Evaluation of Serum Fetuin-A and Osteoprotegerin Levels in Patients with Psoriasis.

Psoriasis patients are determined to have a high ratio of coronary artery calcification. Fetuin-A and osteoprotegerin are systemic calcification inhibitors and related to vascular calcification and cardiovascular mortality. In this study we investigated the relationship between fetuin-A and osteoprotegerin levels in psoriasis patients. The study included 40 healthy volunteers and 40 psoriasis patients. Venous blood were collected from healthy volunteers and psoriasis patients in order to search the fetuin-A and osteoprotegerin levels. Disease severity were grouped as mild, moderate and severe according to psoriasis area and severity index (PASI). The relationship between fetuin-A and osteoprotegerin levels and clinical features as sex, PASI and presence of psoriatic arthritis were analyzed. Fetuin-A levels in psoriasis patients were statistically lower than the control group (p < 0.001). In serum osteoprotegerin levels, no statistically significant difference was found in two groups (p > 0.05). Serum fetuin-A and osteoprotegerin level differences were not statistically significant between patients with psoriatic arthritis history and those without. When we grouped patients in respect of their sexes fetuin-A and osteoprotegerin levels of males and females were not significantly different (p > 0.05). No correlation was detected between the ages and PASI scores and the fetuin-A and osteoprotegerin levels of patients. As a result fetuin-A levels in psoriasis patients are found to be low but not related to disease severity. In the light of our results we concluded that fetuin-A may have a role in psoriasis pathogenesis and may contribute to the calcification process developed in psoriasis.

Autologous Serum Skin Test versus Autologous Plasma Skin Test in Patients with Chronic Spontaneous Urticaria.

Previous studies indicate that 25-45% of chronic urticaria patients have an autoimmune etiology. Autologous serum skin test (ASST) and autologous plasma skin test (APST) are simple tests for diagnosing chronic autoimmune urticaria (CAU). However, there are still some questions about the specificity of these tests. This study consisted of 50 patients with chronic spontaneous urticaria (CSU) and 50 sex- and age-matched healthy individuals aged 18 years, and older. A total of 31 (62%) patients and 5 (10%) control patients had positive ASST; 21 (42%) patients and 3 (6%) control patients had positive APST. Statistically significant differences were noted in ASST and APST positivity between the patient and control groups (ASST P < 0.001; APST P < 0.001). Thirteen (26%) patients and 5 (10%) control patients had antithyroglobulin antibodies or antithyroid peroxidase antibody positivity. No statistically significant differences were noted in thyroid autoantibodies between the patient and control groups (anti-TG P = 0.317; anti-TPO P = 0.269). We consider that the ASST and APST can both be used as in vivo tests for the assessment of autoimmunity in the etiology of CSU and that thyroid autoantibodies should be checked even when thyroid function tests reveal normal results in patients with CSU.

Is there a need for audiologic evaluation in patients with Behçet disease?

Behçet disease is known to be a multisystem condition. We conducted a study to determine the prevalence of hearing loss in patients with Behçet disease and to identify any associations between audiologic findings and other clinical manifestations and treatment. Our study group was made up of 41 adults with Behçet disease and 41 healthy sex- and age-matched controls. All patients and controls underwent a complete clinical otolaryngologic examination, which included pure-tone audiometry, acoustic impedance testing, and otoacoustic emissions testing. Audiology revealed that the prevalence of sensorineural hearing loss (SNHL) was significantly higher in the Behçet patients than in the controls-68.3 vs. 22.0% (p < 0.002). The duration of Behçet disease had no significant impact on whether patients did or did not experience hearing loss. Hearing loss was the fourth most common clinical finding in the Behçet group, after oral ulcers, genital ulcers, and skin lesions. We conclude that SNHL is present in a significant number of Behçet patients, and we suggest the need for an adequate investigation of hearing in the routine follow-up of these patients.

Purified protein derivative: the vital part of the cervical tuberculous adenitis diagnosis.

OBJECTIVE: The purpose of this study was to review the diagnostic procedures for tuberculous cervical adenitis (TCA) and state the most valuable diagnostic protocol. Patients and methods Fifty-eight patients who presented with progressive, painless, enlarging neck masses and were diagnosed with TCA between 1988 and 1998 at Beyoglu Hospital, Istanbul, were retrospectively reviewed. RESULTS: The chest roentgenograms were normal in all patients. The purified protein derivative skin testing was positive in every case. The fine needle aspiration biopsy was consistent with mycobacterial infection in 27 (46%) of 58 cases, and biopsy results correctly diagnosed TCA in all masses excised. CONCLUSION: Tuberculosis should be considered in the differential diagnosis of the neck masses. Purified protein derivative with detailed history and physical examination should be the first step in the diagnosis.