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    Adult langerhans cell histiocytosis: Differential diagnosis
    (Turkiye Klinikleri, 2007) Çil T.; Gökalp D.; Tuzcu A.; Işikdoğan A.; Bahçeci M.
    Langerhans cell histiocytosis is a group of idiopathic disorders characterized by the abnormal proliferation of specialized bone marrow-derived Langerhans cells. There are one to two cases per million population. Most reports are based only on anecdotal experience in adult patients. Surgical excision, radiotherapy and chemotherapy, either alone or in combination are the main treatment options. In this report, we present a rare case of Langerhans cell histiocytosis in a 32 years-old-woman who developed symptomatic diabetes insipidus and multiple bone and cranial metastases during the disease course. This paper discusses controversial treatment modalities. Copyright © 2007 by Türkiye Klinikleri.
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    A case with lipoid proteinosis intersected with diabetes mellitus
    (Turkiye Klinikleri, 2009) Gökalp D.; Tuzcu A.; Bahçeci M.; Yildirim M.; Akdeniz S.; Özekinci S.; Urakçi Z.
    Lipoid proteinosis (LP) is a rare disorder inherited as an autosomal recessive trait. LP is characterized by deposition of hyaline-like material in the skin, mucous membranes, and other tissues. LP has been mapped to chromosome 1q21, the locus for the extracellular matrix protein 1 (ECM1) gene. In this case report, we aimed to present a case with LP accompanied by diabetes mellitus, and to discuss the possible mechanisms of diabetes in LP. A 16-year-old girl presented to the endocrinology department with hyperglycemia. She reported a history of progressive hoarseness of her voice since she was two years old. Our patient meets the clinical and histopathological criteria for the diagnosis of LP. Her fasting glucose was 310 mg/dl. Plasma insulin and C-peptide levels were 5.1 uU/ml and 1.57 ng/ml,respectively. Hemoglobin A1c was 12.3%. HOMA-IR (Homeostasis Model Assessment-Insulin Resistance) ratio was 3.1 (normal range <3.7). Serum islet cell antibodies, anti-GAD antibodies and anti-insulin antibodies were negative. Diabetes mellitus was diagnosed and insulin treatment was initiated. In conclusion, possible mechanism of diabetes mellitus may be result of the diffuse deposition of amorphous material into the capillary vessels or in pancreas. The other possible mechanism responsible for the association of diabetes mellitus and insulin resistance in LP patients may be sharing a mutation at 1q21 locus. Future studies which aimed screening of insulin resistance and diabetes mellitus in LP patients may be helpful to explain this association.
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    A comparative study of a gonadotropin-releasing hormone agonist and finasteride on idiopathic hirsutism
    (2000) Bayhan G.; Bahçeci M.; Demirkol T.; Ertem M.; Yalinkaya A.; Erden A.C.
    Objective: To compare the efficacy of finasteride and GnRH agonist in the treatment of idiopathic hirsutism. Methods: Sixty women with hirsutism were randomly assigned to receive either 5 mg of finasteride or long-acting GnRH agonist (depot leuprolide 3.75 mg) intramuscularly monthly for six months. Main outcome measures: Hirsutism scores were measured according to the Ferriman-Gallway scoring system, and side-effects were monitored for six months of treatment. Blood samples were taken at each visit for assessment of endocrine (FSH, LH, estradiol, progesterone, total and free testosterone, androstenedione, DHEAS-S, 17-OH-P, SHBG), biochemical, and hematologic parameters. Results: All of the patients treated with finasteride or GnRH agonist showed neither menstrual abnormalities nor side-effects. The mean percent change (±SD) in hirsutism scores in the GnRH and finasteride groups was 36%±14% and 14%±11% at six months, respectively. Serum total testosterone, free testosterone, androstenedion and DHEA-S showed a meaningful decrease in patients treated with GnRH agonist. On the other hand, only serum total testosterone and free testosterone levels decreased with finasteride treatment (p<0.05 and p<0.0001, respectively).