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    Genital Attacks in Hereditary Angioedema and Their Effects on Sexual Life
    (MDPI, 2024) Camyar, Asuman; Bulut, Gokten; Ozisik, Melih; Altay, Sevgi; Tuncel, Ozlem Kuman; Ozgul, Semiha; Sin, Aytul Zerrin; Gokmen, Nihal Mete
    Background and Objectives: Hereditary angioedema (HAE) is characterized by unpredictable skin and mucosal angioedema attacks. We aimed to find the frequency of sexual-activity-triggered attacks (STAs) and understand how the sexual life of HAE with C1-inhibitor deficiency (HAE-C1INH) patients is affected. Materials and Methods: Adult HAE-C1INH patients were included in this cross-sectional study, which started in March 2020. Demographic information, marriage properties, gender-specific sexual life characteristics, and the HAE-specific histories of the patients were collected. The Hospital Anxiety and Depression Scale (HADS) and the Turkish version of the New Sexual Satisfaction Scale (NSSS) were applied to all participants. Results: Among 42 symptomatic HAE patients, 33 (78.57%) had genital attacks and 17 (42.5%) had STAs. Ten (58.8%) had genital pain, tenderness, or swelling, and five (29.4%) had isolated abdominal and groin pain. Eight (47.1%) patients with STAs experienced a HAE attack during their first time engaging in sexual intercourse. Anxiety/depression scales, NSSS scores, and distribution of other HAE attack localizations were similar in patients with and without STAs, and no gender differences were observed. Compared to the patients without STAs, the ratio of patients who stated that their sexual lives were negatively affected and that they lost their sexual desire was higher in patients with STAs. Conclusions: Genital or abdominal attacks triggered by sexual activity may be more common than thought. Sexual activity should also be questioned for evaluating attack triggers. There is a possibility of triggering an attack with the first and ongoing sexual intercourse, and patients should be informed to keep their attack treatment medications ready in advance.
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    Postorgasmic illness syndrome benefiting from omalizumab and antidepressant: a case report
    (Bmc, 2024) Okan, Kasim; Kural, Ragip Fatih; Demir, Meryem; Cot, Furkan; Dinckal, Mustafa; Altay, Sevgi; Gokmen, Nihal Mete
    BackgroundPostorgasmic illness syndrome is characterized by flu, rhinitis, conjunctivitis, loss of appetite, muscle weakness, and fatigue after ejaculation, lasting 2-7 days. The multidisciplinary treatment approach, incorporating omalizumab and antidepressants, has rarely been documented in literature.Case presentationIn this article, we present the case of a 33-year-old single Turkish male with postorgasmic illness syndrome, characterized by typical clinical symptoms and a positive autologous semen test. Notably, his serum estrogen and progesterone levels were elevated. The patient's Beck anxiety score was 42 points, the depression scale score was 37, and suicidal thoughts. Fresh autologous semen taken at the hospital was diluted with 0.9% saline, and prick and intradermal skin tests were performed.ConclusionThe patient's symptoms improved significantly with the combination of omalizumab and escitalopram. This case not only provides a new perspective on the management of postorgasmic illness syndrome but also highlights the potential roles of allergic, psychiatric, and endocrinological mechanisms in the etiology and treatment of this complex condition.
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    Psychosocial Evaluation of Adults with Primary Immunodeficiency
    (Springer/Plenum Publishers, 2024) Gumusburun, Reyhan; Altay, Sevgi; Cengiz, Hasancan; Yont, Gulendam Hakverdioglu; Tuncel, Ozlem Kuman; Ardeniz, Omur
    Purpose Primary immunodeficiency disorder (PID) is a heterogeneous group of diseases characterized by immune dysregulation and increased susceptibility to infections, with various cognitive, emotional, behavioral, and social effects on patients. This study aimed to evaluate loneliness, social adaptation, anxiety, and depression and to identify associated factors in adults with immunodeficiency. Methods A cross-sectional study in Turkey (Feb-Aug 2022) obtained sociodemographic data from patient records. The Social Adaptation Self-Evaluation Scale (SASS), UCLA-Loneliness Scale (UCLA-LS), and Hospital Anxiety and Depression Scale (HADS) were administered in individual patient interviews. HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D) scores were assessed using cut-offs of 10 and 7, respectively; SASS cut-offs for social imbalance and normalcy were < 25 and > 35, respectively. Results A total of 104 patients (60 women, 44 men) with a median age of 34 years (range: 18-89) were included in the study. Mean scores were SASS: 34.46 +/- 8.11, UCLA-LS: 44.89 +/- 12.66, HADS-A: 9.87 +/- 4.77, and HADS-D: 9.12 +/- 4.80. SASS score was negatively correlated with HADS-A, HADS-D, and UCLA-LS scores. There were positive correlations between UCLA-LS and HADS-A (r = -0.355, p < 0.01) and HADS-D (r = -0.614, p < 0.01) and between HADS-A and HADS-D (r = -0.454, p < 0.01). Low-income level was associated with higher HADS-A, HADS-D, and UCLA-LS scores and lower SASS score (p = 0.012, p = 0.041, p = 0.008, and p = 0.001, respectively). Conclusion Adults with PID are at risk for depression and experience high levels of loneliness. Social maladjustment and loneliness contribute to anxiety and depression, and loneliness is correlated with impaired social functioning. These findings emphasize the importance of biopsychosocial evaluation of individuals diagnosed with PID.