Exposure to high levels of endogenous or exogenous glucocorticoids suppresses the infl ammatory response genes. Excessive endogenous hypercortisolism may mask the active inflammatory diseases. Rebound immune modulation may occur after Cushing's syndrome (CS) remission, leading to the new onset of autoimmune diseases. Here, we report a 27-year-old female patient who was recently diagnosed with sarcoidosis after remission of CS. Normal thorax imaging showed that the patient was free of disease during the course of CS and without any symptoms of sarcoidosis. After complete remission of CS, she was diagnosed with sarcoidosis based on clinical and radiological evidence. Excessive hypercortisolism may suppress the active inflammatory stage of sarcoidosis. However, the disease became apparent after the reduction of cortisol levels following the treatment of CS.
Objective: Subclinical chronic inflammation plays an important role in the pathogenesis of type 2 diabetes mellitus (DM) and inflammation-related hemogram parameters have been proposed as an indicator of inflammation. In our study, we aimed to compare the hemogram parameters of normal oral glucose tolerance test (OGTT), prediabetes (preDM) and newly diagnosed type 2 DM patients. Methods: Medical data of the patients who underwent 75 gr OGTT in the endocrinology outpatient clinic of our institution between february 2019 and december 2019 were obtained from the database and analyzed retrospectively. The test results were divided into 3 groups as normal OGTT, preDM and DM. Anthropometric measurements of patients, HbA1c and hemogram parameters were recorded. Results: A total of 496 cases (246 normal OGTT, 105 patients with preDM and 145 patients with DM) were included in the study. Fasting plasma glucose (FPG) and HbA1c levels of men were higher than women (p<0.05). There was no significant difference between the three groups in terms of inflammation-related hemogram parameters. But, there was a positive correlation between FPG and MPV to platelet ratio (MPR) in diabetic patients (r=0.173; p=0.037).
Conclusion:Hemogram parameters associated with inflammation are easily calculated and cheap indices. However, they are not strong markers in new diagnosis, HbA1c ≤6.5% diabetic patients and prediabetic patients.
Aim: Primary hyperparathyroidism is the most common cause of hypercalcemia. Primary hyperparathyroidism shows a marked increase in postmenopausal women.In this study, we aimed to evaluate the estrogen receptors alpha (ERα) expression in parathyroid adenomas and the association of preoperative serum calcium and parathyroid hormone (PTH) levels with adenoma weight of patients diagnosed with primary hyperparathyroidism. Material and Methods: Total of 50 patients were included in the study, after excluding the patients diagnosed with tertiary hyperparathyroidism, double adenoma, parathyroid hyperplasia and parathyroid carcinoma. The diagnosis of parathyroid adenoma was confirmed by pathologist. After validation of parathyroid adenoma, ERα expression was evaluated with immunohistochemical method. Pathological features of the parathyroid adenomas were recorded. Results: The patients included in the study are mostly women and are in the postmenopausal period. Parathyroid adenoma hasn't shown ERα expression in immunohistochemical staining. Male patients had higher mean pre-operative calcium and vitamin D levels than women (p=0.026, p=0.009 respectively). There was no correlation between menopause and pre-postoperative calcium, vitamin D and PTH. Correlation was found between adenoma diameter and adenoma weight with pre-operative serum calcium and PTH levels. Conclusion: In our study, statistically significant positive correlation was detected between the diameter of parathyroid adenoma and preoperative serum calcium together with PTH levels. This finding suggests the preoperative clinical features of the patients may be useful in predicting the adenoma diameter. However, it is important to determine the cutoff values of serum calcium and PTH level which might have a significant association with the adenoma diameter.
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