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Öğe 5-Alpha Reductase Deficiency: A Review of Five Cases Diagnosed with Ambiguous Genitalia(Galenos Yayincilik, 2017) Pekkolay, Zafer; Kilinc, Faruk; Tuzcu, Sadiye Altun; Soylu, Hikmet; Tuzcu, Alpaslan Kemal5-alpha reductase is an enzyme which is responsible for the conversion of testosterone to dihydrotestosterone (DHT) in the peripheral tissues. It plays a key role in the development of male external genitalia. The present study was carried to make a clinical presentation of five male patients diagnosed with 5-alpha reductase deficiency resulting in the developmental disorder of male sexuality as well as to draw attention to the patients' medical history, physical examination and laboratory features. A test group comprising of five male subjects previously diagnosed with 5-alpha reductase deciency after being hospitalized and a series of examinations between April 2007 and July 2014, were enrolled in the study. Physical examination, hormonal profiles, radiological findings and karyotype analyses of the patients were carried out and their previous medical history was recorded. All the patients with karyotype 46 XY were raised as a female. They had external genitalia similar to each other and expressed a lower level of DHT. The patients with a disorder of male sex development, who expressed lower levels of dihydrotestosterone, must be checked for 5-alpha reductase deficiency.cÖğe Adrenal İnsidentalomalı 78 Hastanın Demografik ve Klinik Özellikleri(2015) Kılınç, Faruk; Pekkolay, Zafer; Tuna, Mazhar Müslüm; Soylu, Hikmet; Tuzcu, Alpaslan Kemal; Barutçu, SezginAdrenal insidentalomalar (AI); adrenal bezde herhangi bir hastalık kuşkusu yokken görüntüleme yöntemleri veya abdominal laparotomide tesadüfen saptanan kitlelerdir. Abdominal ultrasonografi, BT ve MR kullanımının artması ile adrenal insidentalomaların tespit edilme sıklığı da artmıştır. Bu çalışmamızda, AI nedeniyle takip edilen hastalarmızın demografik ve klinik verilerini sunmayı amaçladık. Bu çalışmaya 2007-2013 yılları arasında Dicle Üniversitesi Tıp Fakültesi Endokrinoloji Anabilim Dalı'na başvuran 78 hasta ( 53 kadın; 25 erkek) dahil edildi. Hasta dosyalarından hastalara ait fizik muayene, USG, BT sonuçları kaydedildi. Serum kortizolü, idrar metanefrini, idrar normetanefrini, idrar VMA, serum aldosteronu ve serum renin değerleri kaydedildi. Hastaların yaş ortalaması 48.6 ± 14.9 idi. Tespit edilen kitlelerin lokalizasyonu açısından anlamlı farklılık saptanmadı. Hastaların vücut kitle indeksi 28.54 ± 5.82 idi. 45 hastada (% 57.7) non-fonksiyonel adenom, 10 hastada (% 12.8) subklinik cushing, 11 hastada (% 14.1) feokromasitoma, 3 hastada (% 3.8) adrenal karsinom, 2 hastada (% 2.6) hiperaldosteronizm, 2 hastada (% 2.6) ganglionörom, 1 hastada (% 1.3) myelolipom, 1 hastada adrenal adenom, 1 hastada adrenal kist, 1 hastada schwannom ve 1 hastada da küçük yuvarlak hücreli tümör tespit edildi. Radyolojik görüntüleme sıklığı arttıkça adrenal insidentaloma olgularının sayısı da artmaktadır. Her adrenal insidentaloma, malign olup olmadığı ve hormonal işlevi olup olmadığı açısından değerlendirimelidir.Öğe Alternative treatment of resistant hypoparathyroidism by intermittent infusion of teriparatide using an insulin pump: A case report(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2019) Pekkolay, Zafer; Kilinc, Faruk; Soylu, Hikmet; Balsak, Belma; Guven, Mehmet; Tuzcu, Sadiye Altun; Kara, Ali VeyselHypoparathyroidism usually responds to oral active vitamin D and calcium, but, although rare, some patients do not respond to this treatment. A 47-year-old Caucasian female presented to our medical unit with classical oral treatment-resistant hypocalcemia after thyroidectomy. Teriparatide was infused through the insulin pump with dosage set to 1 unit which equals to 2.5 mu g of teriparatide. In conclusion, intermittent subcutaneous infusion of teriparatide using an insulin pump is a safe and effective treatment modality to ensure normocalcemic conditions in patients with classical treatment-resistant hypoparathyroidism.Öğe Biochemical characteristics and calcium and PTH levels of patients with high normal and elevated serum 25(OH)D levels in Turkey: DeVIT-TOX survey(Springer London Ltd, 2021) Pekkolay, Zafer; Yavuz, Dilek Gogas; Saygili, Emre Sedar; Degertekin, Ceyla Konca; Topaloglu, Omercan; Onder, Cagatay Emir; Soylu, HikmetA Summary Vitamin D intake over the recommended dose is usually associated with high serum 25(OH)D levels and generally not associated with symptoms of hypercalcemia. High doses of cholecalciferol need to be avoided to protect against vitamin D toxicity and related complications. Strict adherence to the clinical guidelines for treating vitamin D deficiency can ensure safe and effective treatment. Purpose We observed a tendency to use high doses of cholecalciferol for vitamin D deficiency treatment or vitamin D supplementation. We aimed to determine the biochemical characteristics of patients with high normal and elevated serum 25(OH)D levels. Methods An online invitation was sent to all tertiary endocrinology clinics in Turkey to complete an online retrospective survey (DeVIT-TOX Survey) for patients diagnosed with high serum 25(OH)D levels (> 88 ng/mL) between January 2019 and December 2019. The patients were evaluated according to the presence of signs and symptoms of hypercalcemia and doses of vitamin D intake, evaluated into the following three groups according to their 25(OH)D levels: group 1, > 150 ng/mL; group 2, 149-100 ng/mL; and group 3, 99-88 ng/mL. Results A total of 253 patients were included in the final analysis (female/male: 215/38; mean age, 51.5 +/- 15.6 years). The average serum 25(OH)D level was 119.9 +/- 33 (range, 88-455) ng/mL, and the average serum calcium level was 9.8 +/- 0.7 (range, 8.1-13.1) mg/dL. Most (n = 201; 75.4%) patients were asymptomatic despite having high serum 25(OH)D and calcium levels. The serum 25(OH)D level was significantly higher in the symptomatic groups than in the asymptomatic groups (138.6 +/- 64 ng/mL vs. 117.7 +/- 31 ng/mL, p < 0.05). The most common cause (73.5%) associated with high serum 25(OH) D levels was the inappropriate prescription of a high dose of oral vitamin D (600.000-1.500.000 IU) for treating vitamin D deficiency/insufficiency in a short time (1-3 months). The cut-off value of 25 (OH) D level in patients with hypercalcemia was found to be 89 ng/mL [median 116.5 (89-216)]. Conclusions High dose of vitamin D intake is associated with a high serum 25 OH D level, without symptoms of hypercalcemia. Inappropriate prescription of vitamin D is the primary cause for elevated 25(OH) D levels and related hypercalcemia. Hypercalcemia may not be observed in every patient at very high 25(OH) D levels. Adherence to the recommendation of guidelines is essential to ensure safe and effective treatment of vitamin D deficiency.Öğe A case of mediastinitis accompanied with hyperosmolar nonketotic coma(Kare Publ, 2016) Tuna, Mazhar Muslum; Kilinc, Faruk; Pekkolay, Zafer; Soylu, Hikmet; Tuzcu, Alpaslan KemalMediastinitis is a serious infection involving mediastinal spaces after cervical infections spread along the facial planes. A late diagnosis of mediastinitis may result in death. Here we present a diabetic patient suffered from mediastinit accompanied with hyperosmolar nonketotic coma. A 61 years old male patient with type 2 diabetes was admitted to our hospital, with complaint of generalized worsening and fever. A diagnosis of nonketotic hyperosmolar coma was done and proper treatment started immediately. Neck tomography revealed abscess formation in the upper mediastinum. The needle aspirat culture failed to show bacterial growth. After five days of antibiotic treatment the patient's symptoms resolved. The abscess formation and pleural effusion almost disappeared on control tomography. No similar case presentation was seen in the current literature. Apart from this case, mediastinit should be keep in mind when a patient suffered from dysphagia, fever and cervical swelling. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner.Öğe A case report of allgrove syndrome with neurological involvement(Society of TURAZ BİLİM, 2015) Pekkolay, Zafer; Kılınç, Faruk; Tuna, Mazhar Müslüm; Soylu, Hikmet; Ateş, Kenan; Tuzcu, Alpaslan KemalAllgrove syndrome is a very rare seen disorder with an autosomal recessive trait. The three characteristics of disease are alacrima, achalasia and adrenal failure. Alacrimia is the first manifestation in most cases. Achalasia and adrenal failure are seen later. Neurological involvement is rare and usually occurs in older age. A woman 22 years old admitted to our hospital with adrenal failure crisis. She had alacrimia and used teardrop for many years. Achalasia was diagnosed after evaluation of her dysphagia. Thus, diagnosis of Allgrove syndrome was done. Autonomic cardiac dysfunction and peripheral motor neuropathy were detected. In conclusion, Allgrove syndrome is rare and has life threatening potential due to adrenal failure. Early diagnosis and appropriate treatment may improve life quality and expectancy. Patients with relevant symptoms should be evaluated for autonomic neuropathy.Öğe A Case Report of Allgrove Syndrome with Neurological Involvement(2015) Tuzcu, Alpaslan Kemal; Soylu, Hikmet; Kılınç, Faruk; Tuna, Mazhar Müslüm; Ateş, Kenan; Pekkolay, ZaferAllgrove syndrome is a very rare seen disorder with an autosomal recessive trait. The three characteristics of disease are alacrima, achalasia and adrenal failure. Alacrimia is the first manifestation in most cases. Achalasia and adrenal failure are seen later. Neurological involvement is rare and usually occurs in older age. A woman 22 years old admitted to our hospital with adrenal failure crisis. She had alacrimia and used teardrop for many years. Achalasia was diagnosed after evaluation of her dysphagia. Thus, diagnosis of Allgrove syndrome was done. Autonomic cardiac dysfunction and peripheral motor neuropathy were detected. In conclusion, Allgrove syndrome is rare and has life threatening potential due to adrenal failure. Early diagnosis and appropriate treatment may improve life quality and expectancy. Patients with relevant symptoms should be evaluated for autonomic neuropathyÖğe Evaluation of the effect of red cell distribution width on the development of acute renal failure in patients with sepsis(Dicle Üniversitesi Tıp Fakültesi, 2017) Kara, Ali Veysel; Tanrikulu, Sema; Aydın, Emre; Aydın, Fatma; Soylu, Hikmet; Yıldırım, Yaşar; Yılmaz, Zülfükar; Kadiroğlu, Ali Kemal; Yılmaz, Mehmet EminObjective: Acute kidney injury (AKI) is an important clinical entity that is known to increase mortality in patients with sepsis. Erythrocyte maturation and proliferation are inhibited by pro-inflammatory cytokines; these cytokines exert effects on red cell distribution width (RDW) well. Based on this knowledge; our aim in this study was to evaluate the impact of RDW on acute kidney injury in patients with sepsis. Methods: 120 patients diagnosed with sepsis and admitted to intesive care unit (ICU) and treated between 2009-2013 were retrospectively evaluated. Patients were divided into two groups as follows: group 1 (RDW≥16.8) and group 2 (RDW<16.8). Multiple logistic regression analysis was used to determine the association between RDW and AKI and mortality. Results: There was a statistically significant relationship between AKI and RDW (p<0.001, OR=11.52) but there were no statistically significant relationship between AKI and sex, age, serum lactate levels as well as SOFA score. Also, there were statistically significant relationship between mortality and RDW (p=0.044, OR=5), serum lactate levels (p=0.030) and SOFA score (p<0.001). RDW was found associated with both AKI and mortality. Conclusions: Results suggest that RDW is an important parameter for predicting development of AKI and mortality in ICU patients with sepsis.Öğe The experience from ten insulinoma cases(Türkiye Klinikleri, 2017) Pekkolay, Zafer; Kılıç, Faruk; Tuna, Mazhar; Soylu, HikmetIntroduction: Insulinoma is a rare, pancreatic functional neuroendocrine tumor, characterized by endogenous hyperinsulinemia, fasting hypoglycemia, and neuroglycopenic symptoms. It is diagnosed by a 72-h-fasting test, followed by localization studies. The common treatment option is the surgical excision. We hereby aim to discuss our clinical experience related to the patients of insulinoma. Material and Method: A retrospective analysis was done on the history of the patients, who were hospitalized to our clinic due to hypoglycemia and biochemically detected insulinoma (glucose [removed] 3 μU/mL and C-peptide >0.6 ng/mL), between June 2007 and May 2015. Findings: The average age of the patients was 52,6 and ranged from 18 to 85 years. Five patients were men and five were women. All of the patients presented with fasting hypoglycemia. In one patient, the tumor was detected by DOTATATE scintigraphy. Seven patients underwent surgery and were cured. One patient demonstrated metastasis. The tumor could not be localized by ultrasound, CT, and MRI in two patients, and therefore, they were subjected to surgery after localizing the tumor by advanced imaging methods. Discussion: In patients with fasting hypoglycemia and neuroglycopenia, along with Whipple’s triad, insulinoma should mainly be considered and a 72-h-fasting test should be conducted for diagnosis. The localization studies should be performed if the results are < 55 mg/dL for blood glucose, >3 μU/mL for insulin and > 0.6 ng/mL for C-peptide in blood sampled during the appearance of symptoms. We found that the triphasic thin slice CT, with multi-detector, was very useful for tumor localization in the test patients.Öğe Gestational Severe, Nonfamilial Hypertriglyceridemia, Management with Insulin and Metformin, A Case Report(Omics Int Pvt Ltd, 2014) Tuna, Mazhar Mslm; Kilinc, Faruk; Pekkolay, Zafer; Soylu, Hikmet; Tuzcu, Alpaslan KemalSevere hypertriglyceridemia is a rare condition in pregnancy. We report a case of gestational, nonfamilial severe hypertriglyceridemia accompanied with gestational diabetes mellitus. Despite an intensive insulin regimen and dietary fat restriction plasma triglyceride levels were remained higher. After a plasmapheresis session, triglyceride levels were reduced nearly 40%. Since plasma glucose and triglyceride levels were higher, metformin therapy was administered. After two weeks of metformin therapy, plasma glucose levels were within target range and triglyceride level was reduced below 1000 mg/dl. She delivered at 38th week of pregnancy via elective cesarean section, a healthy female baby with normal birth weight. Serum triglyceride level decreased immediately to 280 mg/dl after delivery.Öğe Greft sağkalımını etkileyen faktörlerin transplant böbrek biyopsileriyle değerlendirilmesi(Dicle Üniversitesi Tıp Fakültesi, 2018) Saygılı, Emre Serdar; Seyahi, Nurhan; Durak, Haydar; Soylu, Hikmet; Cengiz, Mahir; Altıparmak, Mehmet RızaAmaç: Uzun dönemdeki surviye ve allograft fonksiyonuna etkili olan faktörler her merkezde farklılıklar gösterebilmektedir. Bu nedenle ünitemizden takipli renal allograft biyopsi yapılmış olan hastaların biyopsi sonuçları ve greft sağ kalımları arasındaki ilişkilerin değerlendirilmesi amaçlanmıştır. Yöntemler: 70 hastaya yapılan 94 adet biyopsi retrospektif olarak incelemiştir. Ultrason rehberliğinde tek kullanımlık 16G otomatik iğne ile 2 kore biyopsi alınmıştır. Her biyopsi ışık mikroskopisi ve immunfloresan boyama ile incelenmiştir. Hastalar akut selüler rejeksiyon (ASR), kalsinörin inhibitörü(KNI) toksisitesi, intersitisyel fibrozis tübüler atrofi (IFTA), akut tubüler hasar(ATH) ve greft kaybı gelişenler olarak gruplara ayrılarak alt analizleri yapılmıştır. Bulgular: Toplamda 34(%36,2) biyopsi ile en sık tespit edilen patolojiyi akut selüler rejeksiyon oluşturmaktadır. IFTA, ATH, nüks/de novo glomerülonefrit biyopsi sayıları sırasıyla 21(%22,3), 20(%21,3), 15(%16) olarak bulunmuştur. Akut rejeksiyon öyküsü olanlarda greft sürvisinin daha kısa olduğu tespit edilmiştir (p<0.05). Greft kaybı olan grupta IFTA daha fazla görülmüştür. (p<0.05). Surviler logrank testi ile IFTA ya göre kıyaslandığında istatistiksel anlamlılığını yitirmiştir. Çalışmaya alınan hastalarda KNI toksisitesi, ATH ile greft sürvileri arasında anlamlı fark tespit edilememiştir. Biyopsi sırasındaki albümin seviyesi greft kaybı olan grupta anlamlı olarak daha düşük bulunmuştur (p<0.05). Sonuç: Biyopsilerin yaklaşık üçte birinde öntanıdan farklı bir tanı ile karşılaşılmıştır. Bu da biyopsi olmadan diğer klinik ve laboratuvar bulguların yetersizliğini göstermektedir. Greft survisini ön görmede biyopsi önemli yer teşkil etmektedir. Non-invaziv olarak biyopsi öncesi bakılan serum albumin seviyesi greft kaybını öngörmede bir parametre olarak değerlendirilebilir.Öğe İnfertil bir erkekte 46 XX testiküler bozukluk(Kırıkkale Üniversitesi, 2017) Pekkolay, Zafer; Kılınç, Faruk; Tuna, Mazhar Müslüm; Soylu, Hikmet; Tuzcu, Alpaslan Kemal46 XX erkek cinsel gelişim bozukluğu çok nadir görülen bir hastalıktır. Y kromozomuna yerleşmiş olan SRY (sexdetermining region Y) geni cinsiyet belirleyen gendir. Bu gen bölgesini içeren Y kromozomunun bir parçasının X kromozomuna transloke olmasıyla hastalığın geliştiği düşünülmektedir. Otuz beş yaşında erkek hasta infertilite, cinsel istekte azalma şikayetleriyle polikliniğimize başvurdu. Fizik muayenesinde yüzde kırışıklıklar, kıllanma azlığı, kısa boy, küçük testisler mevcuttu. Hastada hipergonadotropik hipogonadizm ve azospermi saptandı. Hastanın karyotip analizi 46 XX olarak rapor edildi. SRY gen analizi pozitif bulundu. Bu hastalarda spermatogenez olmadığından testis biyopsisi ile sperm elde edilemez. Hastalığın başlıca tedavisi testosteron yerine koyma tedavisidir. İnfertilite ile başvuran primer hipogonadizmli hastaların ayırıcı tanısında bu nadir hastalık dikkate alınmalıdır.Öğe Nonfonksiyonel adrenal insidentaloma insülin direnci ile ilişkili olabilir(Modestum Publishing Ltd., 2014) Barutçu, Sezgin; Tuna, Mazhar Müslüm; Kılınç, Faruk; Pekkolay, Zafer; Soylu, Hikmet; Tuzcu, Alpaslan KemalAmaç: Adrenal insidentalomalar; adrenal bezle ilişkili herhangi bir hastalık kuşkusu yokken görüntüleme yöntemleri veya abdominal laparotomide tesadüfen saptanan kitlelerdir. Abdominal görüntüleme yöntemlerinin kullanımının artması ile adrenal insidentalomaların tespit edilme sıklığı da artmıştır. Bu çalışmada nonfonksiyonel adrenal insidentalomalı (NFAI) hastaların demografik özellikleri ve insülin direncini araştırmayı amaçladık.Yöntemler: Çalışmaya 2007-2013 yılları arasında Dicle Üniversitesi Tıp Fakültesi Endokrinoloji Anabilim Dalı'nda NFAI nedeniyle takip edilen 30 hasta (20 kadın, 10 erkek) ve 66 sağlıklı birey (44 kadın, 22 erkek) dahil edildi. Hasta dosyalarından hastalara ait fizik muayene, ultrason, bilgisayarlı tomografi sonuçları kaydedildi. Tüm hastalara 1 mg deksametazon testi, idrar metanefrin ve normetanefrin, serum aldosteron ve renin düzeyi bakılmıştı. Açlık kan şekeri (AKŞ) ve insülin değerleri mevcut olan hastaların homeostatic model assessment- insulin resistance (HOMA-IR) formülüne göre insülin direnci hesaplandı, yaş ve beden kitle indeksi (BKİ) farklı olmayan kontrol grubundaki sağlıklı bireylerle karşılaştırıldı.Bulgular: Hastaların yaş ortalaması 45,9±10,9, BKİ 28,5±5,8 kg/m2 idi. Gruplar arasında yaş, cinsiyet ve BKİ açısından fark yoktu. AKŞ ve HOMA IR, NFAI grubunda kontrol grubuna göre anlamlı olarak yüksekti (sırasıyla, p= 0,022 ve p=0,005). LDL, HDL kolesterol ve trigliserid düzeyleri bakımında gruplar arasında farklılık gözlenmedi (p>0,05). Sonuç: Nonfonksiyonel adrenal insidentalomalı hastalar insulin direnci ve metabolik parametreler açısından riskli olduklarından bu açıdan değerlendirilmelidir.Öğe Preoperative intravenous ibandronate for treating severe hypercalcemia associated with primary hyperparathyroidism: an effective and low cost(Mattioli 1885, 2018) Pekkolay, Zafer; Kilinc, Faruk; Soylu, Hikmet; Balsak, Belma; Guven, Mehmet; Tuzcu, Sadiye Altun; Tuzcu, Alpaslan KemalPrimary hyperparathyroidism (PHPT) is a prevalent mineral metabolism disorder usually caused by a single parathyroid adenoma. Although PHPT is the most frequent cause of hypercalcemia, severe hypercalcemia cases are rarely encountered. Severe hypercalcemia results in fatal complications unless immediately treated; moreover, it causes delays in surgery for PHPT, the primary treatment. Some patients admitted because of hypercalcemia require intravenous bisphosphonate treatment. Aimed to investigate the efficacy of intravenous ibandronate, which is a relatively cheap drug than other intravenous bisphosphonates, in the preoperative treatment of symptomatic hypercalcemia in patients with PHPT. Also, there are some difference in the total cost of treatment for patients treated with ibandronate and zolendronate. The medical records of patients operated at Dicle University Department of General Surgery between 2010 and 2017 due to PHPT were retrospectively evaluated. Patients who were admitted because of hypercalcemia associated with parathyroid adenoma and underwent minimally invasive surgery subsequent to the lowering of calcium levels via preoperative intravenous ibandronate and zolendronate were included. Totally, 20 of 167 patients received a preoperative bisphosphonate due to hypercalcemia associated with PHPT. Seven patients treated with zoledronate only. Thirteen were treated with ibandronate only. There was no difference in hypercalcemia correction between the groups. Percentage of patients with hypocalcemia was less in the ibandronate group. The hypocalcaemic period was shorter in patients receiving ibandronate. Cost of hospital stay in patients receiving ibandronate is cheaper than zolendronate (780 +/- 462 USD versus 1765 +/- 1537 USD). Ibandronate use reduces the cost of hypercalcemia treatment by 55% in comparison with zolendronic acid. Intravenous ibandronate for treating severe hypercalcemia associated with PHPT is an effective and relatively cheap drug.Öğe Psödohipoparatiroidi Tip 1A: Olgu sunumu(Dicle Üniversitesi Tıp Fakültesi, 2017) Güven, Mehmet; Pekkolay, Zafer; Soylu, Hikmet; Balsak, Belma Özlem Tural; Tuzcu, Alpaslan KemalPsödohipoparatiroidizm (PHPT); hedef organın parathormona (PTH) yanıt vermediği kalıtımsal bir bozukluktur. Biyokimyasal olarak; hipokalsemi, hiperfosfatemi ve PTH yüksekliği ile karakterizedir. PTH uygulamasına verilen yanıt belirgin derecede düşüktür. Tip 1A, biyokimyasal özelliklere ek olarak Albright herediter osteodistrofisi (AHO) olarak bilinen karakteristik somatik bir fenotipe de sahiptir. Bu fenotipin, kısa boy, yuvarlak yüz, frontal bombelik, brakidaktili, obezite özelikleri bulunmaktadır. Burada biz, hipokalsemi ve Albright herediter osteodistrofisi tanısı koyduğumuz; kalsiyum, aktif D vitamini ile tedavi ettiğimiz olgumuzu sunduk.Öğe A rare cause of acromegaly: McCune-Albright syndrome(Dicle Üniversitesi Tıp Fakültesi, 2015) Bodakçi, Erdal; Tuna, Mazhar Müslüm; Kılınç, Faruk; Pekkolay, Zafer; Soylu, Hikmet; Tuzcu, Şadiye Altun; Tuzcu, Alpaslan KemalMcCune-Albright syndrome is characterized by polyostatic fibrous dysplasia, brown spots on the skin (café au lait pigmentation) and autonomous endocrine hyperfunction. Early puberty and other endocrinological manifestations, such as acromegaly, gigantism and hypercortisolism are widely observed in the syndrome. Acromegaly is seen in 20% of patients. We report a case of acromegaly accompanied with this syndromeÖğe TİROTOKSİKOZUN NADİR BİR NEDENİ: MOL HİDATİFORM(2017) Soylu, Hikmet; Tuzcu, Alpaslan Kemal; Pekkolay, Zafer; Fındık, Fatih Mehmet; Balsak, Belma Özlem Tural1Dicle Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Endokrinoloji Bilim Dalı, DİYARBAKIR 2 Dicle Üniversitesi Tıp Fakültesi, Kadın Doğum Hastalıkları Anabilim Dalı, DİYARBAKIR
