Diagnosing latent tuberculosis in immunocompromised patients measuring blood IP-10 production capacity: an analysis of chronic renal failure patients.

OBJECTIVE: Patients undergoing haemodialysis for chronic renal failure-hemodialysis (CRF-HD) are at risk of latent tuberculosis infection (LTBI). The effectiveness of using blood IP-10 production capacity to diagnose LTBI in CRF-HD patients was analysed. METHODS: The study enrolled 50 CRF-HD patients. Interferon-γ release assay (IGRA) was done using QuantiFERON-TB Gold In Tube (QFG-IT) system. Blood IP-10 production capacity was measured using the QFG-IT system tubes. Tuberculin skin testing (TST) was performed on the same day and the test results were compared. RESULTS: TST turned out to be positive in 36.4% of the patients and QFG-IT in 54% of them. After stimulation with specific tuberculosis antigens, blood IP-10 levels increased noticeably. The antigen-stimulated blood IP-10 level was significantly higher in patients who were either TST or QFG-IT positive than in patients whose tests were negative (p=0.0001). Using 4.02 pg/mL as the threshold for stimulated blood log-transformed IP-10 level, good agreement was observed between IP-10 and QFG-IT results (κ=1). CONCLUSION: Blood IP-10 level, which can be measured simply, provides results equivalent to IGRAs for the diagnosis of LTBI in CRF-HD patients.

Pleural angiosarcoma: a rare cause of spontaneous haemothorax.

Angiosarcoma is a rare soft tissue tumour and constitutes less than 1% of all soft tissue cancers. Pleural angiosarcomas are extremely rare and have an aggressive course. We report the case of a 79-year-old female patient who presented with complaints of increasing dyspnoea on exertion and homogeneous opacification of the left hemithorax on chest radiograph. Epithelioid angiosarcoma was determined on pleural tissue obtained by video-assisted thoracoscopic surgery (VATS).

Tumor necrosis factor gene polymorphisms in Turkish patients with sarcoidosis.

BACKGROUND: As reported recently, some gene polymorphisms are suspected to determine susceptibility to sarcoidosis and are held responsible for the extent and progression of the disease. Polymorphism at -857 locus of tumor necrosis factor (TNF)-alpha gene is considered to be a predisposition factor in sarcoidosis and held responsible for pathogenesis of the disease. We compared these polymorphisms in healthy Turkish control subjects and Turkish patients with sarcoidosis. METHODS: We examined gene polymorphisms in 90 cases which were histopathologically diagnosed as sarcoidosis and 110 healthy subjects without any history of a chronic disease. TNF-alpha-857 gene polymorphisms were determined using a polymerase chain reaction (PCR)-based method after DNA isolation. Genotype distributions of the groups were evaluated by the Hardy-Weinberg equilibrium test. RESULTS: Genotype distributions were in agreement with the Hardy-Weinberg equilibrium both in sarcoidosis patients and healthy subjects. TNF-alpha gene (C/T) polymorphism, at position -857, revealed no differences in genotype and allele frequency between patients and control subjects but more relapses and more frequently involvement of three or more organs were found in sarcoidosis patients who have this polymorphism (p<0.05, p<0.01 respectively). CONCLUSION: T allele at -857 locus of TNF gene is a marker for more extensive disease in Turkish sarcoidosis patients.

Vascular endothelial growth factor and tumor necrosis factor genes polymorphisms in Turkish patients with sarcoidosis.

Polymorphism at -857 locus of tumor necrosis factor (TNF)-alpha gene is considered to be a predisposition factor in sarcoidosis and held responsible for pathogenesis of the disease and polymorphism at +813 locus of vascular endothelial growth factor (VEGF) gene is thought to decrease predisposition to sarcoidosis. In our study, we examined and compared these polymorphisms in healthy Turkish control subjects and Turkish patients with sarcoidosis. We examined gene polymorphisms in 70 cases which were histopathologically diagnosed as sarcoidosis and 80 healthy subjects without any history of a chronic disease. 5 cc of blood were collected in tubes with EDTA from all of the cases. TNF-alpha-857 gene polymorphism and VEGF+813 gene polymorphism were determined using PCR + RFLP method after DNA isolation. TNF-alpha promoter polymorphism, at position -857, revealed no differences in genotype and allele frequency between patients and control subjects but more relapses were found in sarcoidosis patients who have this polymorphism. Considering the VEGF polymorphism at position +813, we observed a significant increase in the frequency of rarer T allele at this position in healthy subjects compared with sarcoidosis patients. VEGF gene polymorphism at +813 locus may diminish susceptibility to sarcoidosis. TNF-alpha-857 gene polymorphism influence severity of the disease.

Nutritional and prognostic significance of sick euthyroid syndrome in non-small cell lung cancer patients.

OBJECTIVES: Our study aimed to determine the frequency of sick euthyroid syndrome (SES) among patients diagnosed as non-small cell lung cancer (NSCLC) and its association with the stage of the disease, Karnofsky index (KI), and nutritional parameters. METHODS: We enrolled 80 consecutive patients with newly diagnosed NSCLC. Cases with NSCLC were staged by using the TNM system. The cases were examined for thyroid function tests, KI and nutritional evaluation before treatment. Moreover, cases were investigated for their overall survival ratio. RESULTS: Out of 80 patients, SES was identified in 28 (35%). SES was more frequent among stage III (26%) and stage IV (62%) cases. The body mass index (BMI), KI and serum albumin level were found to be significantly low in cases with SES when compared to cases without SES. SES was found to be negatively correlated with BMI, KI and serum albumin level, and it was positively correlated with disease stage and weight loss. Additionally, the presence of SES was found as a prognostic factor at survival analysis (p=0.0002). CONCLUSION: SES was frequently seen in cases with NSCLC. SES can be used as a predictor of poor prognosis in NSCLC patients.