Fatma Gür Hati̇p

Background and Objectives: Autoimmune thyroid diseases are more prevalent in patients diagnosed with Sjögren disease (SD) than in the general population. SD and autoimmune thyroid diseases are two distinct yet interrelated autoimmune disorders. The objective of this study was to determine the frequency of autoimmune thyroiditis (AT), autoantibody relationships, and clinical features in patients with SD. Materials and Methods: The study included 525 patients. A retrospective evaluation was conducted on the demographic data, biochemical and serological tests, and pathological data of the patients. An anti-nuclear antibody (ANA) test was performed using the indirect immunofluorescence (IIF) method using HEp-2 (HEp-2000) cells as substrate. The Schirmer test and minor salivary gland biopsy were conducted on all patients. Results: AT was detected in 167 (31.8%) of 525 patients who participated in the study. The anti-nuclear antibody (ANA) test and anti-SS-A positivity rate were higher in the AT group (p value < 0.001 and 0.002 respectively). We found that the likelihood of developing AT increased as ANA titres increased. ANA positivity titres were found to be significant at 2+, 3+, and 4+ values (odd ratios 2.41, 3.40, and 4.21, respectively). Additionally, histological examination of salivary gland biopsies revealed a significantly higher prevalence of diffuse lymphocytic infiltration in the AT group. Conclusions: AT was present in 31% of patients with SD. The presence of ANA positivity, anti-SS-A positivity, and diffuse lymphocytic infiltration appears to exert an influence on the association between these two diseases.

Objectives: We aimed to reveal predictors of response and response duration to steroid therapy in first line of treatment in immune thrombocytopenia (ITP). Methods: Fifty patients, who were diagnosed with ITP in hematology department of Suleyman Demirel University Hospital between 2005-2019, who had sufficient clinical and laboratory data, followed up for at least one year and received corticosteroid treatment in first line, were evaluated retrospectively for treatment response time, remission, prognosis on their first line treatment. The patients who maintained remission for more than 12 months was defined as group 1 and those who did not achieve remission or relapsed in less than 12 months were defined as group 2. Results: Twenty-two (44%) patients responded in first 3 days of the treatment, 16 (32%) patients in 4 to 7 days and 4 (8%) patients responded in more than 7 days. Eighty-four percent (n = 42) of these patients had complete response to corticosteroid treatment. When the remission maintenances were examined, it was observed that 22 (44%) patients were in remission for more than 12 months, 20 (40%) patients were in remission with treatment but relapsed before 12 months and 8 (16%) patients did not respond to corticosteroid treatment. When the response time to treatment in patients with or without remission was compared, remission was significantly lower in those who responded late to treatment (p = 0.01). When the response rates to corticosteroid treatment of patients in group 1 and 2 were evaluated, it was found that the response time to treatment was not related to the maintenance of remission (p = 0.267). Conclusions: Faster response time to treatment produced higher remission rates but, we could not find any relationship between response time to treatment and duration of remission.

OBJECTIVE: Bone marrow fibrosis in primary immune thrombocytopenia (ITP) has become a centre of attention since cases with fibrosis were reported during trombopoeitin receptor agonist therapies but, there have been few studies evaluating the fibrosis status of the patients at diagnosis. The aim of the study was to evaluate the impact of marrow fibrosis on especially response to treatment and prognosis in patients with ITP. MATERIAL AND METHODS: Bone marrow reticulin fiber grade, haemoglobin, platelets, age, sex, co-morbidities of the patients, hepatitis and autoimmune markers on admission, response, remission status and duration of remission and treatments were recorded from medical files of the patients and each parameter was evaluated for an association with reticular fiber grade in 53 patients with ITP. RESULTS: 79.3% of patients had marrow reticulin content grade 1 or more. No significant correlations were found between bone marrow reticular fiber grade and total blood count at diagnosis, response times to the first, second- and third-line treatment, platelet counts after treatment and time between two treatment lines, age, gender, presence of comorbidity and antinuclear antibody positivity and response rate and time. There was a significant and positive correlation between platelet count at diagnosis and age (p<0.05) and, there was a statistically significant and negative correlation between white blood and neutrophil count at diagnosis and age (p<0.05) CONCLUSIONS: For the first time, higher grade of fibrosis was found in patients with ITP. Prospective studies with follow-up bone marrow biopsies are needed to validate the link between ITP and autoimmune fibrosis.