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    Granulomatous disease in common variable immunodeficiency
    (Academic Press Inc Elsevier Science, 2009) Ardeniz, Oemuer; Cunningham-Rundles, Charlotte
    Granulomatous disease occurs in 8-22% of patients with common variable immunodeficiency (CVID). We examined the clinical and immunologic information of all 37 of 455 (8.1%) CVID subjects with this complication. The median age at diagnosis of CVID was 26 (2-59). 14 had granulomas 1-18 years before diagnosis of CVID. In 6 detection of granulomas coincided with this diagnosis; for 17, granulomas were documented later. 54% had lung granulomas, 43% in lymph nodes and 32% in liver. 54% of the group had had autoimmune diseases, mostly immune thrombocytopenia and hemolytic anemia. 24% had had a splenectomy. Nineteen (51.3%) required steroid treatment for granulomas; other immune suppressants were used in some. Over 25 years 28.5% died (median age 37.5), but not significantly more when compared to our CVID patients without granulomas (19.8%). Those with lung granulomas had similar mortality to those with granulomas in other tissues. (C) 2009 Elsevier Inc. All rights reserved.
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    Granulomatous disease in common variable immunodeficiency
    (Academic Press Inc Elsevier Science, 2009) Ardeniz, Oemuer; Cunningham-Rundles, Charlotte
    Granulomatous disease occurs in 8-22% of patients with common variable immunodeficiency (CVID). We examined the clinical and immunologic information of all 37 of 455 (8.1%) CVID subjects with this complication. The median age at diagnosis of CVID was 26 (2-59). 14 had granulomas 1-18 years before diagnosis of CVID. In 6 detection of granulomas coincided with this diagnosis; for 17, granulomas were documented later. 54% had lung granulomas, 43% in lymph nodes and 32% in liver. 54% of the group had had autoimmune diseases, mostly immune thrombocytopenia and hemolytic anemia. 24% had had a splenectomy. Nineteen (51.3%) required steroid treatment for granulomas; other immune suppressants were used in some. Over 25 years 28.5% died (median age 37.5), but not significantly more when compared to our CVID patients without granulomas (19.8%). Those with lung granulomas had similar mortality to those with granulomas in other tissues. (C) 2009 Elsevier Inc. All rights reserved.
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    Thymoma and immunodeficiency syndrome (Good's syndrome): Medical education
    (Ortadogu Ad Pres & Publ Co, 2007) Ardeniz, Oemuer
    Thymomas are tumors originating from tyhmic epithelium that should be considered in the differential diagnosis of adult patients with hypogammaglobulinemia. Thymomas are usually detected in patients over 40 with myasthenia gravis or in asymptomatic patients with a mediastinal mass recognized during a routine check-up. Patients with thymoma who were referred to a chest surgery clinic for removal of the tumor should be evaluated in terms of an accompanying immune deficiency (Good's syndrome). Ignorance or a delay in the diagnosis may cause death due to severe infections associated with opportunistic pathogens. It should be noted that hypogammaglobulinemia might be detected many years after the removal of the thymoma and so it would be appropriate to follow such patients regularly in an immunology department.
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    Vitamin D and the immune system: Medical education
    (Ortadogu Ad Pres & Publ Co, 2008) Ardeniz, Oemuer
    Vitamin D plays important role in calcium homeostasis and bone metabolism. However, the researches performed during the past twenty years revealed that it also has a significant immunomodulatory effect. D vitamin deficiency has been shown to be related to increased tendency for development of several autoimmune diseases such as type 1 diabetes and inflammatory bowel diseases. D vitamin deficiency has also been associated with increased risk of development of infections such as tuberculosis and malignancy. In experimental models, it has been found to be successful in reducing the risk of graft rejection. D vitamin has been found to have salutary effects on renal allograft function. The findings of the researches indicate that vitamin D might have a role as an alternative and safer treatment modality in many autoimmune diaseases and transplantation practice.