Selective IgA deficiency and ankylosing spondylitis.

A man with an ankylosing spondylitis (AS) and selective IgA deficiency is described. There have been several reports in the literature indicating coexistence of AS with selective IgA deficiency. As it is suggested in the literature, we believe that selective IgA deficiency is a poor prognostic factor in AS.

Sensitivity to Parietaria pollen in Izmir, Turkey as determined by skin prick and serum specific IgE values.

As the first study of its kind in the Aegean region of Turkey, we examined the incidence of sensitivity to Parietaria pollen in patients with allergic rhinitis and/or asthma living in the Mediterranean climate of the Aegean coast. On the Mediterranean, there are characteristic climatic conditions (mild winters, dry summers, etc.) which facilitate the growth of a typical vegetation and the production of allergenic pollen, such as that from Parietaria. These pollen types differ greatly from those of central and northern Europe. We skin tested 132 patients with a clinical history of seasonal rhinitis and/or asthma symptoms. Each patient was skin tested with extracts of grass, weed, tree and cereal pollens, and serum samples were collected for specific IgE assays for Parietaria. Sixty-nine of the 132 patients (52%) showed skin reactivity to Parietaria; seven of these (10%) had monosensitization to Parietaria. Fifty-six out of 69 patients (81%) had specific IgE in their serum to Parietaria pollen. Based on skin test reactions, we concluded that Parietaria is important in terms of clinical symptoms and that it is the most common weed pollen in the Aegean region in Turkey.

Allergy as an etiologic factor in nasal polyposis.

Allergy has been reported as an important factor in the etiology of nasal polyposis. Asthma, chronic sinusitis and aspirin hypersensitivity are frequently found together with nasal polyposis. Total IgE, RAST for specific IgE and skin prick test were used to investigate the incidence of allergy in 95 patients with nasal polyposis. In addition, histopathologic appearance of polyp tissue was examined in 21 patients after polypectomy and compared in allergic and nonallergic groups. IgG subclass levels were also measured to detect if there were any changes. Mean serum IgE level was found to be higher in the patient group and the skin prick test (SPT) was positive in 66.3% of patients. On the basis of positive SPT and serum RAST results, 45.2% of all patients with nasal polyposis were defined as allergic. Both total IgE and IgG4 were detected at increased levels in the SPT-positive group. These findings suggest that an IgE-mediated mechanism may be present in a subpopulation of patients with nasal polyposis.

Superior vena cava syndrome together with multiple venous thrombosis in Behçet's disease.

In this paper, we describe a 25-year-old white man with Behçet's disease who developed superior vena cava syndrome which was followed with the diagnosis of pseudotumour cerebri based on bilateral papilledema for 6 months. Complete superior vena cava obstruction was detected by magnetic resonance imaging (MRI). Secondary reasons for papilledema were all excluded. Treatment of prednisone, pulse cyclophosphamide and heparin was started and clinical symptoms and fundoscopic changes completely disappeared in 2 weeks. In conclusion, we think that Behcet's disease should always be remembered in the differential diagnosis of unidentified neurological signs especially in regions where the disease is relatively common.

Prevalence of atopy in young healthy population, in Izmir, Turkey.

The aim of this study was to determine the prevalence of atopy especially in young aged group in which allergic diseases are frequently seen. We carried out this study in Izmir which is located on the west coast of Turkey and has all the characteristics of mediterranean climate. However, we evaluated whether geographical characteristics such as climate, dampness, kinds of plant might be affected on prevalence of atopy. Participants were randomly selected and detailed standard questionnaire about if they or their relatives had any allergic symptoms were applied. The skin prick tests (SPT) with standardzied allergen extracts were performed and serum total IgE levels were assayed. The study group consisted of 277 individuals, aged 15-25 years. Based on the questionnaire, 123 (44.4%) participants described positive history of atopy. In 127 of 277 subjects (46%) was found at least one positive skin-test response and the most frequent allergen was house-dust mites. SPT was positive in 68 (55.2%) of 123 subjects who had atopic history and in 59 (38%) of 154 subjects who had negative history of atopy. The subjects who had atopic history showed more frequently positive SPT prevalence than the others (p < 0.01). Geometric mean of total IgE level was 105.5 kU/L in SPT positive 127 subjects and 57.7 kU/L in SPT negative 150 subjects. There was a positive relationship between total IgE level and positive SPT (p < 0.01). History of atopy was correlated with total IgE levels in males (p < 0.01) but not in females. Women more often than men reported atopic history in the absence of true atopy.

Serum eosinophil cationic protein (ECP) levels in patients with seasonal allergic rhinitis and allergic asthma.

We studied serum ECP levels in 21 seasonal allergic patients (16 patients with rhinitis; 5 with rhinitis and asthma) diagnosed by history, skin tests, and RAST. Seventeen healthy subjects were selected as a control group. None of the patients had received medications. Total IgE levels were also measured and correlated with ECP levels. Mean IgE level was found to be higher in patients than controls (p < 0.05). Patients with asthma and rhinitis had higher IgE values than those with rhinitis alone (p < 0.05). Serum ECP levels in the patient group were significantly higher than those in the control group (p < 0.05). No statistically significant difference was found between ECP levels in patients with rhinitis and rhinitis plus asthma groups, although mean ECP was higher level in the later group. Total IgE and ECP levels were correlated positively in the patients (r = 0.630, p < 0.05). We conclude that the extent of allergic inflammation in mucosal surfaces such as allergic rhinitis plus asthma, might influence serum ECP levels.