Bunyamin Kisacik | GAZİANTEP ÜNİVERSİTESİ (original) (raw)

Papers by Bunyamin Kisacik

Research paper thumbnail of Successful treatment of primary Sjögren's syndrome complicated with primary biliary cirrhosis and lung involvement

The Turkish Journal of Gastroenterology the Official Journal of Turkish Society of Gastroenterology, Mar 1, 2010

Research paper thumbnail of Performance of the new American College of Rheumatology classification criteria in Turkish systemic sclerosis patients: a multicenter study

Clinical rheumatology, Jan 7, 2015

In our study, we compared the sensitivity and specificity of the new ACR/EULAR 2013 criteria to t... more In our study, we compared the sensitivity and specificity of the new ACR/EULAR 2013 criteria to the ACR 1980 criteria in our systemic sclerosis (SSc) population. Three rheumatology centers from Turkey participated into this study. The medical records of SSc patients diagnosed between 2008 and 2014 were retrospectively reviewed, and their features at disease onset were recorded. Patients admitted to each center within the same time period for conditions other than SSc, in whom ANA was positive and was deemed necessary within the diagnostic workup, were included as controls. One hundred and ninety-seven SSc patients (174 females, 23 males) and 103 controls (96 females, 7 males) were included. Limited cutaneous SSc was present in 68 % of patients, and 30.5 % had diffuse SSc. The sensitivity of ACR/EULAR 2013 and ACR 1980 criteria were, respectively, 94.4 and 85.3 % (p = 0.003). The specificity of ACR/EULAR 2013 and ACR 1980 criteria were, respectively, 98.1 and 100 %. According to the ...

Research paper thumbnail of Successful treatment of primary Sjögren's syndrome complicated with primary biliary cirrhosis and lung involvement

The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2010

A patient with primary Sjögren's syndrome complicated with primary biliary cirrhosis and lymp... more A patient with primary Sjögren's syndrome complicated with primary biliary cirrhosis and lymphocytic interstitial pneumonia is presented. She was 38 years old and was admitted to our hospital for generalized pruritus, xerostomia, xerophthalmia, fatigue, and reticulonodular changes on her chest X-ray. With the findings of ground-glass attenuation and centrilobular nodules in high resolution computerized tomography, the diagnosis of lymphocytic interstitial pneumonia was made. Oral methylprednisolone 1 mg/kg/day and ursodeoxycholic acid 15 mg/kg/day were started. At the 6th month follow-up, she had no complaints, and pulmonary function tests and high resolution computerized tomography were normal. This is the first case of Sjögren's syndrome, primary biliary cirrhosis and lymphocytic interstitial pneumonia in the English literature.

Research paper thumbnail of Rituximab seems a promising therapeutic option in granulomatosis with polyangiitis with intestinal perforation: a case report and literature review

Case Reports, 2013

Granulomatosis with polyangiitis (Wegener&amp... more Granulomatosis with polyangiitis (Wegener's) (GPA) is a chronic disease of unknown aetiology that leads to necrotising vasculitis in small and medium-sized vessels characterised by respiratory system and kidney involvement. Intestinal involvement is rare and perforation is even rarer in GPA. In this study, we are presenting a literature review of related cases, and a 29-year-old man referred from the emergency department with a multiple distal ileal perforation that was diagnosed with GPA, and successfully treated with rituximab.

Research paper thumbnail of Enhanced Depth Imaging Optical Coherence Tomography Findings in Behçet Disease

Ocular Immunology and Inflammation, 2013

Investigation of subfoveal choroidal thickness in Behçet disease (BD) with enhanced depth imaging... more Investigation of subfoveal choroidal thickness in Behçet disease (BD) with enhanced depth imaging optical coherence tomography (EDI-OCT). The study included 35 patients with posterior uveitis (PU) associated with BD, 35 patients with BD without ocular involvement, and 30 healthy controls. There were no significant differences between the groups in terms of age, gender, axial length, or spherical equivalent refractive error. The mean subfoveal choroidal thickness was thinner in eyes with PU than in eyes without PU and healthy controls (p = 0.026). EDI-OCT is a beneficial test for evaluating choroid morphology in BD. Thinning of the subfoveal choroidal tissue has been observed in patients with BD-associated PU.

Research paper thumbnail of The antibodies cyclic citrullinated peptides (anti-CCP) positivity could be a promising marker in brucellosis patients presented with peripheric arthritis

Modern Rheumatology, 2013

The anti-cyclic citrullinated peptide (anti-CCP) enzyme-linked immunosorbent assay has a high sen... more The anti-cyclic citrullinated peptide (anti-CCP) enzyme-linked immunosorbent assay has a high sensitivity and specificity for rheumatoid arthritis (RA). It has been used in especially early diagnosis of RA, and used to discriminate from other forms of arthritis. Anti-CCP positivity is unknown in brucellosis presented with peripheric arthritis (BPA), like other rheumatic diseases. The objective of this study was to investigate the positivity of anti-CCP in patients with BPA in contrast to the patients with RA and healthy controls. Additionally, we have aimed to monitor changes of anti-CCP levels following the brucellosis treatment. The study group consisted of 137 subjects. 62 brucellosis patients presented with peripheric arthritis. Additionally, 33 RA patients and 42 healthy subjects selected as control groups. The anti-CCP, rheumatoid factor and anti-nuclear antibody levels of the subjects were measured. Concerning the 62 BPA, 20 % (13 patients) of them had elevated anti-CCP levels. On the other side, of the 33 RA patients, 78.78 % (26 patients) of them had increased anti-CCP levels. Only one healthy subject's anti-CCP level was positive. There was statistically significant difference among the groups. After brucellosis treatment, monitorisation of the 13 patients with BPA who have the positive anti-CCP levels, were challengingly interesting because none of the patients had positive anti-CCP levels. Anti-CCP may be positive marker in the diagnosis of BPA but clinicians need to be careful during the follow up period because it may turn into normal ranges. Additionally, patients presented with peripheric arthritis and anti-CCP positivity need to be evaluated also for the differential diagnosis of BPA.

Research paper thumbnail of The role of resistin in Behçet’s disease: a Turkish experiment

Modern Rheumatology, 2012

The objective of this study was to assess the role of resistin, a proinflammatory cytokine potent... more The objective of this study was to assess the role of resistin, a proinflammatory cytokine potentially involved in Behçet's disease (BD), and to determine its relationship with tumor necrosis factor α (TNF-α), another important inflammatory cytokine known to be involved in BD. Forty-five persons diagnosed with BD were enrolled into this study, 25 of whom were being followed or had recently been diagnosed with clinically active BD, whereas the remaining 20 were previously diagnosed and had clinically inactive BD for the previous 3 months. Thirty persons were recruited as a healthy control group. Patients' C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), resistin, and TNF-α levels were determined with enzyme-linked immunosorbent assay (ELISA). Resistin and TNF-α levels were significantly higher in patients with BD (p < 0.05 and p < 0.05) than in the control group. The major interest of this study was to investigate the role of resistin in patients with BD. An elevated resistin level was associated with activation of BD. Elevated TNF-α and resistin levels could be determined simultaneously, and the presence of these two cytokines together suggests that resistin plays an important role in the pathogenesis and activation of BD.

Research paper thumbnail of Mean Platelet Volume Seems To Be a Valuable Marker in Patients with Systemic Sclerosis

Inflammation, 2014

The predictors for the development of cardiovascular diseases and peripheral arterial diseases in... more The predictors for the development of cardiovascular diseases and peripheral arterial diseases in patients with systemic sclerosis (SSc) were not clearly established, and there is no specific study conducted to investigate the mean platelet volume (MPV) levels in SSc patients. Therefore, this study evaluates the MPV levels in SSc and possible relationship between SSc, its clinical features and activity/severity scores, and MPV. In total, 76 SSc patients (67 women and 9 men, mean age 50.44 ± 13.21 years) diagnosed according to the classification criteria of the American College of Rheumatology and 45 healthy volunteers were enrolled into study. Data relating to anamnesis, physical examination, MPV, erythrocyte sedimentation rate, C-reactive protein levels, electrocardiography, echocardiography, high-resolution computerized tomography findings, complaints, and treatment processes were recorded into the database. Of the total cases, 17 had (22.3 %) cardiac involvement, 45 had gastrointestinal involvement (59.2 %), 47 had (61.8 %) lung involvement, 31 (32 %) had finger flexion deformity, and 27 (35.5 %) had digital ulcers at the fingertips. The mean MPV levels of SSc patients were significantly higher than those of the control group (p = 0.008). The mean MPV levels of SSc patients with cardiac involvement, digital ulcers, and gangrene presence were significantly high, and lower in Ilomedin-receiving patients than in the Ilomedin naives (p < 0.05). A negative relationship was discovered between the mean MPV levels, Valentini score, and Disease Severity Index of the patients with systemic sclerosis (p = 0.006, r = -0.310; p = 0.047, r = -0.229). MPV levels were significantly elevated in SSc patients and they were negatively correlated with disease activity scores. Increased MPV levels would be a predictive marker in the diagnosis of macrovascular and microvascular disease involvement in SSc patients.

Research paper thumbnail of Mediterranean fever (MEFV) gene mutation frequency is not increased in adults with rheumatic heart disease

Clinical Rheumatology, 2011

It is well established that there are people with higher risk of developing acute rheumatic fever... more It is well established that there are people with higher risk of developing acute rheumatic fever (ARF) and rheumatic heart disease (RHD). Mediterranean fever (MEFV) gene mutations might be one of the genetic predisposition factors in the development of ARF/RHD since defect in familial Mediterranean fever (FMF) patients is proposed to be heightened inflammatory response to certain stimuli. Previous clinical observations suggested a relationship between FMF and ARF/RHD. The aim of this study was to investigate the role of the MEFV gene mutations in the susceptibility to RHD in Turkish patients. A total of 100 patients with RHD and 100 healthy controls were included in the study. Diagnosis of RHD was based on echocardiographic findings in which a predominant mitral stenosis was used as an inclusion criterion. Genetic analysis was carried out by sequence analysis investigating two hot spots (exons 2 and 10) for MEFV mutations. Mutation analysis showed that 22 RHD patients (22%) and 24 healthy controls (24%) carried at least one mutated allele. MEFV mutations were identified in 22 of 200 (11%) chromosomes in RHD patients while 26 of the 200 (13%) chromosomes of healthy controls were found to carry a mutated allele. No difference was found in allele frequencies and their distribution between the patients and healthy controls (p = 0.54). MEFV mutations are not associated with a predisposition to develop RHD in adult Turkish patients.

Research paper thumbnail of Inverse relationship between neutrophil lymphocyte ratio (NLR) and bone mineral density (BMD) in elderly people

Archives of Gerontology and Geriatrics, 2013

Research paper thumbnail of Low Dose Methotrexate Associated Pancytopenia in a Patient with Rheumatoid Arthritis

Türkiye Fiziksel Tıp ve …

... Author: Nil Güler ; Berna Tander ; Bünyamin Kısacık ; Umut Utku ; Ata Çevik ; Vehbi Erçolak ;... more ... Author: Nil Güler ; Berna Tander ; Bünyamin Kısacık ; Umut Utku ; Ata Çevik ; Vehbi Erçolak ;Gülçin Ecemiş ; Özgür Ecemiş ; Rahmi Aslan ; Ferhan Cantürk. Abstract: Methotrexate (MTX) is one of the most widely used anti-rheumatoid drugs for Rheumatoid Arthritis (RA). ...

Research paper thumbnail of Demographic and clinical features of gout patients in Turkey: a multicenter study

Rheumatology International, 2013

Gout results from multifactor interactions between gender, age, genetic and environmental factors... more Gout results from multifactor interactions between gender, age, genetic and environmental factors. Environmental factors underlying gout and precipitating factors triggering acute attacks might vary in different populations with different lifestyles. In this study, we aimed to collect data regarding the demographic and clinical features, comorbid factors, and precipitating factors associated with the initiation of acute attacks in gout patients in Turkey. A total of 312 patients were included in this study (mean age, 58.8 ± 13.8 years; female/male ratio, 55/257). The demographic features, alcohol intake, clinical and laboratory features, and comorbid conditions including obesity, diabetes mellitus, hyperlipidemia, hypertension, and coronary heart disease were noted in a standard questionnaire. Precipitating factors initiating acute attacks (if any) were also noted. The patients were divided into 4 groups according to the region of location as central Anatolian region, southeast Anatolian region, Aegean region, and Trakya region. Our results were compared according to the gender and the location of the patients. The mean age at the start of the symptoms was 10 years higher in women (60.4 ± 14.8 and 50.6 ± 13.5 years in women and men, respectively, p < 0.001).Obesity was present in 40.1 %, diabetes mellitus in 17.9 %, hyperlipidemia in 30.1 %, hypertension in 53.5 %, coronary artery disease in 17 %, and nephrolithiasis in 21.8 % of patients. Precipitating factors triggering gout flares were as follows: diet (high consumption of meat or fish) in 46.5 %, alcohol consumption in 15.7 %, diuretics in 8.3 %, diet or diuretics in 5.1 %, diet or alcohol in 4.5 %, diet or alcohol or diuretics in 1.6 %, others in 4.2 %, and none in 14.1 %. The presence of diabetes and diuretic use was more common among women. Use of diuretics is a more common trigger for gout flares among women. On the other hand, various comorbid conditions, such as obesity and hypertension, and triggers for gout flares may differ between patients living in different geographic regions. In summary, we reported the first data regarding clinical and demographic characteristics of gout in Turkey. The majority of our patients could describe at least one "trigger" that initiated gout flare. Both comorbid conditions and triggers of attack might differ between men and women, and in different geographic areas. Better knowledge of the modifiable risk factors can be useful for the management strategy to optimize long-term patient outcomes in local clinics.

Research paper thumbnail of Varicocele and Epididymitis in Behçet Disease

Journal of Ultrasound in Medicine Official Journal of the American Institute of Ultrasound in Medicine, Jul 1, 2011

Research paper thumbnail of A multicenter report of biologic agents for the treatment of secondary amyloidosis in Turkish rheumatoid arthritis and ankylosing spondylitis patients

Rheumatology International, 2016

In this multicenter, retrospective study, we evaluated the efficacy and safety of biologic therap... more In this multicenter, retrospective study, we evaluated the efficacy and safety of biologic therapies, including anti-TNFs, in secondary (AA) amyloidosis patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA). In addition, the frequency of secondary amyloidosis in RA and AS patients in a single center was estimated. Fifty-one AS (39M, 12F, mean age: 46.7) and 30 RA patients (11M, 19F, mean age: 51.7) with AA amyloidosis from 16 different centers in Turkey were included. Clinical and demographical features of patients were obtained from medical charts. A composite response index (CRI) to biologic therapy-based on creatinine level, proteinuria and disease activity-was used to evaluate the efficacy of treatment. The mean annual incidence of AA amyloidosis in RA and AS patients was 0.23 and 0.42/1000 patients/year, respectively. The point prevalence in RA and AS groups was 4.59 and 7.58/1000, respectively. In RA group with AA amyloidosis, effective response was obtained in 52.2 % of patients according to CRI. RA patients with RF positivity and more initial disease activity tended to have higher response rates to therapy (p values, 0.069 and 0.056). After biologic therapy (median 17 months), two RA patients died and two developed tuberculosis. In AS group, 45.7 % of patients fulfilled the criteria of good response according to CRI. AS patients with higher CRP levels at the time of AA diagnosis and at the beginning of anti-TNF therapy had higher response rates (p values, 0.011 and 0.017). During follow-up after anti-TNF therapy (median 38 months), one patient died and tuberculosis developed in two patients. Biologic therapy seems to be effective in at least half of RA and AS patients with AA amyloidosis. Tuberculosis was the most important safety concern.

Research paper thumbnail of Impaired quality of life, disability and mental health in Takayasu Arteritis

Rheumatology, Jun 1, 2013

Objective. Patient-reported outcomes (PROs) are increasingly accepted to be among the major tools... more Objective. Patient-reported outcomes (PROs) are increasingly accepted to be among the major tools for outcome assessment in rheumatic disorders. In this study we aimed to assess quality of life (QoL), disability, anxiety and depression in patients with Takayasu's arteritis (TAK).

Research paper thumbnail of Ulnar artery aneurysm in a patient with Beh�et�s disease

Research paper thumbnail of Definition, diagnosis and treatment of axial spondyloarthritis: Recommendations of Turkish Study Group

Raed Dergisi, 2014

Amaç: Aksiyel spondiloartropati (SpA) tan›m›n›n ve teflhis kriterlerinin daha iyi anlafl›lmas› ve... more Amaç: Aksiyel spondiloartropati (SpA) tan›m›n›n ve teflhis kriterlerinin daha iyi anlafl›lmas› ve aksiyel SpA'n›n yerel olarak nas›l tedavi ve takip edilebilece¤ine iliflkin güncel konular hakk›nda uzman önerilerinde bulunmak.

Research paper thumbnail of Três casos de miosite induzida pelo anti‐TNF e revisão da literatura

Revista Brasileira de Reumatologia, 2016

Anti-tumor necrosis factor (anti-TNF) drugs are frequently preferred in the treatment of rheumato... more Anti-tumor necrosis factor (anti-TNF) drugs are frequently preferred in the treatment of rheumatologic diseases and other inflammatory diseases. The development of myositis after using anti-TNF is a rare clinical condition. Here we aimed to report cases who developed myositis after using anti-TNF and review the current literature. We report two cases of rheumatoid arthritis (RA) and a case of ankylosing spondylitis (AS) developed idiopathic inflammatory myopathy following anti-TNF therapy. In conclusion, myositis could develop during anti-TNF therapy, so these patients should be evaluated carefully initially for myositis and should be closely monitored due to the potential for developing myositis in treatment process.

Research paper thumbnail of Pneumocystis carinii pneumonia in a rheumatoid arthritis patient treated with adalimumab

Scandinavian Journal of Infectious Diseases, Feb 1, 2007

Research paper thumbnail of Assessment of the New 2012 EULAR/ACR Clinical Classification Criteria for Polymyalgia Rheumatica: A Prospective Multicenter Study

The Journal of Rheumatology, 2016

To assess the performance of the new 2012 provisional European League Against Rheumatism (EULAR)/... more To assess the performance of the new 2012 provisional European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) polymyalgia rheumatica (PMR) clinical classification criteria in discriminating PMR from other mimicking conditions compared with the previous 5 diagnostic criteria in a multicenter prospective study. Patients older than 50 years, presenting with new-onset bilateral shoulder pain with elevated acute-phase reactants (APR), were assessed for the fulfillment of the new and old classification/diagnostic criteria sets for PMR. At the end of the 1-year followup, 133 patients were diagnosed with PMR (expert opinion) and 142 with non-PMR conditions [69 rheumatoid arthritis (RA)]. Discriminating capacity, sensitivity, and specificity of the criteria sets were estimated. Discriminating capacity of the new clinical criteria for PMR from non-PMR conditions and RA as estimated by area under the curve (AUC) were good with AUC of 0.736 and 0.781, respectively. The new criteria had a sensitivity of 89.5% and a specificity of 57.7% when tested against all non-PMR cases. When tested against all RA, seropositive RA, seronegative RA, and non-RA control patients, specificity changed to 66.7%, 100%, 20.7%, and 49.3%, respectively. Except for the Bird criteria, the 4 previous criteria had lower sensitivity and higher specificity (ranging from 83%-93%) compared with the new clinical criteria in discriminating PMR from all other controls. The new 2012 EULAR/ACR clinical classification criteria for PMR is highly sensitive; however, its ability to discriminate PMR from other inflammatory/noninflammatory shoulder conditions, especially from seronegative RA, is not adequate. Imaging and other modifications such as cutoff values for APR might increase the specificity of the criteria.

Research paper thumbnail of Successful treatment of primary Sjögren's syndrome complicated with primary biliary cirrhosis and lung involvement

The Turkish Journal of Gastroenterology the Official Journal of Turkish Society of Gastroenterology, Mar 1, 2010

Research paper thumbnail of Performance of the new American College of Rheumatology classification criteria in Turkish systemic sclerosis patients: a multicenter study

Clinical rheumatology, Jan 7, 2015

In our study, we compared the sensitivity and specificity of the new ACR/EULAR 2013 criteria to t... more In our study, we compared the sensitivity and specificity of the new ACR/EULAR 2013 criteria to the ACR 1980 criteria in our systemic sclerosis (SSc) population. Three rheumatology centers from Turkey participated into this study. The medical records of SSc patients diagnosed between 2008 and 2014 were retrospectively reviewed, and their features at disease onset were recorded. Patients admitted to each center within the same time period for conditions other than SSc, in whom ANA was positive and was deemed necessary within the diagnostic workup, were included as controls. One hundred and ninety-seven SSc patients (174 females, 23 males) and 103 controls (96 females, 7 males) were included. Limited cutaneous SSc was present in 68 % of patients, and 30.5 % had diffuse SSc. The sensitivity of ACR/EULAR 2013 and ACR 1980 criteria were, respectively, 94.4 and 85.3 % (p = 0.003). The specificity of ACR/EULAR 2013 and ACR 1980 criteria were, respectively, 98.1 and 100 %. According to the ...

Research paper thumbnail of Successful treatment of primary Sjögren's syndrome complicated with primary biliary cirrhosis and lung involvement

The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2010

A patient with primary Sjögren's syndrome complicated with primary biliary cirrhosis and lymp... more A patient with primary Sjögren's syndrome complicated with primary biliary cirrhosis and lymphocytic interstitial pneumonia is presented. She was 38 years old and was admitted to our hospital for generalized pruritus, xerostomia, xerophthalmia, fatigue, and reticulonodular changes on her chest X-ray. With the findings of ground-glass attenuation and centrilobular nodules in high resolution computerized tomography, the diagnosis of lymphocytic interstitial pneumonia was made. Oral methylprednisolone 1 mg/kg/day and ursodeoxycholic acid 15 mg/kg/day were started. At the 6th month follow-up, she had no complaints, and pulmonary function tests and high resolution computerized tomography were normal. This is the first case of Sjögren's syndrome, primary biliary cirrhosis and lymphocytic interstitial pneumonia in the English literature.

Research paper thumbnail of Rituximab seems a promising therapeutic option in granulomatosis with polyangiitis with intestinal perforation: a case report and literature review

Case Reports, 2013

Granulomatosis with polyangiitis (Wegener&amp... more Granulomatosis with polyangiitis (Wegener's) (GPA) is a chronic disease of unknown aetiology that leads to necrotising vasculitis in small and medium-sized vessels characterised by respiratory system and kidney involvement. Intestinal involvement is rare and perforation is even rarer in GPA. In this study, we are presenting a literature review of related cases, and a 29-year-old man referred from the emergency department with a multiple distal ileal perforation that was diagnosed with GPA, and successfully treated with rituximab.

Research paper thumbnail of Enhanced Depth Imaging Optical Coherence Tomography Findings in Behçet Disease

Ocular Immunology and Inflammation, 2013

Investigation of subfoveal choroidal thickness in Behçet disease (BD) with enhanced depth imaging... more Investigation of subfoveal choroidal thickness in Behçet disease (BD) with enhanced depth imaging optical coherence tomography (EDI-OCT). The study included 35 patients with posterior uveitis (PU) associated with BD, 35 patients with BD without ocular involvement, and 30 healthy controls. There were no significant differences between the groups in terms of age, gender, axial length, or spherical equivalent refractive error. The mean subfoveal choroidal thickness was thinner in eyes with PU than in eyes without PU and healthy controls (p = 0.026). EDI-OCT is a beneficial test for evaluating choroid morphology in BD. Thinning of the subfoveal choroidal tissue has been observed in patients with BD-associated PU.

Research paper thumbnail of The antibodies cyclic citrullinated peptides (anti-CCP) positivity could be a promising marker in brucellosis patients presented with peripheric arthritis

Modern Rheumatology, 2013

The anti-cyclic citrullinated peptide (anti-CCP) enzyme-linked immunosorbent assay has a high sen... more The anti-cyclic citrullinated peptide (anti-CCP) enzyme-linked immunosorbent assay has a high sensitivity and specificity for rheumatoid arthritis (RA). It has been used in especially early diagnosis of RA, and used to discriminate from other forms of arthritis. Anti-CCP positivity is unknown in brucellosis presented with peripheric arthritis (BPA), like other rheumatic diseases. The objective of this study was to investigate the positivity of anti-CCP in patients with BPA in contrast to the patients with RA and healthy controls. Additionally, we have aimed to monitor changes of anti-CCP levels following the brucellosis treatment. The study group consisted of 137 subjects. 62 brucellosis patients presented with peripheric arthritis. Additionally, 33 RA patients and 42 healthy subjects selected as control groups. The anti-CCP, rheumatoid factor and anti-nuclear antibody levels of the subjects were measured. Concerning the 62 BPA, 20 % (13 patients) of them had elevated anti-CCP levels. On the other side, of the 33 RA patients, 78.78 % (26 patients) of them had increased anti-CCP levels. Only one healthy subject's anti-CCP level was positive. There was statistically significant difference among the groups. After brucellosis treatment, monitorisation of the 13 patients with BPA who have the positive anti-CCP levels, were challengingly interesting because none of the patients had positive anti-CCP levels. Anti-CCP may be positive marker in the diagnosis of BPA but clinicians need to be careful during the follow up period because it may turn into normal ranges. Additionally, patients presented with peripheric arthritis and anti-CCP positivity need to be evaluated also for the differential diagnosis of BPA.

Research paper thumbnail of The role of resistin in Behçet’s disease: a Turkish experiment

Modern Rheumatology, 2012

The objective of this study was to assess the role of resistin, a proinflammatory cytokine potent... more The objective of this study was to assess the role of resistin, a proinflammatory cytokine potentially involved in Behçet's disease (BD), and to determine its relationship with tumor necrosis factor α (TNF-α), another important inflammatory cytokine known to be involved in BD. Forty-five persons diagnosed with BD were enrolled into this study, 25 of whom were being followed or had recently been diagnosed with clinically active BD, whereas the remaining 20 were previously diagnosed and had clinically inactive BD for the previous 3 months. Thirty persons were recruited as a healthy control group. Patients' C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), resistin, and TNF-α levels were determined with enzyme-linked immunosorbent assay (ELISA). Resistin and TNF-α levels were significantly higher in patients with BD (p < 0.05 and p < 0.05) than in the control group. The major interest of this study was to investigate the role of resistin in patients with BD. An elevated resistin level was associated with activation of BD. Elevated TNF-α and resistin levels could be determined simultaneously, and the presence of these two cytokines together suggests that resistin plays an important role in the pathogenesis and activation of BD.

Research paper thumbnail of Mean Platelet Volume Seems To Be a Valuable Marker in Patients with Systemic Sclerosis

Inflammation, 2014

The predictors for the development of cardiovascular diseases and peripheral arterial diseases in... more The predictors for the development of cardiovascular diseases and peripheral arterial diseases in patients with systemic sclerosis (SSc) were not clearly established, and there is no specific study conducted to investigate the mean platelet volume (MPV) levels in SSc patients. Therefore, this study evaluates the MPV levels in SSc and possible relationship between SSc, its clinical features and activity/severity scores, and MPV. In total, 76 SSc patients (67 women and 9 men, mean age 50.44 ± 13.21 years) diagnosed according to the classification criteria of the American College of Rheumatology and 45 healthy volunteers were enrolled into study. Data relating to anamnesis, physical examination, MPV, erythrocyte sedimentation rate, C-reactive protein levels, electrocardiography, echocardiography, high-resolution computerized tomography findings, complaints, and treatment processes were recorded into the database. Of the total cases, 17 had (22.3 %) cardiac involvement, 45 had gastrointestinal involvement (59.2 %), 47 had (61.8 %) lung involvement, 31 (32 %) had finger flexion deformity, and 27 (35.5 %) had digital ulcers at the fingertips. The mean MPV levels of SSc patients were significantly higher than those of the control group (p = 0.008). The mean MPV levels of SSc patients with cardiac involvement, digital ulcers, and gangrene presence were significantly high, and lower in Ilomedin-receiving patients than in the Ilomedin naives (p < 0.05). A negative relationship was discovered between the mean MPV levels, Valentini score, and Disease Severity Index of the patients with systemic sclerosis (p = 0.006, r = -0.310; p = 0.047, r = -0.229). MPV levels were significantly elevated in SSc patients and they were negatively correlated with disease activity scores. Increased MPV levels would be a predictive marker in the diagnosis of macrovascular and microvascular disease involvement in SSc patients.

Research paper thumbnail of Mediterranean fever (MEFV) gene mutation frequency is not increased in adults with rheumatic heart disease

Clinical Rheumatology, 2011

It is well established that there are people with higher risk of developing acute rheumatic fever... more It is well established that there are people with higher risk of developing acute rheumatic fever (ARF) and rheumatic heart disease (RHD). Mediterranean fever (MEFV) gene mutations might be one of the genetic predisposition factors in the development of ARF/RHD since defect in familial Mediterranean fever (FMF) patients is proposed to be heightened inflammatory response to certain stimuli. Previous clinical observations suggested a relationship between FMF and ARF/RHD. The aim of this study was to investigate the role of the MEFV gene mutations in the susceptibility to RHD in Turkish patients. A total of 100 patients with RHD and 100 healthy controls were included in the study. Diagnosis of RHD was based on echocardiographic findings in which a predominant mitral stenosis was used as an inclusion criterion. Genetic analysis was carried out by sequence analysis investigating two hot spots (exons 2 and 10) for MEFV mutations. Mutation analysis showed that 22 RHD patients (22%) and 24 healthy controls (24%) carried at least one mutated allele. MEFV mutations were identified in 22 of 200 (11%) chromosomes in RHD patients while 26 of the 200 (13%) chromosomes of healthy controls were found to carry a mutated allele. No difference was found in allele frequencies and their distribution between the patients and healthy controls (p = 0.54). MEFV mutations are not associated with a predisposition to develop RHD in adult Turkish patients.

Research paper thumbnail of Inverse relationship between neutrophil lymphocyte ratio (NLR) and bone mineral density (BMD) in elderly people

Archives of Gerontology and Geriatrics, 2013

Research paper thumbnail of Low Dose Methotrexate Associated Pancytopenia in a Patient with Rheumatoid Arthritis

Türkiye Fiziksel Tıp ve …

... Author: Nil Güler ; Berna Tander ; Bünyamin Kısacık ; Umut Utku ; Ata Çevik ; Vehbi Erçolak ;... more ... Author: Nil Güler ; Berna Tander ; Bünyamin Kısacık ; Umut Utku ; Ata Çevik ; Vehbi Erçolak ;Gülçin Ecemiş ; Özgür Ecemiş ; Rahmi Aslan ; Ferhan Cantürk. Abstract: Methotrexate (MTX) is one of the most widely used anti-rheumatoid drugs for Rheumatoid Arthritis (RA). ...

Research paper thumbnail of Demographic and clinical features of gout patients in Turkey: a multicenter study

Rheumatology International, 2013

Gout results from multifactor interactions between gender, age, genetic and environmental factors... more Gout results from multifactor interactions between gender, age, genetic and environmental factors. Environmental factors underlying gout and precipitating factors triggering acute attacks might vary in different populations with different lifestyles. In this study, we aimed to collect data regarding the demographic and clinical features, comorbid factors, and precipitating factors associated with the initiation of acute attacks in gout patients in Turkey. A total of 312 patients were included in this study (mean age, 58.8 ± 13.8 years; female/male ratio, 55/257). The demographic features, alcohol intake, clinical and laboratory features, and comorbid conditions including obesity, diabetes mellitus, hyperlipidemia, hypertension, and coronary heart disease were noted in a standard questionnaire. Precipitating factors initiating acute attacks (if any) were also noted. The patients were divided into 4 groups according to the region of location as central Anatolian region, southeast Anatolian region, Aegean region, and Trakya region. Our results were compared according to the gender and the location of the patients. The mean age at the start of the symptoms was 10 years higher in women (60.4 ± 14.8 and 50.6 ± 13.5 years in women and men, respectively, p < 0.001).Obesity was present in 40.1 %, diabetes mellitus in 17.9 %, hyperlipidemia in 30.1 %, hypertension in 53.5 %, coronary artery disease in 17 %, and nephrolithiasis in 21.8 % of patients. Precipitating factors triggering gout flares were as follows: diet (high consumption of meat or fish) in 46.5 %, alcohol consumption in 15.7 %, diuretics in 8.3 %, diet or diuretics in 5.1 %, diet or alcohol in 4.5 %, diet or alcohol or diuretics in 1.6 %, others in 4.2 %, and none in 14.1 %. The presence of diabetes and diuretic use was more common among women. Use of diuretics is a more common trigger for gout flares among women. On the other hand, various comorbid conditions, such as obesity and hypertension, and triggers for gout flares may differ between patients living in different geographic regions. In summary, we reported the first data regarding clinical and demographic characteristics of gout in Turkey. The majority of our patients could describe at least one "trigger" that initiated gout flare. Both comorbid conditions and triggers of attack might differ between men and women, and in different geographic areas. Better knowledge of the modifiable risk factors can be useful for the management strategy to optimize long-term patient outcomes in local clinics.

Research paper thumbnail of Varicocele and Epididymitis in Behçet Disease

Journal of Ultrasound in Medicine Official Journal of the American Institute of Ultrasound in Medicine, Jul 1, 2011

Research paper thumbnail of A multicenter report of biologic agents for the treatment of secondary amyloidosis in Turkish rheumatoid arthritis and ankylosing spondylitis patients

Rheumatology International, 2016

In this multicenter, retrospective study, we evaluated the efficacy and safety of biologic therap... more In this multicenter, retrospective study, we evaluated the efficacy and safety of biologic therapies, including anti-TNFs, in secondary (AA) amyloidosis patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA). In addition, the frequency of secondary amyloidosis in RA and AS patients in a single center was estimated. Fifty-one AS (39M, 12F, mean age: 46.7) and 30 RA patients (11M, 19F, mean age: 51.7) with AA amyloidosis from 16 different centers in Turkey were included. Clinical and demographical features of patients were obtained from medical charts. A composite response index (CRI) to biologic therapy-based on creatinine level, proteinuria and disease activity-was used to evaluate the efficacy of treatment. The mean annual incidence of AA amyloidosis in RA and AS patients was 0.23 and 0.42/1000 patients/year, respectively. The point prevalence in RA and AS groups was 4.59 and 7.58/1000, respectively. In RA group with AA amyloidosis, effective response was obtained in 52.2 % of patients according to CRI. RA patients with RF positivity and more initial disease activity tended to have higher response rates to therapy (p values, 0.069 and 0.056). After biologic therapy (median 17 months), two RA patients died and two developed tuberculosis. In AS group, 45.7 % of patients fulfilled the criteria of good response according to CRI. AS patients with higher CRP levels at the time of AA diagnosis and at the beginning of anti-TNF therapy had higher response rates (p values, 0.011 and 0.017). During follow-up after anti-TNF therapy (median 38 months), one patient died and tuberculosis developed in two patients. Biologic therapy seems to be effective in at least half of RA and AS patients with AA amyloidosis. Tuberculosis was the most important safety concern.

Research paper thumbnail of Impaired quality of life, disability and mental health in Takayasu Arteritis

Rheumatology, Jun 1, 2013

Objective. Patient-reported outcomes (PROs) are increasingly accepted to be among the major tools... more Objective. Patient-reported outcomes (PROs) are increasingly accepted to be among the major tools for outcome assessment in rheumatic disorders. In this study we aimed to assess quality of life (QoL), disability, anxiety and depression in patients with Takayasu's arteritis (TAK).

Research paper thumbnail of Ulnar artery aneurysm in a patient with Beh�et�s disease

Research paper thumbnail of Definition, diagnosis and treatment of axial spondyloarthritis: Recommendations of Turkish Study Group

Raed Dergisi, 2014

Amaç: Aksiyel spondiloartropati (SpA) tan›m›n›n ve teflhis kriterlerinin daha iyi anlafl›lmas› ve... more Amaç: Aksiyel spondiloartropati (SpA) tan›m›n›n ve teflhis kriterlerinin daha iyi anlafl›lmas› ve aksiyel SpA'n›n yerel olarak nas›l tedavi ve takip edilebilece¤ine iliflkin güncel konular hakk›nda uzman önerilerinde bulunmak.

Research paper thumbnail of Três casos de miosite induzida pelo anti‐TNF e revisão da literatura

Revista Brasileira de Reumatologia, 2016

Anti-tumor necrosis factor (anti-TNF) drugs are frequently preferred in the treatment of rheumato... more Anti-tumor necrosis factor (anti-TNF) drugs are frequently preferred in the treatment of rheumatologic diseases and other inflammatory diseases. The development of myositis after using anti-TNF is a rare clinical condition. Here we aimed to report cases who developed myositis after using anti-TNF and review the current literature. We report two cases of rheumatoid arthritis (RA) and a case of ankylosing spondylitis (AS) developed idiopathic inflammatory myopathy following anti-TNF therapy. In conclusion, myositis could develop during anti-TNF therapy, so these patients should be evaluated carefully initially for myositis and should be closely monitored due to the potential for developing myositis in treatment process.

Research paper thumbnail of Pneumocystis carinii pneumonia in a rheumatoid arthritis patient treated with adalimumab

Scandinavian Journal of Infectious Diseases, Feb 1, 2007

Research paper thumbnail of Assessment of the New 2012 EULAR/ACR Clinical Classification Criteria for Polymyalgia Rheumatica: A Prospective Multicenter Study

The Journal of Rheumatology, 2016

To assess the performance of the new 2012 provisional European League Against Rheumatism (EULAR)/... more To assess the performance of the new 2012 provisional European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) polymyalgia rheumatica (PMR) clinical classification criteria in discriminating PMR from other mimicking conditions compared with the previous 5 diagnostic criteria in a multicenter prospective study. Patients older than 50 years, presenting with new-onset bilateral shoulder pain with elevated acute-phase reactants (APR), were assessed for the fulfillment of the new and old classification/diagnostic criteria sets for PMR. At the end of the 1-year followup, 133 patients were diagnosed with PMR (expert opinion) and 142 with non-PMR conditions [69 rheumatoid arthritis (RA)]. Discriminating capacity, sensitivity, and specificity of the criteria sets were estimated. Discriminating capacity of the new clinical criteria for PMR from non-PMR conditions and RA as estimated by area under the curve (AUC) were good with AUC of 0.736 and 0.781, respectively. The new criteria had a sensitivity of 89.5% and a specificity of 57.7% when tested against all non-PMR cases. When tested against all RA, seropositive RA, seronegative RA, and non-RA control patients, specificity changed to 66.7%, 100%, 20.7%, and 49.3%, respectively. Except for the Bird criteria, the 4 previous criteria had lower sensitivity and higher specificity (ranging from 83%-93%) compared with the new clinical criteria in discriminating PMR from all other controls. The new 2012 EULAR/ACR clinical classification criteria for PMR is highly sensitive; however, its ability to discriminate PMR from other inflammatory/noninflammatory shoulder conditions, especially from seronegative RA, is not adequate. Imaging and other modifications such as cutoff values for APR might increase the specificity of the criteria.