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Direk MÇ, Besen Ş, Öncel İ, Günbey C, Özdoğan O, Orgun LT, Sahin S, Cansu A, Yıldız N, Kanmaz S, Yılmaz S, Tekgül H, Türkdoğan D, Ünver O, Thomas GÖ, Başıbüyük S, Yılmaz D, Kurt AN, Gültutan P, Özsoy Ö, Yiş U, Kurul SH, Güngör S, Özgör B, Karadağ M, Dündar NO, Gençpınar P, Bildik O, Orak SA, Kabur ÇÇ, Kara B, Karaca Ö, Canpolat M, Gümüş H, Per H, Yılmaz Ü, Karaoğlu P, Ersoy Ö, Tosun A, Öztürk SB, Yüksel D, Atasoy E, Gücüyener K, Yıldırım M, Bektaş Ö, Çavuşoğlu D, Yarar Ç, Güngör O, Mert GG, Sarıgeçili E, Edizer S, Çetin İD, Aydın S, Diler B, Özdemir AA, Erol İ, Okuyaz Ç, Anlar B. Optic neuritis in Turkish children and adolescents: A multicenter retrospective study. Mult Scler Relat Disord 2024; 81:105149. [PMID: 38096730 DOI: 10.1016/j.msard.2023.105149] [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] [Received: 09/14/2023] [Revised: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Various etiologies may underlie optic neuritis, including autoantibody-mediated disorders described in the last decade. We re-examined demographic, clinical, laboratory features and prognostic factors in pediatric patients with autoimmune optic neuritis according to current knowledge. METHODS Cases of pediatric ON from 27 centers in Türkiye diagnosed between 2009 and 2022 were included for retrospective evaluation. RESULTS The study included 279 patients, 174 females and 105 males, with a female-to-male ratio of 1.65. The average age at onset was 12.8 ± 3.4 years, and mean follow-up, 2.1 years (range: 1-12.1 years). Patients <10 years old were grouped as "prepubertal" and those ≥10 years old as "others". The diagnoses made at the end of follow-up were multiple sclerosis associated optic neuritis (n = 90, 32.3 %), single isolated optic neuritis (n = 86, 31 %), clinically isolated syndrome (n = 41, 14.7 %), myelin oligodendrocyte glycoprotein antibody associated optic neuritis (n = 22, 7.9 %), and relapsing isolated optic neuritis (n = 18, 6.5 %). Predominant diagnoses were myelin oligodendrocyte glycoprotein antibody associated optic neuritis and acute disseminated encephalomyelitis associated optic neuritis in the prepubertal group and multiple sclerosis associated optic neuritis in the older group. Recurrences were observed in 67 (24 %) patients, including 28 with multiple sclerosis associated optic neuritis, 18 with relapsing isolated optic neuritis, 11 with myelin oligodendrocyte glycoprotein antibody associated optic neuritis, 8 with aquaporin-4 antibody related optic neuritis, and 2 with chronic relapsing inflammatory optic neuropathy. Recurrences were more common among female patients. Findings supporting the diagnosis of multiple sclerosis included age of onset ≥ 10 years (OR=1.24, p = 0.027), the presence of cranial MRI lesions (OR=26.92, p<0.001), and oligoclonal bands (OR=9.7, p = 0.001). Treatment in the acute phase consisted of intravenous pulse methylprednisolone (n = 46, 16.5 %), pulse methylprednisolone with an oral taper (n = 212, 76 %), and combinations of pulse methylprednisolone, plasmapheresis, or intravenous immunoglobulin (n = 21, 7.5 %). Outcome at 12 months was satisfactory, with 247 out of 279 patients (88.5 %) demonstrating complete recovery. Thirty-two patients exhibited incomplete recovery and further combination treatments were applied. Specifically, patients with relapsing isolated optic neuritis and aquaporin-4 antibody related optic neuritis displayed a less favorable prognosis. CONCLUSION Our results suggest optic neuritis is frequently bilateral in prepubertal and unilateral in peri‑ or postpubertal patients. Age of onset 10 or older, presence of oligoclonal bands, and brain MRI findings reliably predict the development of multiple sclerosis. The risk of developing multiple sclerosis increases mostly during the second and third years of follow-up. Relapsing isolated optic neuritis remains a separate group where the pathogenesis and outcome remain unclear. Investigation of predisposing and diagnostic biomarkers and long follow-up could help to define this group.
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Affiliation(s)
- Meltem Çobanoğulları Direk
- Department of Pediatrics, Division of Pediatric Neurology, Mersin University Faculty of Medicine, Faculty Of Medicine, 34, Cadde, Çiftlikköy Kampüsü, Mersin 33343, Türkiye.
| | - Şeyda Besen
- Department of Pediatrics, Division of Pediatric Neurology, Başkent University Faculty of Medicine, Adana, Türkiye
| | - İbrahim Öncel
- Department of Pediatrics, Division of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Ceren Günbey
- Department of Pediatrics, Division of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Orhan Özdoğan
- Department of Pediatrics, Division of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Leman Tekin Orgun
- Department of Pediatrics, Division of Pediatric Neurology, Başkent University Faculty of Medicine, Adana, Türkiye
| | - Sevim Sahin
- Department of Pediatrics, Division of Pediatric Neurology, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
| | - Ali Cansu
- Department of Pediatrics, Division of Pediatric Neurology, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
| | - Nihal Yıldız
- Department of Pediatrics, Division of Pediatric Neurology, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
| | - Seda Kanmaz
- Department of Pediatrics, Division of Pediatric Neurology, Ege University Faculty of Medicine, İzmir, Türkiye
| | - Sanem Yılmaz
- Department of Pediatrics, Division of Pediatric Neurology, Ege University Faculty of Medicine, İzmir, Türkiye
| | - Hasan Tekgül
- Department of Pediatrics, Division of Pediatric Neurology, Ege University Faculty of Medicine, İzmir, Türkiye
| | - Dilşad Türkdoğan
- Department of Pediatrics, Division of Pediatric Neurology, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye
| | - Olcay Ünver
- Department of Pediatrics, Division of Pediatric Neurology, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye
| | - Gülten Öztürk Thomas
- Department of Pediatrics, Division of Pediatric Neurology, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye
| | - Salih Başıbüyük
- Department of Pediatrics, Division of Pediatric Neurology, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye
| | - Deniz Yılmaz
- Department of Pediatrics, Division of Pediatric Neurology, Ankara City Hospital, Ankara, Türkiye
| | - Ayşegül Neşe Kurt
- Department of Pediatrics, Division of Pediatric Neurology, Ankara City Hospital, Ankara, Türkiye
| | - Pembe Gültutan
- Department of Pediatrics, Division of Pediatric Neurology, Ankara City Hospital, Ankara, Türkiye
| | - Özlem Özsoy
- Department of Pediatrics, Division of Pediatric Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Türkiye
| | - Uluç Yiş
- Department of Pediatrics, Division of Pediatric Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Türkiye
| | - Semra Hız Kurul
- Department of Pediatrics, Division of Pediatric Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Türkiye
| | - Serdal Güngör
- Department of Pediatrics, Division of Pediatric Neurology, İnönü University Faculty of Medicine, Malatya, Türkiye
| | - Bilge Özgör
- Department of Pediatrics, Division of Pediatric Neurology, İnönü University Faculty of Medicine, Malatya, Türkiye
| | - Meral Karadağ
- Department of Pediatrics, Division of Pediatric Neurology, İnönü University Faculty of Medicine, Malatya, Türkiye
| | - Nihal Olgaç Dündar
- Department of Pediatrics, Division of Pediatric Neurology, Katip Celebi University Faculty of Medicine, İzmir, Türkiye
| | - Pınar Gençpınar
- Department of Pediatrics, Division of Pediatric Neurology, Katip Celebi University Faculty of Medicine, İzmir, Türkiye
| | - Olgay Bildik
- Department of Pediatrics, Division of Pediatric Neurology, Katip Celebi University Faculty of Medicine, İzmir, Türkiye
| | - Sibğatullah Ali Orak
- Department of Pediatrics, Division of Pediatric Neurology, Celal Bayar University Faculty of Medicine, Manisa, Türkiye
| | - Çişil Çerçi Kabur
- Department of Pediatrics, Division of Pediatric Neurology, Celal Bayar University Faculty of Medicine, Manisa, Türkiye
| | - Bülent Kara
- Department of Pediatrics, Division of Pediatric Neurology, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye
| | - Ömer Karaca
- Department of Pediatrics, Division of Pediatric Neurology, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye
| | - Mehmet Canpolat
- Department of Pediatrics, Division of Pediatric Neurology, Erciyes University Faculty of Medicine, Kayseri, Türkiye
| | - Hakan Gümüş
- Department of Pediatrics, Division of Pediatric Neurology, Erciyes University Faculty of Medicine, Kayseri, Türkiye
| | - Hüseyin Per
- Department of Pediatrics, Division of Pediatric Neurology, Erciyes University Faculty of Medicine, Kayseri, Türkiye
| | - Ünsal Yılmaz
- İzmir Faculty of Medicine, Dr. Behçet Uz Children's Education and Research Hospital, Department of Pediatrics, Division of Pediatric Neurology, University of Health Sciences Türkiye, İzmir, Türkiye
| | - Pakize Karaoğlu
- İzmir Faculty of Medicine, Dr. Behçet Uz Children's Education and Research Hospital, Department of Pediatrics, Division of Pediatric Neurology, University of Health Sciences Türkiye, İzmir, Türkiye
| | - Özlem Ersoy
- Department of Pediatrics, Division of Pediatric Neurology, Mersin University Faculty of Medicine, Faculty Of Medicine, 34, Cadde, Çiftlikköy Kampüsü, Mersin 33343, Türkiye
| | - Ayşe Tosun
- Department of Pediatrics, Division of Pediatric Neurology, Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Semra Büyükkorkmaz Öztürk
- Department of Pediatrics, Division of Pediatric Neurology, Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Deniz Yüksel
- Dr Sami Ulus Maternity and Children's Education and Research Hospital, University of Health Sciences, Ankara, Türkiye
| | - Ergin Atasoy
- Dr Sami Ulus Maternity and Children's Education and Research Hospital, University of Health Sciences, Ankara, Türkiye
| | - Kıvılcım Gücüyener
- Department of Pediatrics, Division of Pediatric Neurology, Gazi University Faculty of Medicine, Ankara, Türkiye
| | - Miraç Yıldırım
- Department of Pediatrics, Division of Pediatric Neurology, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Ömer Bektaş
- Department of Pediatrics, Division of Pediatric Neurology, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Dilek Çavuşoğlu
- Department of Pediatrics, Division of Pediatric Neurology, Afyonkarahisar Health Sciences University, Afyon, Türkiye
| | - Çoşkun Yarar
- Department of Pediatrics, Division of Pediatric Neurology, Osmangazi University Faculty of Medicine, Eskişehir, Türkiye
| | - Olcay Güngör
- Department of Pediatrics, Division of Pediatric Neurology, Pamukkale University Faculty of Medicine, Denizli, Türkiye
| | - Gülen Gül Mert
- Department of Pediatrics, Division of Pediatric Neurology, Cukurova University Faculty of Medicine, Adana, Türkiye
| | - Esra Sarıgeçili
- Department of Pediatrics, Division of Pediatric Neurology, Adana City Training and Research Hospital, Adana, Türkiye
| | - Selvinaz Edizer
- Department of Pediatrics, Division of Pediatric Neurology, Istanbul Bezm-i Alem Vakıf University Hospital, İstanbul, Türkiye
| | - İpek Dokurel Çetin
- Department of Pediatrics, Division of Pediatric Neurology, Balıkesir Ataturk City Hospital, Balıkesir, Türkiye
| | - Seren Aydın
- Department of Pediatrics, Division of Pediatric Neurology, Samsun Ondokuz Mayıs University Faculty of Medicine, Samsun, Türkiye
| | - Betül Diler
- Giresun Maternity and Children's Education and Research Hospital, Pediatric Neurology, Giresun, Türkiye
| | - Asena Ayça Özdemir
- Department of Medical Education, Mersin University Faculty of Medicine, Mersin, Türkiye
| | - İlknur Erol
- Department of Pediatrics, Division of Pediatric Neurology, Başkent University Faculty of Medicine, Adana, Türkiye
| | - Çetin Okuyaz
- Department of Pediatrics, Division of Pediatric Neurology, Mersin University Faculty of Medicine, Faculty Of Medicine, 34, Cadde, Çiftlikköy Kampüsü, Mersin 33343, Türkiye
| | - Banu Anlar
- Department of Pediatrics, Division of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
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Yılmaz D, Teber S, Gültutan P, Yıldırım M, Bektaş Ö, Alikılıç D, Güngör M, Kara B, Öncel İ, Dilek TD, Saltık S, Kanmaz S, Yılmaz S, Tekgül H, Çavuşoğlu D, Karaoğlu P, Yılmaz Ü, Orak SA, Güngör O, Anlar B. A multicenter study of radiologically isolated syndrome in children and adolescents: Can we predict the course? Mult Scler Relat Disord 2023; 79:104948. [PMID: 37659352 DOI: 10.1016/j.msard.2023.104948] [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] [Received: 03/23/2023] [Revised: 06/29/2023] [Accepted: 08/20/2023] [Indexed: 09/04/2023]
Abstract
OBJECTIVES To evaluate clinical characteristics, imaging features and etiological profile of Radiologically Isolated Syndrome (RIS) along with clinical and radiological follow-up. METHODS Demographic, clinical and radiological data of patients younger than 18 years fulfilling the criteria for RIS were retrospectively analyzed. RIS was defined by the detection of lesions meeting the revised 2010 McDonald Criteria for dissemination in space on magnetic resonance imaging (MRI) in the absence of any symptoms of demyelinating disease or an alternative cause for the MRI findings. RESULTS There were total 69 patients (38 girls, 31 boys). The median age at index MRI was 15.7 years, and median follow-up time was 28 months. The most common reason for neuroimaging was headache (60.9%). A first clinical event occurred with median 11 months in 14/69 (20%) of cases. Those with oligoclonal bands (OCB) in cerebrospinal fluid (CSF) and follow-up longer than 3 years were more likely to experience a clinical event (p<0.05): 25% of those with OCB manifested clinical symptoms within the first year and 33.3% within the first two years compared to 6.3% and 9.4%, respectively in those without OCB. Radiological evolution was not associated with any variables: age, sex, reason for neuroimaging, serum 25-hydroxyvitamin D level, elevated IgG index, OCB positivity, total number and localization of lesions, presence of gadolinium enhancement, achievement of 2005 criteria for DIS and duration of follow-up. CONCLUSION Children and adolescents with RIS and CSF OCB should be followed-up for at least 3 years in order to detect any clinical symptoms suggestive of a demyelinating event. Because disease-modifying treatments are not approved in RIS and no consensus report justifies their use especially in pediatric RIS, close follow-up of OCB-positive patients is needed for early recognition of any clinical event and timely initiation of specific treatment.
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Affiliation(s)
- Deniz Yılmaz
- Department of Pediatrics, Division of Pediatric Neurology, Ankara City Hospital, Children's' Hospital, Ankara, Turkey.
| | - Serap Teber
- Department of Pediatrics, Division of Pediatric Neurology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Pembe Gültutan
- Department of Pediatrics, Division of Pediatric Neurology, Ankara City Hospital, Children's' Hospital, Ankara, Turkey
| | - Miraç Yıldırım
- Department of Pediatrics, Division of Pediatric Neurology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ömer Bektaş
- Department of Pediatrics, Division of Pediatric Neurology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Defne Alikılıç
- Department of Pediatrics, Division of Pediatric Neurology, Kocaeli University Faculty of Medicine, Ankara, Turkey
| | - Mesut Güngör
- Department of Pediatrics, Division of Pediatric Neurology, Kocaeli University Faculty of Medicine, Ankara, Turkey
| | - Bülent Kara
- Department of Pediatrics, Division of Pediatric Neurology, Kocaeli University Faculty of Medicine, Ankara, Turkey
| | - İbrahim Öncel
- Department of Pediatrics, Division of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tuğçe Damla Dilek
- Department of Pediatrics, Division of Pediatric Neurology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Sema Saltık
- Department of Pediatrics, Division of Pediatric Neurology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Seda Kanmaz
- Department of Pediatrics, Division of Pediatric Neurology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Sanem Yılmaz
- Department of Pediatrics, Division of Pediatric Neurology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Hasan Tekgül
- Department of Pediatrics, Division of Pediatric Neurology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Dilek Çavuşoğlu
- Department of Pediatrics, Division of Pediatric Neurology, Afyonkarahisar Health Science University Faculty of Medicine, Afyon, Turkey
| | - Pakize Karaoğlu
- Izmir Faculty of Medicine, Dr. Behçet Uz Children's Education and Research Hospital, Department of Pediatrics, Division of Pediatric Neurology, University of Health Sciences, Izmir, Turkey
| | - Ünsal Yılmaz
- Izmir Faculty of Medicine, Dr. Behçet Uz Children's Education and Research Hospital, Department of Pediatrics, Division of Pediatric Neurology, University of Health Sciences, Izmir, Turkey
| | - Sibğatullah Ali Orak
- Department of Pediatrics, Division of Pediatric Neurology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Olcay Güngör
- Department of Pediatrics, Division of Pediatric Neurology, Pamukkale University Faculty of Medicine, Denizli, Turkey
| | - Banu Anlar
- Department of Pediatrics, Division of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Oğuz M, Gürses D, Ufuk F, Yılmaz M, Güngör O. Successful treatment of acute myocardial injury of Duchenne muscular dystrophy with steroids: a case report. J Cardiothorac Surg 2023; 18:80. [PMID: 36869352 PMCID: PMC9985224 DOI: 10.1186/s13019-023-02159-8] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 01/24/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Duchenne muscular dystrophy (DMD) is an X-linked muscular disease which is caused by the absence of dystrophin. Troponin elevation with acute chest pain may indicate acute myocardial injury in these patients. We report a case of DMD that presented with ACP and troponin elevation, who was diagnosed with acute myocardial injury, and successfully treated with corticosteroids. CASE PRESENTATION A 9-year-old with DMD was admitted to the emergency department with the complaint of acute chest pain. His electrocardiogram (ECG) revealed inferior ST elevation and serum troponin T was elevated. The transthoracic echocardiography (TTE) demonstrated inferolateral and anterolateral hypokinesia with depressed left ventricular function. An ECG-gated coronary computed tomography angiography ruled out acute coronary syndrome. Cardiac magnetic resonance imaging revealed mid-wall to sub-epicardial late gadolinium enhancement at the basal to the mid inferior lateral wall of the left ventricle and corresponding hyperintensity on T2-weighted imaging, consistent with acute myocarditis. A diagnosis of acute myocardial injury associated with DMD was made. He was treated with anticongestive therapy and 2 mg/kg/day of oral methylprednisolone. Chest pain resolved the next day, and ST-segment elevation returned to normal on the third day. Troponin T decreased in the sixth hour of oral methylprednisolone treatment. TTE on the fifth day revealed improved left ventricular function. CONCLUSION Despite advances in contemporary cardiopulmonary therapies, cardiomyopathy remains the leading cause of death in patients with DMD. Acute chest pain attacks with elevated troponin in patients with DMD without coronary artery disease may indicate acute myocardial injury. Recognition and appropriate treatment of acute myocardial injury episodes in DMD patients may delay the development of cardiomyopathy.
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Affiliation(s)
- Merve Oğuz
- Department of Pediatric Cardiology, University of Pamukkale, Kinikli, 20100, Denizli, Turkey.
| | - Dolunay Gürses
- Department of Pediatric Cardiology, University of Pamukkale, Kinikli, 20100, Denizli, Turkey
| | - Furkan Ufuk
- Department of Radiology, University of Pamukkale, Kinikli, 20100, Denizli, Turkey
| | - Münevver Yılmaz
- Department of Pediatric Cardiology, University of Pamukkale, Kinikli, 20100, Denizli, Turkey
| | - Olcay Güngör
- Department of Pediatric Neurology, University of Pamukkale, Kinikli, 20100, Denizli, Turkey
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Becerir T, Girişgen İ, Yılmaz N, Güngör O, Ün EŞ, Sağtaş E, Yüksel S. A case with kidney transplant and cystinosis: Questions. Pediatr Nephrol 2021; 36:2143-2144. [PMID: 33730268 DOI: 10.1007/s00467-021-04997-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/01/2021] [Accepted: 02/09/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Tülay Becerir
- Department of Pediatric Nephrology, Faculty of Medicine, Pamukkale University, Kınıklı Campus, 20070, Denizli, Turkey
| | - İlknur Girişgen
- Department of Pediatric Nephrology, Faculty of Medicine, Pamukkale University, Kınıklı Campus, 20070, Denizli, Turkey
| | - Neslihan Yılmaz
- Department of Pediatric Nephrology, Faculty of Medicine, Pamukkale University, Kınıklı Campus, 20070, Denizli, Turkey
| | - Olcay Güngör
- Department of Pediatric Neurology, Faculty of Medicine, Pamukkale University, Kınıklı Campus, 20070, Denizli, Turkey
| | - Emine Şeker Ün
- Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Kınıklı Campus, 20070, Denizli, Turkey
| | - Ergin Sağtaş
- Department of Radiology, Department of Pediatric Nephrology, Faculty of Medicine,, Pamukkale University, Kınıklı Campus, 20070, Denizli, Turkey
| | - Selçuk Yüksel
- Department of Pediatric Nephrology, Faculty of Medicine, Pamukkale University, Kınıklı Campus, 20070, Denizli, Turkey.
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Acıpayam C, Güneş H, Güngör O, İpek S, Sarışık N, Demir NŞ. Cerebral atrophy in 21 hypotonic infants with severe vitamin B12 deficiency. J Paediatr Child Health 2020; 56:751-756. [PMID: 31868292 DOI: 10.1111/jpc.14733] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 07/17/2019] [Revised: 11/15/2019] [Accepted: 12/02/2019] [Indexed: 11/29/2022]
Abstract
AIM Nutritional B12 deficiency is a treatable cause of neurodevelopmental delay in infants. We report 21 infants with developmental regression and brain atrophy as revealed using cranial magnetic resonance imaging (MRI), secondary to severe vitamin B12 deficiency. METHODS Twenty-one infants aged 4-24 months with B12 deficiencies who were admitted to our clinic between May 2013 and May 2018 were included in the study. MRI, bone marrow aspiration and the Denver-II Developmental Screening Test were performed in all infants. RESULTS The mean age of the infants was 12.3 months, and the mean B12 level was 70.15 ± 32.15 ng/L. Hypotonia and neurodevelopmental retardation, and anaemia were present in all patients. Their bone marrow examinations were compatible with megaloblastic anaemia. Twelve patients had microcephaly, seven had tremor and one patient died of severe sepsis. Almost all patients were fed with breast milk and their mothers were also malnourished. Nine (42.9%) of the patients were Turkish and 12 (57.1%) were Syrian. All patients had abnormal Denver-II Developmental Screening Test scores. Most patients had severe cortical atrophy, cerebral effusion, thinning of the corpus callosum and delayed myelinisation in cranial MRI. Treatment with B12 resulted in dramatic improvement in general activity and appetite within 72 h. Tremors resolved in all cases. CONCLUSION Neurological findings and developmental delay related to nutritional B12 deficiency can be prevented without sequelae if diagnosed early. Screening and treating of mothers for this deficiency will contribute to the health of both the mother and their feeding infant.
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Affiliation(s)
- Can Acıpayam
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - Hatice Güneş
- Department of Pediatrics, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - Olcay Güngör
- Department of Pediatric Neurology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Sevcan İpek
- Department of Pediatrics, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - Nafiz Sarışık
- Department of Pediatrics, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - Nurcan Ş Demir
- Department of Pediatrics, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
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Altun H, Şahin N, Belge Kurutaş E, Güngör O. Homocysteine, Pyridoxine, Folate and Vitamin B12 Levels in Children with Attention Deficit Hyperactivity Disorder. Psychiatr Danub 2019; 30:310-316. [PMID: 30267523 DOI: 10.24869/psyd.2018.310] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND In our study, we aimed to evaluate the serum homocysteine levels, pyridoxine, folate and vitamin B12 levels in children with attention deficit hyperactivity disorders (ADHD). SUBJECTS AND METHODS This study included 30 newly diagnosed drug-naive children with ADHD (23 males and 7 female, mean age 9.3±1.8 years) and 30 sex-and age matched healthy controls. The diagnosis of ADHD was made according to DSM-V criteria. Children and adolescents were administered the Schedule for Affective Disorders and Schizophrenia for School Aged Children, Present and Lifetime Version, the Conners' Parent Rating Scale-Revised, Long Form, the Conners' Teacher Rating Scale and the Wechsler Intelligence Scale for Children Revised (WISC-R) for all participants. Homocysteine, pyridoxine, folate and vitamin B12 levels were measured with enzyme-linked immunosorbent assay. RESULTS Homocysteine, pyridoxine, folate and vitamin B12 levels were significantly lower in children with ADHD compared with their controls (p<0.05). A positive significant correlation was observed between the all WISC-R scores and vitamin B12 level in patients (r=0.408, p=0.025). CONCLUSIONS The results obtained in this study showed that reduced homocysteine, pyridoxine, folate and vitamin B12 levels could be a risk factor in the etiology of ADHD.
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Affiliation(s)
- Hatice Altun
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey,
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Altun H, Kurutaş EB, Şahin N, Güngör O, Fındıklı E. The Levels of Vitamin D, Vitamin D Receptor, Homocysteine and Complex B Vitamin in Children with Autism Spectrum Disorders. Clin Psychopharmacol Neurosci 2018; 16:383-390. [PMID: 30466210 PMCID: PMC6245292 DOI: 10.9758/cpn.2018.16.4.383] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/29/2017] [Accepted: 08/01/2017] [Indexed: 11/18/2022]
Abstract
Objective Autism spectrum disorder (ASD) is a complex neurodevelopmental syndrome with an increasingly prevalent etiology, yet not fully understood. It has been thought that vitamin D, complex B vitamin levels and homocysteine are associated with environmental factors and are important in ASD. The aim of this study was to examine serum vitamin D, vitamin D receptor (VDR), homocysteine, vitamin B6, vitamin B12 and folate levels in ASD. Methods In this study, serum vitamin D and VDR, homocysteine, vitamins B6, B12 and folate levels were determined in 60 patients with ASD (aged 3 to 12 years) and in 45 age-gender matched healthy controls. In addition, calcium, phosphorus and alkaline phosphatase, which are associated with vitamin D metabolism, were measured from serum in both groups. ASD severity was evaluted by the Childhood Autism Rating Scale (CARS). Results Serum vitamin D and VDR were substantially reduced in patients with ASD in comparision to control group. However, homocysteine level was significantly higher and vitamin B6, vitamin B12 and folate were also reduced in patients with ASD. Total CARS score showed a positive association with homocysteine and a negative correlation with vitamins D,B6, B12, folate and VDR. Conclusion This comprehensive study, which examines many parameters has shown that low serum levels of vitamins D, B6, B12, folate and VDR as well as high homocysteine are important in the etiopathogenesis of ASD. However, further studies are required to define the precise mechanism(s) of these parameters and their contributions to the etiology and treatment of ASD.
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Affiliation(s)
- Hatice Altun
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Ergül Belge Kurutaş
- Department of Biochemistry, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Nilfer Şahin
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Olcay Güngör
- Department of Pediatric Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Ebru Fındıklı
- Department of Psychiatry, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
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8
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Kırık S, Güngör O, Işıkay S, Acıpayam C, Çoban Y, Çelik E. Evaluation of two non-myasthenic patients with ptosis. Turk Pediatri Ars 2017; 52:240-243. [PMID: 29483806 PMCID: PMC5819864 DOI: 10.5152/turkpediatriars.2017.3535] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 06/20/2016] [Indexed: 06/08/2023]
Abstract
Decreased height of the eyelid or the narrowing of the lid is called ptosis. Ptosis has several causes. Malignancy-related conditions such as Horner's syndrome, which causes unilateral ptosis in the pediatric age group, and patients with malignancy receiving chemotherapeutic treatment, are often secondary to these drugs and ptosis is a clue of underlying diseases. Underlying pathologies can lead to different clinical conditions such as cognitive impairment from coma, the presence of ptosis should be cautionary. In this study, we present two patients with malignancy who were admitted with ptosis. The first patient was diagnosed as having neuroblastoma and treated with neuroblastoma-directed chemotherapeutics. The second patient was diagnosed as having acute lymphoblastic leukemia and developed vincristine-induced ptosis and recovered on treatment with pyridoxine and pyridostigmine. In conclusion, non-myasthenic ptosis may develop due to involvement of the central nervous system during malignancy or neurotoxic effects of chemotherapeutic agents. Therefore, patients who present with ptosis should be evaluated for the etiologic diagnosis.
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Affiliation(s)
- Serkan Kırık
- Sütçü İmam University, Medical Faculty, Department of Pediatrics, Division of Pediatric Neurology, Kahramanmaraş, Turkey
| | - Olcay Güngör
- Sütçü İmam University, Medical Faculty, Department of Pediatrics, Division of Pediatric Neurology, Kahramanmaraş, Turkey
| | - Sedat Işıkay
- Sütçü İmam University, Medical Faculty, Department of Pediatrics, Division of Pediatric Neurology, Kahramanmaraş, Turkey
| | - Can Acıpayam
- Sütçü İmam University, Medical Faculty, Department of Pediatrics, Division of Pediatric Hematology and Oncology, Kahramanmaraş, Turkey
| | - Yasemin Çoban
- Sütçü İmam University, Medical Faculty, Department of Pediatrics, Division of Pediatric Intensive Care, Kahramanmaraş, Turkey
| | - Emre Çelik
- Esenler Maternity and Child Health Hospital, Clinic of Pediatrics, Istanbul, Turkey
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9
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Baytunca MB, Kalyoncu T, Ozel I, Erermis S, Kayahan B, Ongur D, Aykut DS, Gül HK, Elmas TŞ, Aydın M, İlhan BÇ, Çokünlü Y, Eren İ, Ozdemir İ, Gokcen O, Kuru E, Demir E, Ünal G, Arıcıoğlu F, Nur Hazar Yavuz A, Aydın O, Balıkçı K, Taş C, Aydın PÜ, Torun D, Kayır H, Danacı AE, Ölmez SB, Ataoğlu BB, Kocagöz ZB, Yazar N, Ataoğlu A, Özçetin A, Asoğlu M, Asoğlu M, Doğan H, Öztop DB, Eker ÖO, Özsoy SD, Ekinci Ö, Okuyaz Ç, Güneş S, Direk MÇ, Ekinci N, Teke H, Kalınlı M, Yalvaç ÇT, Fidan T, Sarı BA, Özkula G, Karaokur R, Esen HTÇ, Uysal SA, Gül H, Güngör O, Sapmaz ŞY, Demirgören BS, Öztürk M, Bilaç Ö, Erkuran HÖ, Köroğlu E, Aydemir Ö, Yazici KU, Yazici IP, Ustundag B, Altun H, Şahin N, Kurutaş EB, Güngör O, Şahin N, Altun H, Belge Kurutaş E, Balkan D, Karaş H, Mutlu E, Birgül Baran S, Dayı A, Şükrü Gürbüz F, Zinnur Kılıç E, Giynas Ayhan M, Seven H, Hakan Öztürk A, Kırcı Ercan S, Demirel B, Eren İ, Selçuk M, Ibrahim Ozturk H, Atila Uygur H, Varsak N, Ozbek S, Eren I, Erdoğan A, Canan F, Ceren Pak Ş, Murat Kuloğlu M, Kuş S, Öztürk M, Özdemir İ, Kuru E, Şafak Y, Volkan Şahiner İ, Şahiner Ş, Kuru E, Ozturk M, Ozdemir İ, Volkan Sahiner İ, Safak Y, Ozdemir İ, Kuru E, Ozturk M, Volkan Sahiner İ, Safak Y, Ekinci S, Uğur Kural H, Varlık C, Ünübol H, İclal Balak Z, Bakirhan A, Yalcin Sahiner S, Safak Y, Özbek S, Güler İ, Eren İ, Yıldırım Özbek S, Er M, Demirel B, Selçuk M, Tolu İ, Ugur C, Sertceli̇k M, Uneri O, Senses Dinc G, Sekmen E, Solmaz E, Balıkçı K, Aydın O, Taş C, Ünal Aydın P, Torun D, Kayır H, Esen Danacı A, Ayrıbaş B, Sayar K, Öztürk P, Zincir S, Yükselir C, Ersan Unal F, Gıca Ş, Gürsu Hariri A, Dikeç G, Baysan Arabacı L, Uzunoğlu G, Demet Mızrak S, Yektaş Ç, Paşabeyoğlu B, Erdoğan A, Mutlu C, Demirtaş Şahin T, Utkan T, Karson A, Selcen Gocmez S, Aricioglu F, Tağcı S, Demirkaya SK, Aksu H, Badur İ, Çıtak S, Bakar B, Avcı SH, Yüksellr C, Zincir S, Öztürk P, Ataoğlu A, Ataoğlu S, Ankaralı H, Bahar Ataoğlu B, Bahar Ölmez S, Ataoğlu A, Ataoğlu S, Ankaralı H, Bahar Ataoğlu B, Bahar Ölmez S, Ulusoy Kaymak S, Norçin Demirtaş S, Uğurlu M, İlhan Atagün M, Karakaş Uğurlu G, Süleyman Can S, Koç Z, Çayköylü A, Kaşak M, Hesapçıoğlu ST, Ceylan MF, Güneş H, Hergüner S, Tanıdır C, Adaletli H, Önal Z, Kutlu E, Önal H, Münir K, Nasıroğlu S, Semerci B, Saday Duman N, Sarı Gökten E, Nadir Rana H, Özdemiroğlu F, Öykü Memiş Ç, Doğan B, Karakuş K, Sevinçok L, Çukurova M, Bağ S, Karşıdağ Ç, Şahmelikoğlu Ö, Akay Ö, Yalçın S, Kutlu G, Aykut DS, Kocagöz K, Arslan FC, Karagüzel EÖ, Tiryaki A, Ekinci Ö, Okuyaz Ç, Güneş S, Ekinci N, Örekeci G, Direk MÇ, Köroğlu E, Sayar K, Topçuoğlu V, Ataoğlu A, Ataoğlu S, Ankaralı H, Bahar Ataoğlu B, Bahar Ölmez S, Ataoğlu S, Ankaralı H, Ataoğlu A, Ankaralı S, Bahar Ataoğlu B, Bahar Ölmez S, Fındıklı E, Onur ÖŞ, Cesur E, Ünal GT, Yalçın S, Çukurova M, Bağ S, Karşıdağ Ç, Tüzer MY, Onur ÖŞ, Yalçın S, Şahmelikoğlu Onur Ö, Yalçın D, Yıldız Aydın F, Bağ S, Aytaç HM, Aydın N, Asoğlu M, Gül A, Gül H, Ceviz Ozkal U, Kıncır Z, Gültekin G, Emul M, Yeşil B, Ünal S, Asoğlu M, Ay H, Aykut DS, Civil Arslan F, Özkorumak Karagüzel E, Selçuk E, Uysal S, Çakır A, Tiryaki A, Asoğlu M, Gormez V, Cahid Örengül A, Yeşil B, Han Almış B, Kıvrak Y, Taşdelen Y, Yağcı İ, Aydın F, Kıvrak Y, Yağcı İ, Ekinci Ö, Okuyaz Ç, Güneş S, Ekinci N, Kalınlı M, Emin Tan M, Teke H, Baran SB, Kocabaş O, Öykü Memiş Ç, Doğan B, Sevinçok L, Sağlam Aykut D, Civil Arslan F, Yıldırım M, Uysal E, Güven S, Tiryaki A, Sezer G, Sezer Z, Asoğlu M, Çetin İ, Faruk Demirel Ö. 9th International Congress on Psychopharmacology & 5th International Symposium on Child and Adolescent Psychopharmacology. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1308706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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10
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Güngör O, Güngör G, Özkaya AK, Dilber C, Aydın K. A new mutation in an infant with Krabbe disease accompanied by enlargement of the optic nerves. Acta Neurol Belg 2017; 117:319-321. [PMID: 27040675 DOI: 10.1007/s13760-016-0637-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 03/24/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Olcay Güngör
- Department of Pediatric Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, 46050, Kahramanmaras, Turkey.
| | - Gülay Güngör
- Department of Radiology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Ahmet Kağan Özkaya
- Department of Pediatric Emergency, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Cengiz Dilber
- Department of Pediatric Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, 46050, Kahramanmaras, Turkey
| | - Kürşad Aydın
- Department of Pediatric Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Sahin Y, Güngör O, Ayaz A, Güngör G, Sahin B, Yaykasli K, Ceylaner S. A novel homozygous HOXB1 mutation in a Turkish family with hereditary congenital facial paresis. Brain Dev 2017; 39:166-170. [PMID: 27640920 DOI: 10.1016/j.braindev.2016.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/05/2016] [Accepted: 09/05/2016] [Indexed: 11/20/2022]
Abstract
Hereditary congenital facial paresis (HCFP) is characterized by isolated dysfunction of the facial nerve (CN VII) due to congenital cranial dysinnervation disorders. HCFP has genetic heterogeneity and HOXB1 is the first identified gene. We report the clinical, radiologic and molecular investigations of three patients admitted for HCFP in a large consanguineous Turkish family. High-throughput sequencing and Sanger sequencing of all patients revealed a novel homozygous mutation p.Arg230Trp (c.688C>T) within the HOXB1 gene. The report of the mutation brings the total number of HOXB1 mutations identified in HCFP to four. The results of this study emphasize that in individuals with congenital facial palsy accompanied by hearing loss and dysmorphic facial features, HOXB1 mutation causing HCFP should be kept in mind.
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Affiliation(s)
- Yavuz Sahin
- Department of Medical Genetics, Necip Fazıl City Hospital, Kahramanmaras, Turkey.
| | - Olcay Güngör
- Department of Pediatric Neurology, Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Akif Ayaz
- Department of Medical Genetics, Adana Research and Training Hospital, Adana, Turkey
| | - Gülay Güngör
- Department of Radiology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Bedia Sahin
- Department of Ophthalmology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Kursad Yaykasli
- Department of Medical Biology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Serdar Ceylaner
- Department of Medical Genetics, Intergen Laboratory, Ankara, Turkey
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12
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Güngör O, Özkaya AK, Şahin Y, Güngör G, Dilber C, Aydın K. A compound heterozygous EARS2 mutation associated with mild leukoencephalopathy with thalamus and brainstem involvement and high lactate (LTBL). Brain Dev 2016; 38:857-61. [PMID: 27117034 DOI: 10.1016/j.braindev.2016.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 04/06/2016] [Accepted: 04/07/2016] [Indexed: 11/18/2022]
Abstract
Mitochondrial glutamyl-tRNA synthetase is a major component of protein biosynthesis that loads tRNAs with cognate amino acids. Mutations in the gene encoding this enzyme have been associated with a variety of disorders related to oxidative phosphorylation. Here, we present a case of leukoencephalopathy with thalamus and brainstem involvement and high lactate (LTBL) presenting a biphasic clinical course characterized by delayed psychomotor development and seizure. High-throughput sequencing revealed a novel compound heterozygous mutation in mitochondrial glutamyl-tRNA synthetase 2 (EARS2), which appears to be causative of disease symptoms.
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Affiliation(s)
- Olcay Güngör
- Department of Pediatric Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
| | - Ahmet Kağan Özkaya
- Department of Pediatric Emergency, Faculty of Medicine, Cukurova University, Adana, Turkey.
| | - Yavuz Şahin
- Department of Medical Genetics, Necip Fazıl City Hospital, Kahramanmaras, Turkey.
| | - Gülay Güngör
- Department of Radiology, Necip Fazıl City Hospital, Kahramanmaras, Turkey.
| | - Cengiz Dilber
- Department of Pediatric Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
| | - Kürşad Aydın
- Department of Pediatric Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey.
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13
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Güngör O, Özkaya AK, Güngör G, Karaer K, Dilber C, Aydin K. Novel mutation in SUCLA2 identified on sequencing analysis. Pediatr Int 2016; 58:659-61. [PMID: 26952923 DOI: 10.1111/ped.12921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 08/30/2015] [Revised: 12/01/2015] [Accepted: 01/12/2016] [Indexed: 11/26/2022]
Abstract
Succinate-CoA ligase, ADP-forming, beta subunit (SUCLA2)-related mitochondrial DNA depletion syndrome is caused by mutations affecting the ADP-using isoform of the beta subunit in succinyl-CoA synthase, which is involved in the Krebs cycle. The SUCLA2 protein is found mostly in heart, skeletal muscle, and brain tissues. SUCLA2 mutations result in a mitochondrial disorder that manifests as deafness, lesions in the basal ganglia, and encephalomyopathy accompanied by dystonia. Such mutations are generally associated with mildly increased plasma methylmalonic acid, increased plasma lactate, elevated plasma carnitine esters, and the presence of methylmalonic acid in urine. In this case report, we describe a new mutation in a patient with a succinyl-CoA synthase deficiency caused by an SUCLA2 defect.
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Affiliation(s)
- Olcay Güngör
- Department of Pediatric Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Ahmet Kağan Özkaya
- Department of Pediatric Emergency, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Gülay Güngör
- Department of Radiology, Necip Fazıl City Hospital, Kahramanmaras, Turkey
| | - Kadri Karaer
- Department of Medical Genetics, Dr Ersin Arslan State Hospital, Gaziantep, Turkey
| | - Cengiz Dilber
- Department of Pediatric Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Kürşad Aydin
- Department of Pediatric Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Güngör O, Güngör G, Yurttutan N, Dilber C. Thalamic T2 hypointensity: a diagnostic clue for Tay-Sachs disease. Acta Neurol Belg 2016; 116:195-7. [PMID: 26338066 DOI: 10.1007/s13760-015-0538-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 08/27/2015] [Indexed: 10/23/2022]
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Güngör O, Kirik S, Işikay S, Güngör G, Bílal N. Concomitance of Goldenhar Syndrome with Congenital Alopecia Areata. Genet Couns 2016; 27:247-249. [PMID: 29485831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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16
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Güngör O, Özkaya AK, Dilber C, Çinar C. Intracranial saccular aneurysm in a child with only persistent headache. J Child Neurol 2015; 30:916-8. [PMID: 25156664 DOI: 10.1177/0883073814544362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 03/07/2014] [Accepted: 06/28/2014] [Indexed: 11/15/2022]
Abstract
Headache is one of the common symptoms of intracranial aneursym. A 5-year-old child lately presented to our pediatric emergency department with persistent headache. Brain magnetic resonance imaging revealed a 7×8 mm rounded lesion with slowly heterogeneous low signal in T2 sequence consistent with a partial occluded aneurysm, in the right medial frontal lobe that close to anterior cerebral artery. Intracranial aneurysms are rare in children and they are noncommon without complications as our case.
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Affiliation(s)
- Olcay Güngör
- Department of Pediatric Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Ahmet Kağan Özkaya
- Department of Pediatric Emergency, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Cengiz Dilber
- Department of Pediatric Neurology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Celal Çinar
- Department of Radiology, Faculty of Medicine, Ege University, Izmir, Turkey
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Güngör O, Kirik S, Cevizli D, Karaokur F, Ozer L, Uysal S, Dilber C. A RETT SYNDROME CASE WITH NOVEL NON-IDENTICAL MUTATION IN MECP2 GENE. Genet Couns 2015; 26:387-392. [PMID: 26852508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The Rett syndrome (RTT; OMIM #312750) is a rare genetic disease observed predominantly among girls that affects neurological development. The incidence of this disorder is approximately 1 in 10,000 female births. Diagnosis of the RTT is based on specific clinical criteria and the identification of a mutation in the methyl-CpG-binding protein (MECP), which mainly occurs on exons 3 and 4 of the gene. Mutations in the X-linked methyl-CpG binding protein 2 gene (MECP2) are observed in nearly 95% of RTT cases. RTT is associated with considerable genotypic and phenotypic heterogeneity. Recently, it has been observed that mutations in the genes Netrin G1 and cyclin-dependent kinase like 5 (CDKL5) also lead to clinical pictures resembling RTT. In this case report, we describe a 4-years-old female patient who met all the relevant criteria for the diagnosis of RTT. Sequence analyses performed on the patient identified a de novo, heterozygous c.489G>A mutation at exon 4 of the MECP2 gene.
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Özkaya AK, Güler E, Arık E, Namlı AR, Cevizli D, Güngör O. A case of congenital insensitivity to pain with anhidrosis. Turk Arch Pediatr 2014; 49:177-9. [PMID: 26078659 DOI: 10.5152/tpa.2014.1549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 12/10/2013] [Indexed: 11/22/2022]
Affiliation(s)
- Ahmet Kağan Özkaya
- Department of Pediatrics, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
| | - Ekrem Güler
- Department of Pediatrics, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
| | - Elif Arık
- Department of Pediatrics, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
| | - Ali Rıza Namlı
- Department of Pediatrics, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
| | - Derya Cevizli
- Department of Pediatrics, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
| | - Olcay Güngör
- Department of Pediatrics, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
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Güven A, Özgen T, Güngör O, Aydın M, Baysal K. Association between the corrected QT interval and carotid artery intima-media thickness in obese children. J Clin Res Pediatr Endocrinol 2010; 2:21-7. [PMID: 21274332 PMCID: PMC3005661 DOI: 10.4274/jcrpe.v2i1.21] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2009] [Accepted: 12/16/2009] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Sudden death has been reported in asymptomatic obese adults and the mechanism is unclear. In recent years, obesity has shown a dramatic increase in children and this enhances the risk factors for the development of cardiovascular disease. The aim of this study was to investigate whether there is repolarization abnormality and any potential risk factor such as increase in intima-media thickness (IMT) of carotid artery for corrected QT (QTc) prolongation among obese children. METHODS A total of 60 obese children, 30 of which had features of metabolic syndrome (MS), and 23 age-matched controls were included in the study. QTc interval was calculated at rest. The IMT of both common carotid arteries (CCA) was measured. The relationship between QTc, IMT of right and left CCA and insulin sensitivity indices were evaluated in the study group. RESULTS The QTc interval of the children with simple exogenous obesity (SEO) were longer than in the controls (p=0.024). The IMT of both carotid arteries of the obese girls and boys with and without MS were higher than the controls (p=<0.001). The QTc was significantly affected by the parameters pertaining to the right carotid artery IMT, to chronologic age and HDL-C. CONCLUSION Since obesity may cause subclinical atherosclerotic disease regardless of sex, obese children must be followed closely for early cardiovascular problems.
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Affiliation(s)
- Ayla Güven
- Göztepe Educational and Research Hospital, Clinics of Pediatric Endocrine, İstanbul, Turkey.
| | - Tolga Özgen
- Ondokuz Mayıs University Medical Faculty, Department of Pediatric Endocrinology, Samsun, Turkey
| | - Olcay Güngör
- Ondokuz Mayıs University Medical Faculty, Department of Pediatric Endocrinology, Samsun, Turkey
| | - Murat Aydın
- Ondokuz Mayıs University Medical Faculty, Department of Pediatric Endocrinology, Samsun, Turkey
| | - Kemal Baysal
- Ondokuz Mayıs University Medical Faculty, Department of Pediatric Cardiology, Samsun, Turkey
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Aygun C, Ozkaya O, Ayyýldýz S, Güngör O, Mutlu B, Küçüködük S. An unusual cause of acute renal failure in a newborn: hydrometrocolpos. Pediatr Nephrol 2006; 21:572-3. [PMID: 16523263 DOI: 10.1007/s00467-006-0022-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2005] [Revised: 10/06/2005] [Accepted: 10/17/2005] [Indexed: 10/24/2022]
Abstract
Here we report on an unusual cause of acute renal failure in a newborn: hydrometrocolpos due to imperforate hymen. Hymenotomy resolved all of the laboratory and clinical abnormalities of the patient and the baby was sent home healthy.
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Affiliation(s)
- Canan Aygun
- Department of Neonatology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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