Semiha Bahceci - Academia.edu (original) (raw)

Papers by Semiha Bahceci

Turkiye Klinikleri Journal of Allergy & Asthma, 2000

Wheezing bronş duvarının titreşimi ile oluşan, genellikle ekspiryumda duyulan ıslık şeklindeki ne... more Wheezing bronş duvarının titreşimi ile oluşan, genellikle ekspiryumda duyulan ıslık şeklindeki nefes alma sesidir. Solunum yolunda kısmi daralmayı gösterir (1,2). Hava yollarındaki daralma, pekçok sebeple oluşabilir; bronkospazma, sekresyona, en

The Journal of Allergy and Clinical Immunology: In Practice, May 1, 2017

What is already known about this topic? Severe cutaneous adverse drug reactions (SCARs) are rare ... more What is already known about this topic? Severe cutaneous adverse drug reactions (SCARs) are rare in children, but potentially may cause morbidity and mortality, and therefore should be treated promptly and appropriately. What does this article add to our knowledge? Data on pediatric patients with SCARs are limited, and our study suggests that the most common causative agents are drugs, especially antibiotics in children. How does this study impact current management guidelines? A high index of suspicion should be maintained to make a rapid diagnosis and manage SCARs in children. There is no consensus yet on the topic of effective systemic and topical treatment of SCARs. Further studies are needed to establish standardized management protocols. BACKGROUND: The severe cutaneous adverse drug reactions (SCARs) are rare but could be life-threatening. These include drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis. OBJECTIVE: The purpose of this study was the evaluation of the clinical characteristics of patients with the diagnosis of SCARs. METHODS: Patients who were diagnosed with SCARs between January 2011 and May 2016 by pediatric allergy clinics in the provinces of Ankara, Trabzon, Izmir, Adana, and Bolu were included in this multicenter study. Clinical and laboratory findings, the time between suspected drug intake and development of clinical findings, treatments they have received, and length of recovery time were recorded. RESULTS: Fifty-eight patients with SCARs were included in this study. The median age of the patients was 8.2 years (interquartile range, 5.25-13 years) and 50% (n [ 29) were males. Diagnosis was Stevens-Johnson syndrome/TEN in 60.4% (n [ 35), DRESS in 27.6% (n [ 16), and acute generalized exanthematous pustulosis in 12% (n [ 7) of the patients. In 93.1% of the patients, drugs were the cause of the reactions. Antibiotics ranked first among the drugs (51.7%) and antiepileptic drugs were the second (31%) most common. A patient who was diagnosed with TEN developed lagophthalmos and a patient who was diagnosed with DRESS developed secondary diabetes mellitus. Only 1 patient with the diagnosis of TEN died. CONCLUSIONS: SCARs in children are not common but potentially serious. Early diagnosis and appropriate treatment of SCARs will reduce the incidence of morbidity and mortality.

İzmir Dr.Behçet Uz çocuk hastanesi dergisi, 2018

Astım allerji immünoloji, Apr 30, 2020

Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) is a rare, idiosyncratic, life-threaten... more Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) is a rare, idiosyncratic, life-threatening drug reaction with a variety of clinical manifestations including symptoms of fever higher than 38.5 ºC, pruritic maculopapular or erythematous eruption, hematologic abnormalities, lymphadenopathy, and multiorgan involvement. Its incidence ranges from 1 in 1000 to 1 in 10,000 drug exposures, and it has an estimated mortality rate of up to 10%. To date, many drugs have been reported to cause DRESS syndrome, but the most common ones are the anticonvulsants and sulfonamides, although the pathogenesis is not clearly understood. Deficiency or defects in the epoxide hydroxylase enzyme, which detoxifies the metabolites of aromatic anticonvulsants, an insufficiency in the detoxification of the drug leading to reactive metabolites which may trigger immunologic reactions, predispositions due to some HLA alleles, and reactivation of herpes viruses are suggested to play a role in the pathogenesis. The latent period varies from two to six weeks. Hematologic, hepatic, renal, cardiac, pulmonary, neurologic, gastrointestinal and endocrine involvement; and hemophagocytic syndrome can be seen during the clinical course of DRESS syndrome. The long term sequels of DRESS syndrome include hepatic, renal and adrenal failure; diabetes mellitus type 1 and type 2, Graves disease, autoimmune hemolytic anemia, lupus, systemic sclerosis, and autoimmune enteropathy. Diagnosis of DRESS syndrome is difficult to establish, and requires a high degree of initial clinical suspicion and ruling out of other etiologies. The most important step in the management of DRESS syndrome is early diagnosis and prompt withdrawal of the offending drug. In cases with organ involvement, systemic corticosteroid treatment is required. In serious and steroid-resistant cases, using more potent immunosuppressive agents or intravenous immunoglobulin treatments may be required.

International Archives of Allergy and Immunology

Introduction: Food protein-induced enterocolitis syndrome (FPIES) is a rare non-IgE, cell-mediate... more Introduction: Food protein-induced enterocolitis syndrome (FPIES) is a rare non-IgE, cell-mediated food allergy disorder. We aimed to report the demographic characteristics, clinical features, and management of pediatric patients with FPIES. Methods: This retrospective study included all children diagnosed with FPIES at the pediatric allergy departments of the participating twelve study centers from January 2015 to November 2020. Results: A total of 73 patients (39 males, 53.4%) with a male/female ratio of 1.1 were included in the study. The median (interquartile ranges) age at symptom onset was 6 months (0.5–168, 4–9.5). The most frequent offending foods were cow’s milk, egg’s yolk, fish, and egg’s white, identified in 38.4% (n = 28), 32.9% (n = 24), 21.9% (n = 16) and 20.5% (n = 15) of the patients, respectively. The total number of reported FPIES episodes was 290 (3.9 episodes per child). Oral food challenge (OFC) was performed in 54.8% (n = 40) of the patients, and tolerance was...

Bagcilar Medical Bulletin, 2020

Allergic reactions to bananas have rarely been reported. The clinic reports mostly moderate local... more Allergic reactions to bananas have rarely been reported. The clinic reports mostly moderate local allergic reactions (Oral Allergy syndrome) to bananas, though some reports state reactions reaching anaphylaxis. We report three cases of banana allergy. The first case, immediately after giving a teaspoon of banana to a 7-month-old baby by the mother, he was admitted to the emergency department with the complaints of vomiting, urticaria, swelling of the mouth and eyes. The second case, after some banana yogurt was eaten by a 6.5-month-old baby, she presented with a rash which developed at the 3 rd hour. In the third case, a 16-year-old male patient applied with itchy rashes on his body after eating a banana in 1-2 hours. Our cases are presented to emphasize that urticaria and anaphylaxis may occur due to banana allergy.

Allergologia et immunopathologia, Jul 1, 2023

The aim of this study is to investigate the long-term prognosis of food proteininduced allergic p... more The aim of this study is to investigate the long-term prognosis of food proteininduced allergic proctocolitis (FPIAP) patients, the risk of developing both allergic and gastrointestinal diseases, and to evaluate whether it leads to allergic march. Methods: A total of 149 children who were diagnosed with FPIAP and developed tolerance at least 5 years prior to the study and 41 children (with no history of food allergy) as a control group were enrolled. Both groups were re-evaluated for allergic diseases as well as gastrointestinal disorders. Results: The mean age of diagnosis for the FPIAP group was 4.2 ± 3.0 months, while the mean age of tolerance was 13.9 ± 7.7 months. The mean age of both FPIAP and control groups at the last visit was 101.6 ± 24.4 and 96.3 ± 24.1 months, respectively (P = 0.213). At the final evaluation of both groups, the comorbid allergic disease was significantly higher in the FPIAP group (P < 0.001). There was no significant difference between the two groups in terms of functional gastrointestinal disorders (FGIDs), eosinophilic gastrointestinal diseases, and inflammatory bowel disease (P = 0.198, 0.579, and 0.579, respectively). In the FPIAP group, the allergic disease was significantly higher at the final visit in patients with comorbid allergic disease at diagnosis (P < 0.001). In the FPIAP group, FGID was significantly higher in the group that developed allergic diseases in the future, compared to the group that did not develop allergic diseases in the future (P = 0.034). The proportion of both FGID and allergic diseases was significantly higher in subjects that developed tolerance at >18 months, compared to subjects that developed tolerance at ≤18 months (P < 0.001 and <0.001, respectively). Conclusions: Patients with FPIAP may develop allergic diseases as well as FGID in the long term.

İzmir Dr.Behçet Uz çocuk hastanesi dergisi, Mar 30, 2023

Objective: Food protein-induced enterocolitis syndrome (FPIES) is an uncommon, non-IgE (immunoglo... more Objective: Food protein-induced enterocolitis syndrome (FPIES) is an uncommon, non-IgE (immunoglobulin E)-mediated food allergy that mainly affects infants and young children. Our study aims to evaluate the etiology, clinical phenotypes, and tolerance status of our cases with FPIES. Method: The file records of the patients who were followed up with the diagnosis of FPIES in the Departments of Pediatric Allergy and Gastroenterology of our hospital, between September 2016 and June 2022 were examined, and families who could not attend follow-up visits regularly were contacted by phone. Results: Twelve (66.66%) of 18 cases with a mean age of admission of 33.0±27.5 (2-108) months were boy. The triggers of FPIES were fish in 66.66%, cow's milk in 16.66%, eggs in 5.55%, eggs and milk in 5.55%, and potato in 5.55% of the patients. While 94.44% of the cases had acute FPIES, and 44.4% of them had early-onset (<9 months) FPIES. The most common symptoms were vomiting (100%), diarrhea (38.88%), pallor (27.77%), lethargy (22.22%). Food-specific IgE sensitization was found in 5.55% of the patients, while tolerance developed in 33.33% of the cases during the follow-up. The mean age of tolerance development was 63±42 (19-112) months. Conclusion: It is important to have knowledge about the symptoms of FPIES for accurate and early diagnosis. While cow's milk is the most prevalent triggers of FPIES in the literature, fish was at the forefront in our series. Despite the limited number of cases, our results are important in terms of giving us an idea about the triggers of FPIES in the western regions of Turkey.

İzmir Dr. Behçet Uz Çocuk Hastanesi Dergisi, 2016

Allergologia et Immunopathologia

Objective: The aim of this study is to investigate the long-term prognosis of food protein--induc... more Objective: The aim of this study is to investigate the long-term prognosis of food protein--induced allergic proctocolitis (FPIAP) patients, the risk of developing both allergic and gastrointestinal diseases, and to evaluate whether it leads to allergic march. Methods: A total of 149 children who were diagnosed with FPIAP and developed tolerance at least 5 years prior to the study and 41 children (with no history of food allergy) as a control group were enrolled. Both groups were re-evaluated for allergic diseases as well as gastrointestinal disorders. Results: The mean age of diagnosis for the FPIAP group was 4.2 ± 3.0 months, while the mean age of tolerance was 13.9 ± 7.7 months. The mean age of both FPIAP and control groups at the last visit was 101.6 ± 24.4 and 96.3 ± 24.1 months, respectively (P = 0.213). At the final evaluation of both groups, the comorbid allergic disease was significantly higher in the FPIAP group (P < 0.001). There was no significant difference between t...

Allergologia et Immunopathologia, 2020

Introduction and Objectives: Asthma may have a detrimental effect on school attendance and achiev... more Introduction and Objectives: Asthma may have a detrimental effect on school attendance and achievement. Friend relations, attendance to school activities, quality of life (QOL) of asthmatic children may be negatively affected. The aim of this study was to evaluate factors influencing school functioning for asthmatic school-age children. Materials and Methods: From January to May 2019, parents and school-age children who were followed by a diagnosis of asthma for more than one year, from seven pediatric allergy centers, were given a standard questionnaire including questions about child's disease, school performance, absenteeism, home-family-school conditions. A pediatric QOL questionnaire was filled out by children. For evaluating control in the previous year, children who had more than two exacerbations and/or had any exacerbations needing systemic corticosteroids in the previous year were defined as inadequate control. School absence over nine days was taken into account as this has been shown to bring a risk for successful school life.

Introduction: Allergen-specific immunotherapy is a treatment modality aiming at ameliorating symp... more Introduction: Allergen-specific immunotherapy is a treatment modality aiming at ameliorating symptoms for an individual known to be atopic. In the achievement of the treatment, it is important that immunotherapy is applied with ideal dosage and in regular intervals and the patient compliance is essential. Aim of the study was to evaluate compliance with immunotherapy protocols of patients who were treated with subcutaneous allergen-specific immunotherapy (SCIT) in our clinic and their reasons for quitting the treatment. Material and methods: All SCIT patients who had completed immunotherapy as well as those whose program was incomplete in 1993–2007 were evaluated retrospectively. Parameters thought to have an effect on compliance such as age, sex, diagnosis of the patients, onset age of immunotherapy, number of injections, SCIT termination period and the place where immunotherapy was performed were gathered from patient files, and reasons for terminating immunotherapy were examined....

Asthma Allergy Immunology, 2020

Asian Pacific Journal of Allergy and Immunology, 2016

Background: Oral food challenges (OFCs) are performed for diagnosis of a food allergy in cases wh... more Background: Oral food challenges (OFCs) are performed for diagnosis of a food allergy in cases where the allergy is not supported by patient history, or when a newly developed tolerance level needs to be established. Objective: We aimed to investigate the prevalence and severity of reactions during OFCs in preschool children. Methods: A retrospective study was conducted on children younger than 5 years, for whom OFC had been performed with milk, egg white and egg yolk. All children had been admitted to the Department of Pediatric Allergy at Behçet Uz Children's Hospital between 1 January 2010 and 31 December 2014. Any symptoms developed during the OFC were classified and recorded. Results: A total of 122 patients who underwent an OFC were included in this study. The patients included 85 males (69.7%), and 50.8% of patients (n = 62) had a history of IgE-mediated food allergy. Co-existing allergies were found for 57.4% (n = 70) of patients. Of the OFCs performed, tests for milk, egg white and egg yolk made up 46.5, 30.5 and 23.0%, respectively. Of these, 19% (n = 33) were mild and 4.5% (n = 7) were moderate allergies in terms of symptom development. It was determined that the skin prick test (SPT) wheal size and the food-specific IgE levels did not effect in determining whether the allergic reaction would develop by OFC if the SPT wheal size and the food-specific IgE levels were below the cutoff point of a 95% positive predictive value (p > 0.05). Conclusion: The severity of egg and milk allergy symptoms resulting from the frequently used OFC in preschool children are generally mild and easy to manage, particularly if the OFC is only conducted if serum-specific IgE or SPT wheal size is below the cutoff point.

European Journal of Inflammation, 2016

Neutrophils are known to play a role in airway inflammation and are activated in inflammatory lun... more Neutrophils are known to play a role in airway inflammation and are activated in inflammatory lung diseases such as asthma. In adult studies the neutrophil/lymphocyte ratio (NLR) was found to be a possible biomarker for both airway and systemic inflammation. However, there is a limited understanding regarding NLR in the pediatric age group. To assess NLR as a biomarker for inflammation in pediatric asthma, 54 children admitted to hospital with exacerbation of asthma between March and October 2013 were enrolled into our study. Complete blood counts were obtained during both exacerbation and an asymptomatic period covering at least 3 months after exacerbation. NLRs of the study group during both exacerbation and the asymptomatic period were compared and these two datasets were then compared with the control group. The study group comprised 27 boys (50%) and 27 girls (50%) with a mean age of 120 ± 36 months. Of the total number of patients, 3.7% had mild, 94.4% had moderate, and 1.9% h...

Advances in Dermatology and Allergology, 2016

Introduction: Platelets play important roles in airway inflammation and are activated in inflamma... more Introduction: Platelets play important roles in airway inflammation and are activated in inflammatory lung diseases, including asthma. Aim: We evaluated the mean platelet volume (MPV), used as a marker of platelet activation, in asthmatic patients during asymptomatic periods and exacerbations compared to healthy controls to determine whether MPV can be used as an indicator of inflammation. Material and methods: Our patient group consisted of 95 children with exacerbation of asthma who were admitted to our allergy clinic. The control group consisted of 100 healthy children matched for age, gender, and ethnicity. Mean platelet volume values of the patient group obtained during exacerbation of asthma were compared to those of the same group during the asymptomatic period and with the control group. We investigated factors that can affect the MPV values of asthma patients, including infection, atopy, immunotherapy treatment, and severity of asthma exacerbation. Results: The patient group consisted of 50 (52.6%) boys and 45 (47.4%) girls with a mean age of 125 ±38 months old. Mean MPV values in the exacerbation period, the healthy period, and in the control group were 8.1 ±0.8 fl, 8.1 ±1.06 fl, and 8.2 ±0.9 fl, respectively; there were no significant differences between groups (p > 0.05). The severity of asthma, severity of asthma exacerbation, immunotherapy, coinfection, eosinophil count, and IgE level also had no effect on MPV (p > 0.05). Conclusions: Although platelets play a role in the pathophysiology of asthma, MPV measurement is insufficient to detect inflammation through platelets.

European Respiratory Journal, 2015

Background: It has been suggested that viral infections can trigger severe asthma attack, pneumon... more Background: It has been suggested that viral infections can trigger severe asthma attack, pneumonia and atelectasia in atopic patients with no asthma attack or asthma treatment. The children (aged between 1-6 years) who had been hospitalized owing to viral pneumonia were involved in multicentered prospective study, performed between 01.11.2013-31.12.2014. For viral pneumonia diagnosis, patients were required to have been hospitalized with no chronic disease, pneumonia must have been confirmed by a radiologist and virus identification must have been carried out by viral PCR. Skin prick test was used to research atopy. It was not investigated whether atopy presence was linked with viral pneumonia severity or not. Among these 198 patients involved in this study 37.4% were female, 62.6% were male. The average age was 34.8±13.9 months. Asthma was present in 20.4% and environmental tobacco exposure was available in 53.4%of the families of patients. RSV (29.5%), Influenza A (25.3%), Rhinovirus (16.9%), Adenovirus (11.4%), hMPV (10.2%), Parainfluenza (5.4%), Coronavirus (1.2%) were determined as viral pneumonia agents. Atopy was established in 24.2% of the patients and its distribution was as follows: mite, cat, Alternaria. The incidence of atopy in adenovirus and rhinovirus positive cases was determined significantly high (p=0.003). Severe pneumonia in group in which atopy was identified was significantly higher. In a group with severe pneumonia, atopy (p=0.001), asthma history in family (p=0.004), smoking history (p=0.016) were found significantly. It was discovered that virus type didn9t have any effect on viral pneumonia, however, atopy presence led to more severe clinical table.

Central European Journal of Immunology, 2015

Hereditary angioedema (HAE) is a very rare and potentially life-threatening genetic disease chara... more Hereditary angioedema (HAE) is a very rare and potentially life-threatening genetic disease characterised by episodes of edema in various parts of the body, including the extremities, face, and airway. The disease is usually associated with attacks of abdominal pain. On the other hand, familial Mediterranean fever (FMF) is an inherited condition characterised by recurrent episodes of painful inflammation in the abdomen, chest, or joints. In this report, we present a child with FMF and undiagnosed HAE, which made him a partial responder to colchicine treatment. Consequently, HAE must be considered in differential diagnosis of cases in which a partial response is obtained from FMF treatment, particularly in countries where FMF is frequently encountered, because early diagnosis of HAE can facilitate prevention of life-threatening complications, such as upper airway obstruction. To our knowledge, our patient is the first patient reported in the literature with the diagnosis of HAE and FMF together.

Journal of Pediatric Endocrinology and Metabolism, 2013

Primary hyperparathyroidism (PHP) and myelofibrosis are rare entities in childhood. Myelofibrosis... more Primary hyperparathyroidism (PHP) and myelofibrosis are rare entities in childhood. Myelofibrosis secondary to PHP is also extremely rare. We report a 15-year-old boy presented with generalized weakness, vomiting, and pallor. A parathyroid adenoma was detected on the left distal parathyroid gland. PHP was diagnosed together with hepatosplenomegaly and pancytopenia. Bone marrow biopsy revealed grade 3-4 reticulin fibrosis. As early as 2 months after the left distal parathyroidectomy, hematologic parameters improved without any other intervention. His liver and spleen also gradually decreased in size. We concluded that the pancytopenia was as a result of myelofibrosis from PHP.

Journal of Dr Behcet Uz Children s Hospital, 2018