1
|
Çelik FÇ, Soyöz Ö, Bölük SÖ, Taşkırdı İ, Hacı İA, Kaya MŞ, Demir A, Uzunoğlu B, Yıldırım AT, Onay H, Gözmen S, Gülez N, Genel F. Successful management of delayed-onset adenosine deaminase deficiency with novel mutation. Per Med 2024; 21:11-19. [PMID: 38088159 DOI: 10.2217/pme-2023-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
A 4-year-old boy presented with acute-onset autoimmune cytopenia with severe, persistent lymphopenia, autoimmune thyroiditis, elevated IgE and glucose 6-phosphate dehydrogenase enzyme deficiency. In immunologic evaluation, lower T, B and natural killer cells and higher levels of adenosine deaminase (ADA) metabolites were observed. The compound heterozygous novel ADA gene mutations causing ADA deficiency were detected. Successful immunologic and metabolic cure was achieved with enzyme replacement therapy, followed by reduced intensity conditioning hematopoietic stem cell transplantation from a matched unrelated donor. An interesting aspect of this patient is the detection of novel compound heterozygous mutations without consanguinity and a secondary outcome is the recovery of glucose 6-phosphate dehydrogenase deficiency after hematopoietic stem cell transplantation.
Collapse
Affiliation(s)
- Figen Çelebi Çelik
- University of Health Sciences, Izmir Faculty of Medicine, Dr. Behcet Uz Pediatric Diseases & Surgery Training & Research Hospital, Department of Pediatric Allergy & Immunology, Izmir, Turkey
| | - Özgen Soyöz
- University of Health Sciences, Izmir Faculty of Medicine, Dr. Behcet Uz Pediatric Diseases & Surgery Training & Research Hospital, Department of Pediatric Allergy & Immunology, Izmir, Turkey
| | - Selime Özen Bölük
- University of Health Sciences, Izmir Faculty of Medicine, Dr. Behcet Uz Pediatric Diseases & Surgery Training & Research Hospital, Department of Pediatric Allergy & Immunology, Izmir, Turkey
| | - İlke Taşkırdı
- University of Health Sciences, Izmir Faculty of Medicine, Dr. Behcet Uz Pediatric Diseases & Surgery Training & Research Hospital, Department of Pediatric Allergy & Immunology, Izmir, Turkey
| | - İdil Akay Hacı
- University of Health Sciences, Izmir Faculty of Medicine, Dr. Behcet Uz Pediatric Diseases & Surgery Training & Research Hospital, Department of Pediatric Allergy & Immunology, Izmir, Turkey
| | - Mehmet Şirin Kaya
- University of Health Sciences, Izmir Faculty of Medicine, Dr. Behcet Uz Pediatric Diseases & Surgery Training & Research Hospital, Department of Pediatric Allergy & Immunology, Izmir, Turkey
| | - Ayça Demir
- University of Health Sciences, Izmir Faculty of Medicine, Dr. Behcet Uz Pediatric Diseases & Surgery Training & Research Hospital, Department of Pediatric Allergy & Immunology, Izmir, Turkey
| | - Berna Uzunoğlu
- University of Health Sciences, Izmir Faculty of Medicine, Dr. Behcet Uz Pediatric Diseases & Surgery Training & Research Hospital, Department of Pediatric Allergy & Immunology, Izmir, Turkey
| | - Ayşen Türedi Yıldırım
- Celal Bayar University Faculty of Medicine, Department of Pediatrics, Department of Pediatric Hematology, Manisa, Turkey
| | | | - Salih Gözmen
- Katip Celebi University Faculty of Medicine, Department of Pediatric Hematology, Dr. Behcet Uz Pediatric Diseases & Surgery Training & Research Hospital Hematopoietic Stem Cell Transplantation Unit, İzmir, Turkey
| | - Nesrin Gülez
- University of Health Sciences, Izmir Faculty of Medicine, Dr. Behcet Uz Pediatric Diseases & Surgery Training & Research Hospital, Department of Pediatric Allergy & Immunology, Izmir, Turkey
| | - Ferah Genel
- University of Health Sciences, Izmir Faculty of Medicine, Dr. Behcet Uz Pediatric Diseases & Surgery Training & Research Hospital, Department of Pediatric Allergy & Immunology, Izmir, Turkey
| |
Collapse
|
2
|
Kartal Öztürk G, Eşki A, Çelebi Çelik F, Conkar S, Gülen F, Demir E, Keskinoğlu A. Prospective evaluation of vascular changes in acute respiratory infections in children with cystic fibrosis. Turk J Med Sci 2020; 50:1007-1014. [PMID: 32421279 PMCID: PMC7379472 DOI: 10.3906/sag-2002-61] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 05/16/2020] [Indexed: 01/15/2023] Open
Abstract
Background/aim Acute exacerbations and chronic inflammation are risk factors for cardiovascular disease (CVD) in cystic fibrosis (CF) patients. The aim of this study was to investigate the effects of acute exacerbation therapy on arterial stiffness in children with CF. Materials and methods Augmentation index (Aix) and pulse wave velocity (PWV) were measured before and after treatment and 1 month after the end of treatment in patients with acute exacerbation. The relationship between hemodynamic measurements and c-reactive protein (CRP) and pulmonary function tests (PFTs) was investigated. Results Measurements before and after treatment were evaluated in 27 patients and were repeated in 21 patients who were clinically stable 1 month following acute exacerbation. There was a significant decrease in CRP and an increase in spirometry parameters after treatment. While no significant difference was found between PWV (P = 0.33), a significant difference for Aix before (41.95 ± 12.96%) and after (30.95 ± 11.47%) treatment and before treatment and stable clinical condition (34.19 ± 14.36%) was obtained (P =0.00, and P =0.01, respectively). No significant difference in heart rate and other hemodynamic measurements was found. Pretreatment Aix is associated with poor clinical condition (PFTs, BMI, and clinical score) and systemic inflammation (CRP) (P <0.05). Conclusion The decrease of arterial stiffness (Aix) with acute exacerbation treatment in children with CF has been demonstrated. This result shows that systemic inflammation in CF may cause an increase in arterial stiffness and recurrent exacerbations may increase the risk of CVD.
Collapse
Affiliation(s)
- Gökçen Kartal Öztürk
- Department of Pediatrics, Division of Pulmonology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Aykut Eşki
- Department of Pediatrics, Division of Pulmonology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Figen Çelebi Çelik
- Department of Pediatrics, Division of Pulmonology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Seçil Conkar
- Department of Pediatrics, Division of Pediatric Nephrology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Figen Gülen
- Department of Pediatrics, Division of Pulmonology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Esen Demir
- Department of Pediatrics, Division of Pulmonology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Ahmet Keskinoğlu
- Department of Pediatrics, Division of Pediatric Nephrology, Faculty of Medicine, Ege University, İzmir, Turkey
| |
Collapse
|
3
|
Çağlar A, Edizer S, Sarıtaş S, Çelebi Çelik F, Önder M, Er A, Ulusoy E, Akgül F, Ünalp A, Yılmaz Ü, Apa H. Pediatric emergency department visit characteristics of the patients on the ketogenic diet. Epilepsy Behav 2019; 99:106446. [PMID: 31398557 DOI: 10.1016/j.yebeh.2019.106446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/13/2019] [Accepted: 07/16/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND The ketogenic diet (KD) has been frequently used for the patients with drug-resistant epilepsy in recent years. The management of these patients in emergency departments (EDs) has some difficulties due to the special needs of KD. We aimed to determine the characteristics and the management of the patients on the KD in the pediatric ED setting. METHODS Patients who were on the KD and admitted to the ED were included in the study. Demographic, clinical, and laboratory data of all patients were retrospectively reviewed and recorded. RESULTS There were 105 emergency admissions of 27 patients. The median age of all patients was 55.0 (IQR: 29.0-91.0) months. The most common symptom was vomiting (43.8%). Four patients had upper gastrointestinal bleeding, and one patient had hyperammonemic acute hepatic failure while receiving KD. Of the patients, 41.9% had seizure-related ED admission. Infections were present in 41.9% of the ED visits. The frequency of status epilepticus was significantly lower in the patients who were on the KD for more than 6 months (p < 0.01). In 42.9% of all ED admissions, dextrose containing maintenance fluids was administered mistakenly; although ketosis rate was lower, no seizure was observed in this group. CONCLUSION The patients on the KD can be admitted to EDs with intercurrent illnesses or adverse effects of the KD. For accurate management, emergency physicians must be aware of the common reasons for ED admission of these patients and the effects of the KD.
Collapse
Affiliation(s)
- Aykut Çağlar
- Department of Pediatric Emergency Care, Dr. Behçet Uz Children's Hospital, İzmir, Turkey..
| | - Selvinaz Edizer
- Department of Pediatric Neurology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Serdar Sarıtaş
- Department of Pediatric Neurology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Figen Çelebi Çelik
- Department of Pediatrics, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Mehmet Önder
- Department of Pediatrics, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Anıl Er
- Department of Pediatric Emergency Care, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Emel Ulusoy
- Department of Pediatric Emergency Care, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Fatma Akgül
- Department of Pediatric Emergency Care, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Aycan Ünalp
- Department of Pediatric Neurology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Ünsal Yılmaz
- Department of Pediatric Neurology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| | - Hurşit Apa
- Department of Pediatric Emergency Care, Dr. Behçet Uz Children's Hospital, İzmir, Turkey
| |
Collapse
|
4
|
Akgül F, Er A, Çelebi Çelik F, Çağlar A, Ulusoy E, Yılmaz D, Duman M. Retrospective Analysis of Childhood Poisoning. cayd 2016. [DOI: 10.4274/cayd.02886] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|