Mehmet D. Demirag

Osteomalacic Myopathy Associated with Coexisting Coeliac Disease and Primary Biliary Cirrhosis

Objective: To report a patient with coeliac disease (CD) associated with primary biliary cirrhosis (PBC) who presented with myopathy without classical symptoms of CD. Clinical Presentation and Intervention: A 42-year-old woman presented with inability to walk and marked loss of motor function. She had elevated liver enzymes with a cholestatic pattern. Antimitochondrial antibody M2 band, anti-endomysial antibody, antigliadin IgA and IgM were positive. Histopathologic findings of the liver revealed PBC and duodenal biopsy was consistent with CD. She was also found to have osteomalacia. She showed slow response to gluten-free diet, but accelerated full recovery with vitamin D replacement. Conclusion: In PBC patients with subclinical CD and myopathy, vitamin D status can provide a basis for treatment.

Abdominal pain may dominate the scene of idiopathic aortitis

A 59-year-old man suffering from abdominal pain and having high acute phase reactants was admitted to hospital. Aortitis was discovered incidentally with magnetic resonance that was performed for another prediagnosis. Steroid and azathioprine combination was unsuccessful for remission and preventing relapses. However, steroid and methotrexate combination was successful for clinical and laboratory remissions. Also, the iliac artery occlusion was improved with stent implementation. In general, isolated idiopathic aortitis is a very rare entity and hard to be diagnosed. In this case, we describe a patient with aortitis that has only abdominal pain and treated with steroid and methotrexate combination.

TEMPORARY HEART FAILURE ASSOCIATED WITH LONG-TERM DAILY ORAL CYCLOPHOSPHAMIDE USE IN A PATIENT WITH WEGENER’S GRANULOMATOSIS

Correspondance/Yazisma Dr. Tayfun Akalin Department of Rheumatology, Faculty of Medicine, Gazi University, Ankara, Turkey Phone: +90 312 202 43 28 e.mail: tayfunakalin@yahoo.com TEMPORARY HEART FAILURE ASSOCIATED WITH LONG-TERM DAILY ORAL CYCLOPHOSPHAMIDE USE IN A PATIENT WITH WEGENER’S GRANULOMATOSIS UZUN SURELI ORAL SIKLOFOSFAMID KULLANIMINA BAĞLI GECICI KALP YETMEZLIĞI GELIŞEN BIR WEGENER GRANULOMATOZU HASTASI