Presence of Autoantibodies in the Sera of Meniere's Disease

We examined the sera of patients with Meniere's disease for the presence of antibodies against 8 inner ear antigens by enzyme-linked immunosorbent assay (ELISA). One hundred eight patients with Meniere's disease and 28 control subjects were studied. The antibodies against chicken type II collagen, bovine type II collagen, the cyanogen bromide cleaved peptide 11 (CB11) of each, type IX and XI collagens, C-Raf, and tubulin were measured by ELISA. The sensitivity of each antigen was between 37% and 60% individually, and was 91% when all 8 inner ear antigens were combined. These results showed that 91% of Meniere's disease sera have antibody activities to 1 or more of these inner ear antigens. The results suggest that performing ELISA for these 8 inner ear antigens was useful as a diagnostic tool for Meniere's disease. Further study is required for elucidating the role of these antigens in the pathogenesis of Meniere's disease, which might eventually result in better therapy.

Oxidative stress status and plasma trace elements in patients with asthma or allergic rhinitis

INTRODUCTION

This study was conducted to evaluate the oxidant/antioxidant balance (oxidative stress status) and plasma essential trace element levels in patients with bronchial asthma or allergic rhinitis.

METHODS

A total of 94 individuals consisting of 19 allergic asthmatics; 17 non-allergic asthmatics; 22 patients with allergic rhinitis; and 36 healthy control people were enrolled into this study. Superoxide dismutase (CuZnSOD) and glutathione peroxidase (GSH-Px) activity as antioxidant defence mechanism parameters, along with malondialdehyde (MDA) as a marker of lipid peroxidation, were determined in erythrocytes of patient groups and controls. Plasma copper and zinc levels were also determined in all groups.

RESULTS

CuZnSOD activity was significantly lower in all groups of patients (p<0.001 for allergic asthmatics, p=0.008 for allergic rhinitis patients, and p<0.001 for non-allergic asthmatics) when compared to those of controls. Erythrocyte GSH-Px enzyme activity was not different when compared to that of the control group. Similarly, the patient groups had no difference from those of the controls with respect to erythrocyte MDA levels. While plasma Cu levels in all asthmatic patients were not different from those of the controls, allergic rhinitis patients had significantly elevated (p<0.001) Cu levels compared to those of the controls. No statistically significant difference was established between patient groups and controls with respect to plasma zinc levels.

CONCLUSION

While defective CuZnSOD activity observed in all patients groups was expected to cause an increase in lipid peroxidation indicated by high MDA levels in these patients groups, the fact that MDA levels were not different from those of controls in all patient groups indicates that other components of anti-oxidant defence system preserve their functions in these patients. On the other hand, statistically significant difference between all patients groups and controls with respect to trace elements was only observed in allergic rhinitis patients who had higher levels of Cu than those of controls.

Oxidative stress status in patients with chronic idiopathic urticaria

AIM

The controversial data related to oxidative stress status in patients with chronic idiopathic urticaria (CIU) have been reported. Therefore, the present study was aimed to contribute to this debate by determining oxidative stress markers along with some trace element levels in patients with CIU.

METHODS

Twenty-five patients with CIU (10 males, 15 females) and 36 healthy controls were enrolled into the study. Erythrocyte lipid peroxidation status, scavenger enzyme activities and trace element levels were determined.

RESULTS

While erythrocyte MDA levels, erythrocyte GSH- Px activities and erythrocyte Zn levels showed no differences between the patient and control groups, a statistically significant decrease and increase were observed in erythrocyte CuZn-SOD activities and Cu levels, respectively, in the CIU patients when compared to those of the controls (p < 0.001 for both of them).

CONCLUSION

In conclusion, an oxidative burden which can be relieved by some preserved antioxidant mechanisms seems to be present in patients with CIU even if they are clinically stable and it may probably have a role in the pathogenesis.

Severe dapsone hypersensitivity syndrome

Dapsone, a potent antiparasitic and anti-inflammatory compound, is mainly used in the treatment of leprosy and a variety of blistering skin diseases. It may cause a severe adverse drug reaction with multiorgan involvement known as dapsone hypersensitivity syndrome. We report the case of a 21-year-old female patient with dapsone hypersensitivity syndrome. The clinical presentation mimicked a viral exanthema.

Comparison of skin tests to aeroallergens in Ankara and Seoul

BACKGROUND

The environment contains many allergenic proteins, and skin test reactivity to aeroallergens may be different among people living in different regions.

OBJECTIVE

To compare skin test results of Turkish and Korean patients with respiratory allergies.

METHODS

The charts of 304 (160 male, 144 female) patients from Ankara, Turkey, and 208 (111 male, 97 female) patients' charts from Seoul, Korea, who had undergone skin prick tests were reviewed. Skin tests were classified as positive when the allergen-induced wheal size was the same size or larger than that caused by histamine.

RESULTS

Grass pollens were found to be major allergens more often in Ankara than in Seoul (74.34% vs. 15.87%, p < 0.001). Skin test reactivities in Ankara were significantly lower (p < 0.001) than in Seoul to weed (6.91% vs. 37.50%) and tree pollens (4.61% vs. 39.42%). Allergic reactions to indoor allergens were significantly higher (p < 0.001) in Seoul than in Ankara: house dust mites (HDM) (83.17% vs. 32.90%), cockroaches (45.67% vs. 1.97%), and cats (17.79% vs. 1.65%).

CONCLUSION

Due to the different aeroallergen environment, the positive skin test results were different in both cities: grass pollens were the most common allergens in Ankara, while patients from Seoul reacted more commonly to indoor allergens, especially to HDMs and cockroaches.

Nonpigmenting solitary fixed drug eruption after skin testing and intra-articular injection of triamcinolone acetonide

BACKGROUND

Although several medications have been reported to cause fixed drug eruption (FDE) reactions, triamcinolone acetonide has not been previously described as an offending agent.

OBJECTIVE

To emphasize both an unprecedented causative agent and the extraordinary development of a FDE, we describe this response in a 42-year-old female patient.

METHODS

Because her history included a questionable reaction to corticosteroid preparations, prick and intradermal testing with triamcinolone acetonide was done to determine whether she could safely receive a triamcinolone acetonide injection.

RESULTS

Both skin test procedures and the intra-articular administration of triamcinolone acetonide caused FDEs on her right retroauricular area.

CONCLUSIONS

Because any drug may induce a FDE by any administration route, physicians should be aware of this delayed skin reaction when skin testing drugs.

Influence of disease duration on visual evoked potentials in migraineurs

OBJECTIVE

To determine the possible influence of the duration of migraine on pattern-reversal visual evoked potentials.

METHODS

An investigation was conducted in 49 patients with migraine without aura according to the International Headache Society criteria. Twenty-two of these patients had had migraine for 2 years or less (group 1), and the other 27 patients had had the disease for 10 years or more (group 2). The control group consisted of 17 healthy subjects.

RESULTS

Comparison of the mean P100 latency and amplitude showed no significant difference among the groups. There was, however, a good negative correlation between age and latency (r = -0.59, P =.003) in group 1, but no such correlation was observed for group 2 or the control group.

CONCLUSIONS

It was concluded that the duration of migraine has no influence on pattern-reversal visual evoked potentials and that the pathogenesis of early- and late-onset migraine may be different.

Impact of Helicobacter pylori and Giardia lamblia infections on chronic urticaria

The etiology of chronic urticaria is largely unknown. The role of Helicobacter pylori infection, which is the most important cause of gastritis and peptic ulcer, is not clear in the pathophysiology of chronic urticaria. In this study, we aimed to define the impact of H. pylori on chronic urticaria. Thirty-eight patients who had chronic urticaria of unknown origin and dyspepsia were included in the study. In all patients, standard laboratory tests for detection of urticaria etiology were performed. Mean urticaria symptom scores of patients were carried out. All patients underwent upper gastrointestinal endoscopy. The presence of H. pylori was investigated using urease testing and histopathology. Duodenal fluid aspirated during upper endoscopy was examined for the presence of Giardia lamblia. H. pylori infection was detected in 29 patients. After successful eradication of H. pylori infection, the mean symptom score of patients did not change significantly (2.6 +/- 0.6 vs., 2.4 +/- 0.8). Only one patient had a total disappearance of urticaria symptoms. Out of 38 patients, only one had G. lamblia infection. The results of our study suggest that there is no association between H. pylori infection and chronic urticaria.

Latex allergy among operating room personnel in Turkey

This study was performed to evaluate the prevalence of latex allergy among health care workers in Turkey, as well as to compare the medical histories with the skin test results and investigate the risk factors. Using a 1/100 weight/volume commercial skin prick test (SPT), we investigated latex sensitization in 206 health care workers who regularly use latex products. One hundred atopic and 100 nonatopic patients without occupational latex exposure were also examined as control groups. Latex SPTs were positive in 10 health care workers (9.22%), whereas none of the control patients was found to have positive SPT to latex. Health care workers were divided into two groups based on the latex SPT results. There was no significant difference between the latex SPT-positive and -negative health care worker groups according to age, sex and total exposure time to latex. In the latex SPT positive group, daily exposure time and daily glove use were significantly higher (p <0.05). The symptoms related to latex products were limited to hands and itching was present in all, however, erythema was found in 68.4%, and contact urticaria in 52.6% in the latex SPT positive group. These symptoms in the latex SPT negative health care group were 21.4%, 14.4%, and 1.6%, respectively (p <0.0001). History of allergic rhinitis, bronchial asthma and conjunctivitis were also higher in the SPT-positive group (p <0.05). Additionally, we found sensitivity to house dust mites and/or grass pollens in seven cases of latex allergy. Patch tests with rubber additives were positive in five out of 42 medical care workers. Two surgeons were found to have both type-I hypersensitivity to latex and type-IV hypersensitivity to rubber additives. Our results suggest that the frequency of latex allergy is higher in the atopic health care workers with a high exposure to latex, and that SPT is a sensitive, safe, cheap and easy method of testing the diagnosis of latex hypersensitivity.

Erythropoietic protoporphyria with antinuclear antibody positivity: avoiding misdiagnosis of systemic lupus erythematosus

A young eunuchoid man was referred to our hospital with suspected erythropoietic protoporphyria. Serum antinuclear antibody (ANA) was found to be positive immediately after the porphyria attack and disappeared 30 days later. Many authors have mentioned the coexistence of systemic lupus erythematosus (SLE) and porphyria. As these two disorders have similar clinical features, the clinician must be alert and use strict diagnostic criteria in determining the presence of SLE with porphyria. In the past, elevation of ANA was reported in the cases of acute intermittent porphyria. However, there have been no reports in the cases of erythropoietic protoporphyria. In addition, the patient was found to have hypogonadotropic hypogonadism consistent with Kallmann's syndrome. To our knowledge, this report is the first case showing the coexistence of Kallmann's syndrome and erythropoietic protoporphyria. As yet, the clinical importance of this association remains unknown.

Acquired unilateral nevoid telangiectasia syndrome

We describe a man with acquired unilateral nevoid telangiectasia syndrome, in whom no underlying disease, alcohol abuse or physiological conditions causing hormonal changes are demonstrable. To our knowledge, this is the first case of acquired unilateral nevoid telangiectasia syndrome seen in a healthy adult male and not associated with a hyperestrogenaemic state and estrogen receptor abnormality. This case report casts doubt on the commonly held view that unilateral nevoid telangiectasia syndrome is an estrogen-sensitive nevoid anomaly.