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Tuncer Karayel

Publications and source records attributed to Tuncer Karayel.

10 recordsLinked to original sources
PubMed2006

Analysis of 275 patients with sarcoidosis over a 38 year period; a single-institution experience.

BACKGROUND: Sarcoidosis is a systemic granulomatous disease with unknown etiology. OBJECTIVES: We evaluated seasonal variation, demographic, clinical and diagnostic features of sarcoidosis in recently diagnosed symptomatic patients in the whole cohort (275 patients) and in the subgroups according to the estimated disease course (subacute course group vs. chronic course group). We also developed a prediction model to predict the course of sarcoidosis using simple clinical and demographic variables. MATERIAL AND METHODS: Two hundred and seventy-five patients with sarcoidosis. MEASUREMENTS AND STATISTICS: Roger's test, chi-square, t-test and multiple logistic regression were used. RESULTS: The distribution of cumulative monthly diagnosis was the lowest in November (fall) (p<0.01). Seasonal pattern was influenced by age and gender. Constitutional symptoms, stages 2 and 3 diseases and the absence of erythema nodosum were highly significant parameters for chronic course. Using these variables, the developed model had a specificity of 93.1% and its positive predictive value was 89.5%. Progression of the disease was documented 6.4% in subacute group vs. 32.1% in chronic group (p=0.00001). Preventive effect of smoking was more pronounced in females than in males in our cohort. CONCLUSIONS: Further well-designed and large prospective studies are required to better understand the importance of these findings, and to validate the prediction model presented here.

Acute Disease↗
PubMed2006

Sarcoidosis: child vs adult.

OBJECTIVE: To compare the features of sarcoidosis in children to those of adults. In spite of the fact that sarcoidosis is a disease frequently seen in adults of 30-40 years, pediatric cases have rarely been reported. METHODS: The authors evaluated 17 (3.3%, 12 females, 5 males) of the 516 patients of sarcoidosis, aged 16 yr and diagnosed within a 36-year period. RESULTS: When the features of sarcoidosis subjects diagnosed during the childhood period were compared to those of subjects >16 years of age, it was seen that patients with advanced stage of the disease were more in the first group (41.2% vs 18%, p=0.02). In addition, children had more frequent extrapulmonary (64.7% vs 40.3%) and lacrimal gland involvement (p values, respectively, 0.044 and 0.003). CONCLUSION: When clinical data are relevant, sarcoidosis should be borne in mind. A child with sarcoidosis has more frequent pulmonary parenchymal and extrapulmonary involvement than in adults.

Adolescent↗
PubMed2006

Upper respiratory tract involvement of sarcoidosis in the Turkish population.

PRINCIPLES AND METHODS: Upper respiratory tract (URT) involvement is rare in sarcoidosis. In this descriptive study, we retrospectively evaluated the clinical and demographic features of 12 (2.19%) patients with URT involvement out of the 546 sarcoidosis patients with follow-up visits at our center within the last 40-year period. RESULTS: Out of the 546 patients, 12 (2.19%) had upper respiratory tract involvement, 5 (0.91%) had laryngeal involvement, 4 (0.73%) had sinonasal tract involvement, 2 (0.36) patients had salivary gland involvement, and 1 patient had tonsillary involvement. The number of stage 0 subjects among other sarcoidosis patients was significantly lower than that among those with URT involvement. CONCLUSIONS: URT involvement is rarely diagnosed in patients with systemic sarcoidosis. The most common site for URT involvement among the Turkish population is the larynx, followed by the sinonasal tract. EBM RATING: C-4.

Adult↗
PubMed2006

Analysis of 87 patients with Löfgren's syndrome and the pattern of seasonality of subacute sarcoidosis.

BACKGROUND AND OBJECTIVE: Sarcoidosis is a multisystem disease of unknown aetiology. The seasonality of sarcoidosis in symptomatic, recently diagnosed patients with Löfgren's syndrome was evaluated to help better understand the possible causative factor(s) in the pathogenesis of sarcoidosis. METHODS: Four hundred and ninety-two consecutive patients with sarcoidosis were investigated. The demographic and clinical features, course of the disease, initial diagnostic methods and both the month and age at initial diagnosis for each patient were analysed. Roger's test for cyclic variation was used to determine the significance of any seasonal variation of incidence. RESULTS: Löfgren's syndrome was diagnosed in 87 patients (18%). The diagnosis of sarcoidosis was delayed in 45% of subjects (mean: 11.2 weeks). The distribution of cumulative monthly presentations peaked in May (spring) and was the lowest in January (winter) and November (autumn) (P < 0.001). The seasonal pattern was also influenced by age and gender (P < 0.05). At the onset, arthralgia was present in 46%, cough or dyspnoea in 37%, constitutional symptoms in 32% and skin lesions in 30% of the patients. CONCLUSIONS: In this study, there were differences in the amplitude of the seasonal variation by age and by gender. Well-designed prospective studies are required to better understand the importance of the findings we respect to the pathogenesis of the disease.

Adult↗
PubMed2004

Bone mineral density in women with sarcoidosis.

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Almost any organs of the body, but mostly the lungs, are involved. Bone mineral density (BMD) can be affected directly or indirectly in chronic granulomatous systemic diseases such as sarcoidosis. The aim of our study was to evaluate BMD in premenopausal and postmenopausal sarcoidosis patients with or without prednisone treatment and to compare their BMD values with those of a control group having the same menopausal status. Thirty-five premenopausal women (18 untreated, 8 treated, and 9 controls) and 21 postmenopausal women (5 untreated, 5 treated, and 11 controls) were included in the study. All of the patients had a histologically proven diagnosis and were being followed-up at the Sarcoidosis Outpatient Clinic of our unit. BMD of the lumbar (L) spine and femoral neck was measured by dual-energy absorptiometry (DEXA). The subgroups of premenopausals and postmenopausals were compared separately. Comparison among the groups was performed by using analysis of variance. Age, duration of the disease, and body mass index were comparable in treated, untreated, and control subgroups of the pre- and postmenopausal groups, and the subgroups of postmenopausals had comparable durations since menopause. For premenopausals, BMD values at L1-4 were not significantly different among the subgroups (0.920 +/- 0.08 g/cm(2), 0.801 +/- 0.09 g/cm(2), and 0.910 +/- 0.05 g/cm(2), for untreated, treated, and controls, respectively). However, the BMD value at the femoral neck in treated patients (0.921 +/- 0.1 g/cm(2)) was significantly lower than the values in untreated patients (1.080 +/- 0.2 g/cm(2); P < 0.01) and in controls (1.028 +/- 0.17 g/cm(2); P < 0.05). For postmenopausals, the BMD value at L1-4 in controls (1.019 +/- 0.07 g/cm(2)) was significantly higher than the values in untreated patients (0.783 +/- 0.01 g/cm(2)) and in treated patients (0.751 +/- 0.08 g/cm(2); P < 0.001 for both). The BMD value at the femoral neck in controls (0.890 +/- 0.1 g/cm(2)) was higher than the values in untreated patients (0.745 +/- 0.08 g/cm(2)) and treated patients (0.747 +/- 0.1 g/cm(2)), but the difference was not statistically significant (P = 0.06). We concluded that sarcoidosis patients, especially postmenopausal patients with corticosteroid treatment, may have an increased risk of bone mineral loss. Large-scale studies are warranted in order to delineate the exact roles of the disease itself, menopausal status, and corticosteroid treatment in this bone mineral loss.

Adult↗
PubMed2003

Cutaneous involvement in sarcoidosis: analysis of the features in 170 patients.

In our study, we retrospectively evaluated the clinical features of patients diagnosed as sarcoidosis at our center within the last 36 years and who had skin involvement. Cutaneous involvement was observed in 170 patients (32.9%, 136 females, 34 males). The most frequent skin lesion was erythema nodosum (EN) (106 subjects, 20.5%). In addition, skin plaques and subcutaneous nodules were observed in 22 cases (4.3%), maculopapular eruptions in 19 cases (3.7%), scar lesions in 15 cases (2.9%), lupus pernio (LP) in 14 cases (2.7%) and psoriasiform plaques in five cases (0.9%). Among patients with LP (64.3%) and scar lesions (40%), pulmonary parenchymal involvement was more frequent than patients with other skin lesions. Parenchymal involvement present in 10.4% of patients with EN was significantly less than in patients with LP and scar lesions (P values, respectively, <0.001, 0.002). When patients with skin involvement were compared to other sarcoidosis patients, it was seen that the frequency of females among those with skin involvement was significantly higher than the frequency among other sarcoidosis patients (P<0.001). Parenchymal involvement in sarcoidosis patients without skin involvement was less frequent than in patients with LP; however, more frequent than in patients with EN (both P values=0.002). As a conclusion, skin involvement was diagnosed in approximately one-third of our sarcoidosis patients with a generally female predominance. EN was the most frequent skin lesion encountered. Parenchymal involvement was more frequent in patients with LP and scar lesions and less frequent in patients with EN.

Adolescent↗
PubMed2003

An increased frequency of carpal tunnel syndrome in sarcoidosis. Results of a study based on nerve conduction study.

Sarcoidosis is a systemic disease which affects the musculoskeletal system; however, its association with carpal tunnel syndrome (CTS) has been reported only rarely. In our study, we tried to determine the prevalence of CTS in our consecutive sarcoidosis patients based on their symptoms and nerve conduction study (NCS). Fifty-six patients (mean age: 45.2) who were followed up with the diagnosis of sarcoidosis at our center and who gave informed consent for NCS were included into the study. The patients were questionned for the presence of hand symptoms: paresthesia, pain, nocturnal paresthesia and/or pain, and, they underwent NCS. Ten (17.9%) patients had recurrent paresthesia, 12 (21.4%) had pain, and 8 (14.3%) had nocturnal paresthesia and/or pain. The results of NCS showed that 41% of the patients had findings compatible with CTS. Extrapulmonary involvement was significantly more frequent in these patients when compared to patients without CTS (p=0.04). Also, patients with CTS were older than the others and CTS-associated symptoms were more frequent in them although this was not significant (p>0.05). In this study, by performing NCS we detected quite a high prevalence of CTS in our sarcoidosis patients. The fact that most of the patients were asymptomatic was interesting.

Adult↗
PubMed2002

Bone marrow involvement in sarcoidosis: an analysis of 50 bone marrow samples.

The incidence of bone marrow involvement in sarcoidosis patients and changes in their peripheral blood parameters have been investigated. Out of 92 patients diagnosed with sarcoidosis at our center between 1994 and 2002, 50 (54.3%) gave consent for a bone marrow biopsy and were included into our study. The clinical features, peripheral blood parameters and bone marrow biopsy findings of the patients were analysed. Of these 50 patients, 39 were females and 11 were males (median age 37 years, range 16-62). Anemia was detected in 11 (22%) cases, and both anemia and leucopenia in 3 (6%). In 10% (5 patients; 3 males, 2 females) of the patients, bone marrow biopsy revealed noncaseatified granulomas. Sarcoidosis patients with bone marrow involvement had higher incidences of extrapulmonary involvement, leucopenia-lymphopenia and anemia than those without involvement (P values were 0.05, 0.001 and 0.06, respectively). Of the 11 patients with anemia, 3 had involvement of the bone marrow by sarcoidosis and 7 had iron deficiency anemia. As a result, bone marrow involvement should be considered in sarcoidosis patients with anemia, leucopenia-lymphopenia, and also extrapulmonary involvement.

Adolescent↗
PubMedDate not supplied

Computed tomography and bronchoscopy in endobronchial tuberculosis.

BACKGROUND: The therapeutic response to endobronchial tuberculosis is usually evaluated by bronchoscopy. Currently, there are no published studies investigating the use of computed tomography for the evaluation of therapeutic response in endobronchial tuberculosis. OBJECTIVE: A retrospective study was performed to evaluate the bronchoscopic and computed tomographic features of endobronchial tuberculosis before and after treatment. The aim of this study was to investigate the usefulness of computed tomography for the assessment of treatment. METHODS: The clinical, pathological and bronchoscopic features of endobronchial tuberculosis were evaluated in 55 patients. The age range of the patients was 21 to 52 years. Computed tomography and bronchoscopy were performed before and after treatment. RESULTS: Diagnosis of tuberculosis was confirmed by culture and histopathological examination. Bronchoscopic examination revealed 89 endobronchial lesions of various types in 55 patients. The exudative type was the most common. Follow-up bronchoscopy revealed that exudative-, ulcerative- and granular-type lesions healed completely. Computed tomography performed after treatment correlated well with the follow-up bronchoscopic findings. CONCLUSION: The results suggest that follow-up computed tomography is useful for the evaluation of therapeutic response and complications associated with endobronchial tuberculosis, and may replace bronchoscopy.

Adult↗