diseases is a rare entity. Usteki- numab, an IL12 / 23 inhibitor, has shown efficacy and safety in the treatment of PsA. Objective : This study presents a case with ustekinumab-induced sarcoidosis in a patient with PsA. Case Report : A 52 years old female patient with complaints of pain and swelling of the wrists, MCP, PIP and DIP joints and skin lesions was referred to our Rheumatology clinic. On her medical history, she had been under follow up for 5 years with the diagnosis of psoriasis and one year ago, she started to receive ustekinumab prescribed by a dermatologist. On physical examination, she had psori- asis skin lesions and arthritis of both wrists, MCP, PIP, DIP joints. Bilateral hilar lymphadenopathies were detected in the chest X-ray and thorax computed tomography. In laboratory tests, acute phase re- actants and serum angiotensin-converting enzyme levels were high. Endobronchial ultrasonography biopsy was performed and non -caseating granuloma consistent with sarcoidosis was reported. Usteki- numab was discontinued, methotrexate and low -dose corticosteroid were started. The patient was clin- ically stable in the 6 th month of the treatment and the findings were regressed. Conclusion : Sarcoidosis development appears to be a new paradoxical effect of ustekinumab thera- py, being another biological agent.
