Tuba Güler

The effect of vitamin D on clinical manifestations and activity of Behçet’s disease

Introduction Immune mechanisms have been implemented to have a role in the pathogenesis of Behçet’s disease (BD) and vitamin D has been shown to have a regulatory role in the immune system function. Aim To evaluate the vitamin D levels of BD patients and its relationship between clinical findings and disease activity of BD. Material and methods Sixty-eight patients with BD and 70 age- and sex-matched controls were examined retrospectively. Demographic features, vitamin D levels for both groups and clinical findings, disease activity, drug usage for BD patients were examined from their medical reports. Disease activity was calculated for each patient according to Krause’s BD activity assessment. Results Mean vitamin D levels of patients and controls were 15.35 ±7.18 ng/ml and 18.44 ±5.79 ng/ml, respectively. Vitamin D levels were significantly lower in BD patients than in controls (p = 0.006). Mean vitamin D levels of active and inactive BD cases were 15.68 ±7.31 ng/ml and 15.08 ±7.17 ng/ml, respectively (p = 0.73). Disease activity of patients using and not using vitamin D was similar (p = 0.51). Conclusions Significantly lower levels of vitamin D were observed in BD patients. Our results indicate that there is no correlation between BD activity and a vitamin D level. Together with these, vitamin D replacement treatment was found to have no effect on disease activity.

Evaluation of Tear Film Function and Corneal Thickness of Behcet's Disease Patients Without Ocular Involvement

ABS TRACT Objective: Behcets disease (BD) is a chronic inflammatory vasculitis characterized by mucocutaneous ulcers and ocular involvement. There are a few studies about the effects of BD on the ocular surface. We aimed to investigate central corneal thickness (CCT) and tear film function in patients without clinically detectable ocular pathology. Material and Methods: Eighty nine eyes of 45 BD patients without ocular pathology were examined and compared with 52 eyes of 26 healthy, age and sex matched volunteers. For both groups, after routine opthalmologic examinations, tear film function tests, containing tear break-up time (BUT) and Schirmer test were done. CCT was measured with ultrasonic pachymeter. Schirmer test results, CCT and BUT measurements were compared and p<0,05 was considered statistically significant. Results: Mean values of Schirmer tests in patient and control groups were 7.62±5.87 mm and 9.32±3.92 mm, respectively. Difference between groups was not statistically significant (p= 0.06). Mean BUT was significantly lower in the patient group (p= 0.0001). Mean CCT of patient and control groups were 536.13±31.47 μm and 540,90±36,39 μm, respectively. There was no significant difference between the CCT of the groups (p= 0.41). All parameters were similar for patients receiving and not receiving immunosuppressive therapy (p>0.05). Conclusion: There may be changes in tear film functions of BD patients without clinically detectable ocular pathology. Since BUT test results were found to be significantly lower in our patient group we concluded that BD patients without ocular pathology must also be evaluated for symptoms of dry eye.

Coexistence of Familial Mediterranean Fever With Ankylosing Spondylitis and Sjogren’s Syndrome: A Rare Occurrence

Familial Mediterranean fever is an autosomal recessive disease characterized by recurrent episodes of fever, peritonitis, synovitis, pleuritis, and erysipelas-like skin lesions. Sjogrens syndrome is a chronic autoimmune disorder characterized by dry eyes, dry mouth, and musculoskeletal involvement. Ankylosing spondylitis is an autoinflammatory rheumatic disease which affects mainly the axial skeleton. To our knowledge, coexistence of familial Mediterranean fever with ankylosing spondylitis and Sjogrens syndrome has not been reported previously in the literature. In this article, we report an unusual case of three autoinflammatory diseases in one patient.