The association between serum YKL-40 levels, mean platelet volume, and c-reactive protein in patients with cellulitis.

BACKGROUND: Lower limb cellulitis is an infectious disease that has serious complications unless it is treated. OBJECTIVES: In this pilot study, we evaluated whether levels of YKL-40, an acute-phase reactant, and mean platelet volume (MPV), which occurs secondary to inflammation in cellulitis, increase compared to healthy subjects. We also aimed to investigate the association between YKL-40 and MPV in the prognosis of the patients. MATERIAL AND METHODS: A total of 55 patients with cellulitis (23 men and 32 women) and a similar age group of 46 healthy individuals (22 men and 24 women) were included in the study. Cellulitis was diagnosed according to guideline. Serum YKL-40 levels, MPV, C-reactive protein (CRP), and other biochemical values of both groups were compared. RESULTS: YKL-40 levels (52.2±34.5 ng/mL vs 34.6±18.0 ng/mL, P=0.004), MPV (7.7±1.0 fL vs 6.9±0.7 fL, P<0.001), and CRP (9.5±8.2 mg/dL vs 0.7±0.6 mg/dL, P<0.001) were significantly higher in the patients with cellulitis than the control. The mean recovery time (RT) of the patients was 22.6±6.9 days. We found that YKL-40 (odds ratio [OR] 0.1, confidence interval [Cl] 0.028-0.191, P=0.009) and MPV (OR 2.4, Cl 0.254-4.578, P=0.029) have an independent association with RT. CONCLUSION: YKL-40 and MPV values were correlated with higher CRP in the cellulitis group than in controls. According to these results, increased YKL-40 and MPV levels might be a prognostic factor for cellulitis in patients.

Syncope in a patient with spontaneous hemorrhage into a thyroid nodule.

BACKGROUND: Spontaneous hemorrhage into a thyroid nodule occurs exceedingly rare and rarely a neck hematoma can develop. We report a case of syncope due to spontaneous hemorrhage into a thyroid nodule during anticoagulant and antithrombotic therapy. CASE PRESENTATION: A 64-year-old man was transferred to the emergency department of our hospital because of syncope. His physical examination revealed a 7 x 5 cm hard and painless mass at the left neck region. The neck MRI confirmed a heterogeneous, hyperintense mass in the left lobe of thyroid compressing the trachea and left common carotid artery, internal jugular vein, and vagus nerve bundle. He did not require a surgery in the follow-up. As the hematoma underwent subtotal shrinkage, he remained well without syncope. CONCLUSION: Hemorrhage into a thyroid nodule should always be considered in patients presenting with neurally mediated syncope.