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  • Küçük Resim
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    A Case of Pituitary Insufficiency in a Patient Presenting with Hyponatremia: Might Be Slow-Progressing Lymphocytic Hypophysitis as a Possible Cause of Empty Sella?
    (Nizameddin KOCA, 2020) Elbüken, Gülşah; Baydar, Ece; Kara, Sonat Pınar
    Case: A 75-year-old female patient presented with complaints of nausea, weakness, fatigue and generalized pain all over her body. Her medical history included essential hypertension, type 2 Diabetes Mellitus, coronary artery disease and hypothyroidism. She was hospitalized due to detecting a serum sodium (Na) concentration of 123 mmol/L. Although her diuretic medications were discontinued and fluid replacement with parenteral hypertonic saline infusion was instituted for approximately 6 days, Na level did not return to normal. Secondary hypothyroidism was considered due to laboratory test results showing low fT4 level and markedly suppressed TSH value. Since further laboratory workup showed that TSH, ACTH, PRL, GH and gonadotropins were also low, the diagnosis was confirmed as “panhypopituitarism”. Her obstetric history was not suggestive of Sheehan’s Syndrome and she did not have a history of head injury or cerebrovascular disease. She was started on parenteral 100 mg hydrocortisone and hormonal replacement therapy with oral levothyroxine. The clinical picture of the patient improved dramatically with resolution of hyponatremia. Results and Discussion: Lymphocytic hypophysitis is an autoimmune disorder of the pituitary gland and it mostly affects middle-aged women. The fact that our patient was the age of 75 without having any clinical symptoms, since she had “panhypopituitarism” and a “partially empty sella” appearance in her pituitary MRI scans, “lymphocytic hypophysitis” was considered as the probably cause of pituitary insufficiency even if her age was older than the typical age of patients affected by the condition. Conclusion: It suggests that slow-progressing primary hypophysitis (probably lymphocytic hypophysitis) can lead to pituitary insufficiency at a later age.
  • Küçük Resim Yok
    Öğe
    Neoadjuvan tedavi alan meme kanserli hastalarda yeni bir inflamatuar belirteç olan serum kalprotektin düzeyinin tedaviye yanıtta prediktif değeri
    (Namık Kemal Üniversitesi, 2021) Baydar, Ece; Şeber, Erdoğan Selçuk
    Meme kanseri kadınlarda en sık rastlanan malignitedir ve dünya genelinde en yaygın ikinci kanserdir. Meme kanserinde neoadjuvan tedavi, cerrahi operasyon şeklinde ilgili hastalığın nihai tedavisinden önce uygulanan yöntemleri kapsamaktadır. Kalprotektin ise memeli S100 protein ailesinin S100A8 ve S100A9 alt ünitelerinden oluşan heterodimerik kompleks yapılı bir proteindir. İnflamasyon sırasında henüz net olarak belirlenememiş bir mekanizma ile salıverilmekte ve nötrofil sitozolünün protein içeriğinin büyük çoğunluğunu oluşturabilmektedir. Fekal kalprotektin güncel yaklaşımda biyobelirteç olarak kullanılırken serum kalprotektin de inflamatuar süreçlerde belirteç olarak araştırılmaktadır. Bu çalışma ile meme kanseri olup neoadjuvan kemoterapi alması planlanan kadın hastalarda neoadjuvan tedaviye yanıtta serum kalprotektin düzeyinin prediktif değerinin araştırılması amaçlanmıştır. Meme kanseri için neoadjuvan tedavi alması planlanan 69 hasta ile meme kanseri açısından araştırılan fakat benign patolojileri bulunan veya patolojisi bulunmayan 20 kişilik kontrol grubu çalışmanın örneklemini oluşturmaktadır. Tüm örneklemden bu çalışma için alınan venöz kan örneği ile çalışılan serum kalprotektin değerleri ve hastaların hastalık seyri dolayısıyla değerlendirilen kan ile patoloji tetkik sonuçları çalışmanın temel verilerini oluşturmaktadır. Ki67 ekspresyonu %20'den yüksek olan hastaların düşük olanlara göre serum kalprotektin seviyeleri yüksek bulunmuştur (p=0,041). Neoadjuvan kemoterapi planlanan hastalarda yaşın artması ve progesteron reseptör ekspresyonunun pozitif olması tam yanıt alamama açısından güçlü prediktör olarak belirlenmiştir (p<0,05). Hasta ve kontrol grubu arasında serum kalprotektin düzeyi açısından anlamlı fark saptanamamış ve kesim değeri belirlenememiştir (p=0,172). Hasta grubu içerisinde yer alan tedaviye tam yanıt ve tam yanıt alınmayan hastaların serum kalprotektin düzeyleri arasında anlamlı fark saptanamamıştır (p=0,587). Fakat bu iki grup ortalama değerlerinin görece farkı daha büyük örneklemli çalışma dizaynlarıyla umut vadedici sonuçlar alınabileceğini düşündürmektedir. Anahtar kelimeler: Meme kanseri, Serum kalprotektin, İnflamasyon, Tam yanıt
  • Küçük Resim Yok
    Öğe
    Predictive Value of Serum Calprotectin Level in Response to Treatment, a New Inflammatory Marker in Patients with Breast Cancer Requesting Neoadjuvant Treatment
    (Galenos Publ House, 2023) Baydar, Ece; Celikkol, Aliye; Gurdal, Sibel Ozkan; Seber, Selcuk
    Aim: There is a close relationship between inflammation and cancer. Calprotectin is a protein released during inflammation. The aim of this study is to investigate the relationship between breast cancer and calprotectin levels in breast cancer patients receiving neoadjuvant therapy the predictive role of calprotectin in response to treatment. Materials and Methods: In our prospective study, a patient group with 69 breast cancer patients and a control group with 20 patients were formed. Calprotectin was studied from the blood tests taken from the whole sample. Patient data were obtained from the electronic record system. In our study, statistical evaluations were made using a package program called IBM Statistical Package for the Social Sciences Statistics 24. Results: Eighty-nine patients (69 cancer, 20 controls) were included in the study. The median age of breast cancer patients was 48 [minimum (min): 24-maximum (max): 73], the control group was 44.5 (min: 19-max: 68) and the ages of the two groups were similar (p=0.599). Mean calprotectin levels in breast cancer patients were 28.63 +/- 30.5, median 16.5 (min: 6.7-max: 160.7). The mean in the control group was 16.09 +/- 6.1 (min: 8.7-max: 27.4) and there was no statistical difference between the 2 groups (p=0.072). A statistically significant difference was found in terms of calprotectin values according to Ki67 classes (Z=-20.043; p=0.041). Calprotectin values of those with Ki67 class >20 were statistically significantly higher than those with <= 20. Parameters that could predict complete chemotherapy response were evaluated with logistic regression analysis. There was no correlation between calprotectin level and complete response. There was a positive correlation between age increase and complete response. Conclusion: There was no significant difference between serum calprotectin levels of the patient and control groups, but calprotectin level was found to be associated with Ki67 level. There was no relationship between calprotectin and chemotherapy response. Studies with larger sample numbers may make a significant difference.