Browsing by Author "Gonultas, Engin"

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Triple a Syndrome: a Case Report
(Galenos Yayincilik, 2014) Atmaca, Murat; Sayin, Refah; Gonultas, Engin; Demir, Mehmet Salim; Ucler, Rifki; Gonullu, Hayriye
Triple A syndrome is a rarely seen autosomal recessive disease characterized by achalasia, adrenal failure and alacrima. The syndrome is frequently seen in childhood. The appearance of its components are usually ordered as alacrima, achalasia and adrenal failure. The majority of the patients diagnosed in the later stages predominantly present with neurological symptoms. In this study, a 21-year-old male who was referred to our clinic with clinical findings of chronic adrenal failure and was diagnosed WITH triple A syndrome is presented. This patient had been operated three years ago due to achalasia. The diagnosis and treatment of adrenal failure in this syndrome is the most important determinant and indicator in the prognosis of the disease.
Type 2 Diabetes Mellitus and Functional Hypoparathyroidism
(Aves, 2014) Atmaca, Murat; Acar, Ismail; Gonultas, Engin; Seven, Ismet; Ucler, Rifki; Ebinc, Senar; Candan, Zehra
Purpose: The present study aims to investigate the effect of blood sugar regulation and vitamin D levels on calcium metabolism and parathormone levels in patients with type 2 diabetes mellitus. Material and Method: We included 132 patients with type 2 diabetes mellitus who presented to our outpatient clinic for regular check up between August 2013 and October 2013. Fasting blood glucose, HbA1c, calcium, phosphorus, magnesium, albumin, creatinine, parathormone, 25-Hydroxy vitamin D [25(OH) D], spot urinary calcium and creatinine levels were studied for each patient. Results: Vitamin D levels were below 30 ng/mL in 96.9% (n = 128) and below 20 ng/mL in 78.7% (n = 102) of the patients included in the study. Patients with impaired blood sugar regulation (HbA1c > 10%) had lower levels of PTH, albumin and 25(OH) D levels and higher phosphorus levels compared to patients with HbA1c levels below 10% (p = 0.018, p = 0.043, p = 0.002, p = 0.01, respectively). The rates of functional hypoparathyroidism (parathormone < 65 ng/mL) in patients with vitamin D levels below 30 ng/mL and 20 ng/mL were 63.2% and 59.6%, respectively. Among the diabetic patients with vitamin D levels < 30 ng/mL, magnesium levels were significantly lower in those with functional hypoparathyroidism (parathormone < 65 ng/mL) compared to those with secondary hyperparathyroidism (p = 0.015). Comparative statistical analysis of patients with HbA1c levels above and below 10% demonstrated higher proportion of patients with functional hypoparathyroidism in the group with impaired blood sugar regulation (p = 0.035 for patients with vitamin levels below 30 ng/mL, and p = 0.031 for patients with vitamin levels below 20 ng/mL). Discussion: Impaired blood sugar regulation leads to functional hypoparathyroidism with secondary hypomagnesemia in type 2 diabetes mellitus, as was previously described for subjects with type 1 diabetes mellitus.