1
|
Sarıkaya Uzan G, Yılmaz Uzman C, Çinleti T, Günay Ç, Ülgenalp A, Hız Kurul S, Yiş U. Molecular Diagnosis of Limb-Girdle Muscular Dystrophy Using Next-Generation Sequencing Panels. Mol Syndromol 2024; 15:14-21. [PMID: 38357257 PMCID: PMC10862319 DOI: 10.1159/000533976] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/01/2023] [Indexed: 02/16/2024] Open
Abstract
Introduction Limb-girdle muscular dystrophies (LGMDs) are clinically and genetically heterogeneous muscle disorders. We aimed to share the diagnostic yield of an NGS gene panel containing LGMD-related genes and our experience with LGMD. Methods Between February 2019 and October 2022, patients with a suspicion of LGMD and their relatives were reviewed in terms of demographic, clinical, and individual genetic data, age of symptom onset, sex, clinical features, LGMD types, cardiac involvement, muscle biopsy results, family history, and consanguinity. Our NGS gene panel consisted of ANO5, CAPN3, CAV3, DAG1, DES, DNAJB6, DYSF, FKTN, FLNC, FRKP, GAA, GMPPB, HNRNPDL, ISPD, LIMS2, LMNA, MYOT, PLEC, POMGNT1, POMK, POMT1, POMT2, SGCA, SGCB, SGCD, SGCG, TCAP, TNPO3, TRAPPC11, TRIM32, and TTN genes. Results The diagnosis rate was 61.1% (11/18). Twelve (80%) patients with LGMD were male and three (20%) were female. The median age was 15.9 (range, 1.5-39) years. Our patient collective was drawn up out of patients with the following variants: LGMDR1 (n = 6; 40%), LGMDR2 (n = 4; 26.6%), LGMDR3 (n = 4; 26.6%), and LGMDR12 (n = 1; 6.7%). Conclusion The present study showed that the NGS panel has a high success rate in the diagnosis of LGMD and contributes to early diagnosis.
Collapse
Affiliation(s)
- Gamze Sarıkaya Uzan
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Ceren Yılmaz Uzman
- Division of Pediatric Genetics, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Tayfun Çinleti
- Division of Pediatric Genetics, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Çağatay Günay
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Ayfer Ülgenalp
- Department of Medical Genetics, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey
| | - Semra Hız Kurul
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Uluç Yiş
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Özsoy Ö, Cinleti T, Günay Ç, Sarıkaya Uzan G, Giray Bozkaya Ö, Çağlayan AO, Hız Kurul S, Yiş U. Genetic, serological and clinical evaluation of childhood myasthenia syndromes- single center subgroup analysis experience in Turkey. Acta Neurol Belg 2023; 123:2325-2335. [PMID: 37656362 DOI: 10.1007/s13760-023-02370-3] [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: 04/04/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Congenital myasthenic syndrome is a disease that occurs due to several types such as mutations in different pre-synaptic, synaptic, post-synaptic proteins and, glycosylation defects associated with congenital myopathy. Juvenile myasthenia gravis is an autoimmune condition usually caused by antibodies targeting the acetylcholine receptor. AIMS Our objective is to conduct an analysis on the subgroup traits exhibited by patients who have been diagnosed with congenital myasthenic syndrome and juvenile myasthenia gravis, with a focus on their long-term monitoring and management. METHODS This study was conducted on children diagnosed with myasthenia gravis, who were under the care of Dokuz Eylul University's Department of Pediatric Neurology for a period of ten years. RESULTS A total of 22 (12 congenital myasthenic syndrome, 10 juvenile myasthenia gravis) patients were identified. Defects in the acetylcholine receptor (6/12) were the most common type in the congenital myasthenic syndrome group. Basal-lamina-related defects (5/12) were the second most prevalent. One patient had a GFPT1 gene mutation (1/12). Patients with ocular myasthenia gravis (n = 6) exhibited milder symptoms. In the generalized myasthenia gravis group (n = 4), specifically in postpubertal girls, a more severe clinical progression was observed, leading to the implementation of more aggressive treatment strategies. CONCLUSION This study highlights that clinical recognition of congenital myasthenic syndrome and knowledge of related genes will aid the rapid diagnosis and treatment of these rare neuromuscular disorders. Findings in the juvenile myasthenia gravis group demonstrate the impact of pubertal development and the need for timely and appropriate active therapy, including thymectomy, to improve prognosis.
Collapse
Affiliation(s)
- Özlem Özsoy
- Department of Pediatric Neurology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey.
| | - Tayfun Cinleti
- Department of Pediatric Genetics, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Çağatay Günay
- Department of Pediatric Neurology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Gamze Sarıkaya Uzan
- Department of Pediatric Neurology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Özlem Giray Bozkaya
- Department of Pediatric Genetics, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Ahmet Okay Çağlayan
- Department of Medical Genetics, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
- Department of Molecular Medicine, Institute of Health Sciences, Dokuz Eylül University, İzmir, Turkey
| | - Semra Hız Kurul
- Department of Pediatric Neurology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
- İzmir Biomedicine and Genome Center, Dokuz Eylül University Health Campus, İzmir, Turkey
- İzmir International Biomedicine and Genome Institute, Dokuz Eylül University, İzmir, Turkey
| | - Uluç Yiş
- Department of Pediatric Neurology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| |
Collapse
|
4
|
Ünalp A, Güzin Y, Ünay B, Tosun A, Çavuşoğlu D, Tekin HG, Kurul SH, Arhan E, Edizer S, Öztürk G, Yiş U, Yılmaz Ü. Retracted: Clinical and genetic evaluations of rare childhood epilepsies in Turkey's national cohort. Epileptic Disord 2023; 25:924. [PMID: 37584621 DOI: 10.1002/epd2.20150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 12/25/2022] [Accepted: 08/10/2023] [Indexed: 08/17/2023]
Abstract
Aycan Ünalp, Yiğithan Güzin, Bülent Ünay, Ayşe Tosun, Dilek Çavuşoğlu, Hande Gazeteci Tekin, Semra Hız Kurul, Ebru Arhan, Selvinaz Edizer, Gülten Öztürk, Uluç Yiş, Ünsal Yılmaz, Turkish Rare Epilepsies Study Group, Clinical and genetic evaluations of rare childhood epilepsies in Turkey's national cohort, Epileptic Disorders, 2023, (https://doi.org/10.1002/epd2.20150) The above article, published online on 16 August 2023 on Wiley Online Library (www.onlinelibrary.wiley.com), has been retracted by agreement between the authors, the Editor-in-Chief, Sándor Beniczky, and John Wiley & Sons Ltd. The authors asked for a retraction based on an experimental error which would alter the results of the study if corrected.
Collapse
|
5
|
Günay Ç, Uzan GS, Asilsoy S, Uzuner N, Kangallı Ö, Kurul SH, Yiş U. Evaluation of risk factors for recurrence of cutaneous adverse reactions due to anti-seizure medications in children: A retrospective study. Curr J Neurol 2023; 22:210-216. [PMID: 38425358 PMCID: PMC10899536 DOI: 10.18502/cjn.v22i4.14524] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/13/2023] [Indexed: 03/02/2024]
Abstract
Background: Cutaneous adverse reactions (CARs) are one of the most important reasons for anti-seizure medication (ASM) discontinuation in epilepsy. However, such discontinuations can cause an increase in seizures. This study investigates the risk factors for ASM-related rash recurrence in children. Methods: This retrospective case-control study consisted of the patient group with a single rash due to ASMs (group 1), the patient group with rash recurrence (group 2), and the control group. While the demographic and clinical features of group 1 and the control group were compared in terms of a single rash, group 1 and group 2 were compared for rash recurrence. Results: Group 1, group 2, and control group consisted of 112, 33, and 166 patients, respectively. Female gender was a risk factor for a single rash (P < 0.001) but not for recurrence (P = 0.439). Presence of atopic disease [odds ratio (OR): 9.5, 95% confidence interval (CI): 3.8-23.1, P < 0.001], family history of drug allergy (OR: 26.3, 95% CI: 9.6-72.1, P < 0.001), and polytherapy (OR: 23.5, 95% CI: 8.7-62.9, P < 0.001) were risk factors for rash recurrence. Aromatic nature of both the ASMs associated with the first rash (OR: 14.4, 95% CI: 3.2-63.2, P < 0.001) and rash recurrence (OR: 11.3, 95% CI: 4.6-27.5, P < 0.001) were determined as risk factors separately. Conclusion: Careful use of aromatic drugs may prevent recurrence of ASM-related CAR in children, particularly in cases of personal history of allergic disease and family history of drug allergy.
Collapse
Affiliation(s)
- Çağatay Günay
- Department of Pediatric Neurology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Gamze Sarıkaya Uzan
- Department of Pediatric Neurology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Suna Asilsoy
- Department of Pediatric Neurology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Nevin Uzuner
- Department of Pediatric Immunology and Allergy, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Özge Kangallı
- Department of Pediatric Immunology and Allergy, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Semra Hız Kurul
- Department of Pediatric Neurology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Uluç Yiş
- Department of Pediatric Neurology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| |
Collapse
|
6
|
Uzan GS, Günay Ç, Kurul SH, Yiş U. Double Trouble: A Case of DYT-TOR1A Diagnosed in the Postoperative Period. Ann Indian Acad Neurol 2023; 26:578-580. [PMID: 37970319 PMCID: PMC10645274 DOI: 10.4103/aian.aian_39_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 11/17/2023] Open
Affiliation(s)
- Gamze Sarıkaya Uzan
- Department of Pediatrics, Division of Child Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Çağatay Günay
- Department of Pediatrics, Division of Child Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Semra Hız Kurul
- Department of Pediatrics, Division of Child Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Uluç Yiş
- Department of Pediatrics, Division of Child Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| |
Collapse
|
7
|
Sarıkaya Uzan G, Vural A, Yüksel D, Aksoy E, Öztoprak Ü, Canpolat M, Öztürk S, Yıldırım Ç, Güleç A, Per H, Gümüş H, Okuyaz Ç, Çobanoğulları Direk M, Kömür M, Ünalp A, Yılmaz Ü, Bektaş Ö, Teber S, Aliyeva N, Olgaç Dündar N, Gençpınar P, Gürkaş E, Keskin Yılmaz S, Kanmaz S, Tekgül H, Aksoy A, Öz Tuncer G, Acar Arslan E, Tosun A, Ayanoğlu M, Kızılırmak AB, Yousefi M, Bodur M, Ünay B, Hız Kurul S, Yiş U. Pediatric-Onset Chronic Inflammatory Demyelinating Polyneuropathy: A Multicenter Study. Pediatr Neurol 2023; 145:3-10. [PMID: 37245275 DOI: 10.1016/j.pediatrneurol.2023.04.018] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/31/2023] [Accepted: 04/22/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND To evaluate the clinical features, demographic features, and treatment modalities of pediatric-onset chronic inflammatory demyelinating polyneuropathy (CIDP) in Turkey. METHODS The clinical data of patients between January 2010 and December 2021 were reviewed retrospectively. The patients were evaluated according to the Joint Task Force of the European Federation of Neurological Societies and the Peripheral Nerve Society Guideline on the management of CIDP (2021). In addition, patients with typical CIDP were divided into two groups according to the first-line treatment modalities (group 1: IVIg only, group 2: IVIg + steroid). The patients were further divided into two separate groups based on their magnetic resonance imaging (MRI) characteristics. RESULTS A total of 43 patients, 22 (51.2%) males and 21 (48.8%) females, were included in the study. There was a significant difference between pretreatment and post-treatment modified Rankin scale (mRS) scores (P < 0.05) of all patients. First-line treatments include intravenous immunoglobulin (IVIg) (n = 19, 44.2%), IVIg + steroids (n = 20, 46.5%), steroids (n = 1, 2.3%), IVIg + steroids + plasmapheresis (n = 1, 2.3%), and IVIg + plasmapheresis (n = 1, 2.3%). Alternative agent therapy consisted of azathioprine (n = 5), rituximab (n = 1), and azathioprine + mycophenolate mofetil + methotrexate (n = 1). There was no difference between the pretreatment and post-treatment mRS scores of groups 1 and 2 (P > 0.05); however, a significant decrease was found in the mRS scores of both groups with treatment (P < 0.05). The patients with abnormal MRI had significantly higher pretreatment mRS scores compared with the group with normal MRI (P < 0.05). CONCLUSIONS This multicenter study demonstrated that first-line immunotherapy modalities (IVIg vs IVIg + steroids) had equal efficacy for the treatment of patients with CIDP. We also determined that MRI features might be associated with profound clinical features, but did not affect treatment response.
Collapse
Affiliation(s)
- Gamze Sarıkaya Uzan
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
| | - Atay Vural
- Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Turkey; Department of Neurology, Koç University School of Medicine, İstanbul, Turkey
| | - Deniz Yüksel
- Faculty of Medicine, Department of Pediatric Neurology, Dr. Sami Ulus Maternity Child Health and Diseases Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Erhan Aksoy
- Faculty of Medicine, Department of Pediatric Neurology, Dr. Sami Ulus Maternity Child Health and Diseases Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ülkühan Öztoprak
- Faculty of Medicine, Department of Pediatric Neurology, Dr. Sami Ulus Maternity Child Health and Diseases Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Mehmet Canpolat
- Division of Child Neurology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Selcan Öztürk
- Division of Child Neurology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Çelebi Yıldırım
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Ayten Güleç
- Division of Child Neurology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Hüseyin Per
- Division of Child Neurology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Hakan Gümüş
- Division of Child Neurology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Çetin Okuyaz
- Division of Child Neurology, Department of Pediatrics, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Meltem Çobanoğulları Direk
- Division of Child Neurology, Department of Pediatrics, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Mustafa Kömür
- Division of Child Neurology, Department of Pediatrics, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Aycan Ünalp
- Division of Pediatric Neurology, Department of Pediatrics, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
| | - Ünsal Yılmaz
- Division of Pediatric Neurology, Department of Pediatrics, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
| | - Ömer Bektaş
- Division of Child Neurology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Serap Teber
- Division of Child Neurology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Nargiz Aliyeva
- Division of Pediatric Neurology, Department of Pediatrics, University of Health Sciences Tepecik Research and Training Hospital, İzmir, Turkey
| | - Nihal Olgaç Dündar
- Division of Child Neurology, Department of Pediatrics, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Turkey
| | - Pınar Gençpınar
- Division of Child Neurology, Department of Pediatrics, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Turkey
| | - Esra Gürkaş
- Department of Pediatric Neurology, Children's Hospital, Ankara City Hospital, Ankara, Turkey
| | - Sanem Keskin Yılmaz
- Division of Child Neurology, Department of Pediatrics, Ege University Faculty of Medicine, İzmir, Turkey
| | - Seda Kanmaz
- Division of Child Neurology, Department of Pediatrics, Ege University Faculty of Medicine, İzmir, Turkey
| | - Hasan Tekgül
- Division of Child Neurology, Department of Pediatrics, Ege University Faculty of Medicine, İzmir, Turkey
| | - Ayşe Aksoy
- Division of Child Neurology, Department of Pediatrics, On Dokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Gökçen Öz Tuncer
- Division of Child Neurology, Department of Pediatrics, On Dokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Elif Acar Arslan
- Division of Child Neurology, Department of Pediatrics, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Ayşe Tosun
- Division of Child Neurology, Department of Pediatrics, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Müge Ayanoğlu
- Division of Child Neurology, Department of Pediatrics, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Ali Burak Kızılırmak
- Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Turkey
| | - Mohammadreza Yousefi
- Koç University Research Center for Translational Medicine (KUTTAM), İstanbul, Turkey
| | - Muhittin Bodur
- Division of Child Neurology, Department of Pediatrics, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Bülent Ünay
- Gülhane Faculty of Medicine, Department of Pediatric Neurology, University of Health Sciences, Ankara, Turkey
| | - Semra Hız Kurul
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Uluç Yiş
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| |
Collapse
|
8
|
Yeşilmen MC, Günay Ç, Sarıkaya Uzan G, Özsoy Ö, Hız Kurul S, Yiş U. Immunization status of patients with spinal muscular atrophy receiving nusinersen therapy. Arch Pediatr 2023:S0929-693X(23)00055-6. [PMID: 37147157 DOI: 10.1016/j.arcped.2023.03.006] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 01/18/2023] [Accepted: 03/25/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Children with chronic neurological diseases, including spinal muscular atrophy (SMA), are particularly susceptible to vaccine-preventable infections. We aimed to evaluate the age-appropriate immunization status and its relationship with nusinersen therapy in pediatric patients with SMA. METHODS Children with SMA who received nusinersen treatment were included in this cross-sectional prospective study. Data were collected on SMA characteristics, nusinersen therapy, vaccination status according to the National Immunization Program (NIP), administration, and influenza vaccination recommendation. RESULTS A total of 32 patients were enrolled. In patients with SMA type 1, the frequency of under-vaccination of hepatitis B, BCG, DTaP-IPV-HiB, OPV, and MMR was statistically higher than in patients with SMA type 2-3 (p<0.001). The influenza vaccine was administered to only 9.3% of patients and was never recommended to 13 (40.6%) parents. The frequency of under-vaccination of hepatitis B, BCG, DTaP-IPV-HiB, OPV, and MMR was statistically higher in patients receiving nusinersen maintenance therapy than in those with loading doses (p<0.001). Physician recommendations for influenza and pneumococcal vaccines were significantly higher in the nusinersen maintenance group (p = 0.029). There was no statistical significance between the groups in terms of administration of influenza and pneumococcal vaccines (p = 0.470). CONCLUSION Children with SMA had lower immunization rates and poor compliance with immunization programs. Clinicians should ensure that children with SMA receive the same preventive health measures as healthy children, including vaccinations.
Collapse
Affiliation(s)
- Mehmet Can Yeşilmen
- Department of Pediatric Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
| | - Çağatay Günay
- Department of Pediatric Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Gamze Sarıkaya Uzan
- Department of Pediatric Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Özlem Özsoy
- Department of Pediatric Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Semra Hız Kurul
- Department of Pediatric Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Uluç Yiş
- Department of Pediatric Neurology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| |
Collapse
|
9
|
Günay Ç, Sarıkaya Uzan G, Hız Kurul S, Yiş U. Sural Sparing Pattern and Sensory Ratio as Electrodiagnostic and Prognostic Markers in Pediatric Guillain-Barré Syndrome. Neuropediatrics 2023; 54:20-30. [PMID: 36096153 DOI: 10.1055/a-1941-4513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND We aimed to evaluate the presence of sural sparing pattern (SSP) and sensory ratio in pediatric Guillain-Barré syndrome (GBS), their distribution to subtypes, and their relationship with demographic and clinical features with a focus on the disability and muscle strength. METHODS This single-center retrospective study was conducted on pediatric GBS patients of both sexes with 2 years follow-up and two nerve conduction studies in which SSP and sensory ratio were calculated. Three subgroups of SSP were formed by separate calculation of median (SSP-m) and ulnar (SSP-u) and both median and ulnar sensory nerve action potentials (SNAPs; SSP-total). Muscle strength and disability were evaluated with the Medical Research Council (MRC) sum score and Hughes functional grading scale (HFGS), respectively. RESULTS SSP total was identified in 70.6% (n: 24) of the patients, while sensory ratio >1 was observed in 20 (66.7%) patients. Patients with SSP-m, SSP-u, SSP-total, or sensory ratio >1 had higher HFGS scores, while patients with SSP-m, SSP-u, or SSP-total had lower MRC sum scores. SSP parameters were significantly associated with muscle strength and disability scores in acute motor axonal neuropathy patients. CONCLUSION Both SSP and sensory ratio can be used for diagnostic and prognostic purposes. Disability and muscle strength are associated with SSP and sensory ratio in pediatric GBS.
Collapse
Affiliation(s)
- Çağatay Günay
- Department of Pediatric Neurology, Dokuz Eylul University Faculty of Medicine, İzmir, Turkey
| | - Gamze Sarıkaya Uzan
- Department of Pediatric Neurology, Dokuz Eylul University Faculty of Medicine, İzmir, Turkey
| | - Semra Hız Kurul
- Department of Pediatric Neurology, Dokuz Eylul University Faculty of Medicine, İzmir, Turkey
| | - Uluç Yiş
- Department of Pediatric Neurology, Dokuz Eylul University Faculty of Medicine, İzmir, Turkey
| |
Collapse
|
10
|
Polat İ, Köse SŞ, Ayanoğlu M, Okur D, Bayram E, Yiş U, Asilsoy S, Kurul SH. Importance of Vitamin D Status and Nerve Conduction in Pediatric Cystic Fibrosis Patients. Journal of Pediatric Neurology 2023. [DOI: 10.1055/s-0042-1758056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AbstractCystic fibrosis is one of the most common inherited diseases. It presents with recurrent respiratory infections, pancreatic insufficiency, and growth retardation. Neurological involvement becomes more common as life expectancy increases. Chronic hypoxia, impaired glucose intolerance, autoimmune mechanisms, vasculitis changes, and micronutrient deficiencies seem to cause neuropathy in cystic fibrosis. This study was aimed to investigate peripheral neuropathy in pediatric cystic fibrosis patients. Twenty-one cystic fibrosis patients and 19 healthy control subjects between the ages of 7 and 17 years were included. Their nerve conduction study results and laboratory investigations were analyzed. Participants were classified into four groups; 1. Cystic fibrosis with vitamin D deficiency, 2. Cystic fibrosis with normal vitamin D levels, 3. Healthy subjects with vitamin D deficiency, 4. Healthy subjects with normal vitamin D levels. We found statistically significantly lower sensory median nerve sensorial nerve action potential, sensorial sural nerve conduction velocity, and motor peroneal nerve compound motor action potential in cystic fibrosis patients with vitamin D deficiency than in other cases. We also found that the main difference between cystic fibrosis and control groups was especially in patients with low vitamin D levels. Nerve damage starts at an early age, especially in cystic fibrosis patients especially those with vitamin D deficiency. Electrophysiological evaluation to assess neuropathy is important even in asymptomatic patients. Prevention of hypovitaminosis D is important to prevent neuropathy in cystic fibrosis patients.
Collapse
Affiliation(s)
- İpek Polat
- Division of Pediatric Neurology, Department of Pediatrics, Dokuz Eylul University School of Medicine, İzmir, Turkey
- Department of Molecular Biology and Genetics, İzmir International Biomedicine and Genome Institute, İzmir, Turkey
| | - Seda Şirin Köse
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Dokuz Eylul University School of Medicine, İzmir, Turkey
| | - Müge Ayanoğlu
- Division of Pediatric Neurology, Department of Pediatrics, Dokuz Eylul University School of Medicine, İzmir, Turkey
| | - Derya Okur
- Division of Pediatric Neurology, Department of Pediatrics, Dokuz Eylul University School of Medicine, İzmir, Turkey
| | - Erhan Bayram
- Division of Pediatric Neurology, Department of Pediatrics, Dokuz Eylul University School of Medicine, İzmir, Turkey
| | - Uluç Yiş
- Division of Pediatric Neurology, Department of Pediatrics, Dokuz Eylul University School of Medicine, İzmir, Turkey
| | - Suna Asilsoy
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Dokuz Eylul University School of Medicine, İzmir, Turkey
| | - Semra Hız Kurul
- Division of Pediatric Neurology, Department of Pediatrics, Dokuz Eylul University School of Medicine, İzmir, Turkey
- Department of Molecular Biology and Genetics, İzmir International Biomedicine and Genome Institute, İzmir, Turkey
| |
Collapse
|
11
|
Sarıkaya Uzan G, Paketçi C, Günay Ç, Edem P, Özsoy Ö, Hız Kurul S, Yiş U. The Effect of Nusinersen Therapy on Laboratory Parameters of Patients with Spinal Muscular Atrophy. Neuropediatrics 2022; 53:321-329. [PMID: 35871521 DOI: 10.1055/s-0042-1750719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
INTRODUCTION We evaluated the effect of nusinersen on clinical and laboratory parameters and presented its safety and effect on laboratory parameters. METHODS Two groups were formed from among patients with spinal muscular atrophy (SMA) followed up between September 2017 and June 2021: group 1, SMA type 1; group 2, SMA type 2 and 3. The laboratory parameters were evaluated in groups 1 and 2 between doses. Motor scale tests were performed on patients before each dose of nusinersen. RESULTS Twenty seven patients (group 1; n = 13, group 2; n = 14) were included. The mean age (±standard deviation) at the onset of symptoms was 3 ± 1.21 (range, 1.5-6) months in group 1 and 12 ± 4.27 (range, 8-24) months in group 2. No significant laboratory treatment-related abnormalities and adverse effects were observed. The cerebrospinal fluid protein levels and the frequency of conventional LP were higher in group 1. Serum creatinine (Cr) levels were higher in group 1 before the first dose and higher in group 2 before the fifth dose (p < 0.05). With treatment, the Cr levels of group 1 decreased and group 2 remained constant or increased. We observed that the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders and Hammersmith Functional Motor Scale-Expand scores increased as our patients received treatment (p < 0.05). CONCLUSION Our results support the safety and efficacy of nusinersen. However, changes in Cr levels according to the clinical type and treatment suggested that serum Cr could be a candidate marker for treatment follow-up.
Collapse
Affiliation(s)
- Gamze Sarıkaya Uzan
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Cem Paketçi
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Çağatay Günay
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Pınar Edem
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Özlem Özsoy
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Semra Hız Kurul
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Uluç Yiş
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| |
Collapse
|
12
|
Cingöz S, Soydemir D, Öner TÖ, Karaca E, Özden B, Kurul SH, Bayram E, Coe BP, Nickerson DA, Eichler EE. Novel biallelic variants affecting the OTU domain of the gene OTUD6B associate with severe intellectual disability syndrome and molecular dynamics simulations. Eur J Med Genet 2022; 65:104497. [PMID: 35430327 PMCID: PMC9448893 DOI: 10.1016/j.ejmg.2022.104497] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 02/13/2022] [Accepted: 03/29/2022] [Indexed: 01/25/2023]
Abstract
Intellectual developmental disorder with dysmorphic facies, seizures, and distal limb anomalies (IDDFSDA) is an autosomal recessive multisystem disorder caused by compound heterozygous or homozygous variants in the gene OTUD6B. Herein, we describe novel pathogenic compound heterozygous variants in OTUD6B identified via whole-exome sequencing in an index case exhibited the severe IDDFSDA phenotype. The potential pathogenicity of the novel frameshift and missense variants in the index case was investigated using in silico tools. The truncating frameshift variant in one allele was predicted to undergo degradation via nonsense-mediated decay of the mRNA molecule. To predict the severity of the damage to the protein caused by the missense variant in the other allele and its effects on phenotypic severity was further investigated together with a previously reported first homozygous missense variant in the same domain in another patient with a less severe IDDFSDA phenotype using structural modeling and molecular dynamics (MD) simulations for the first time. Based on these analyzes, it is anticipated that Tyr216Cys in the earlier reported case with less severe IDDFSDA will lead to localized destabilization, whereas Ile274Arg in the presented index case with the severe IDDFSDA phenotype will lead to significant distortion in the overall fold of OTUD6B. Our findings suggest that compound LOF and ultrarare missense variants may be contribute to the underlying variability expressivity associated with this disorder. In conclusion, our findings support that the clinical severity could be related with the predicted functional severity of the variations in OTUD6B. However, additional functional studies are required.
Collapse
Affiliation(s)
- Sultan Cingöz
- Department of Medical Biology and Genetics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA.
| | - Didem Soydemir
- Department of Pediatrics, Division of Child Neurology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Tülay Öncü Öner
- Department of Medical Biology and Genetics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ezgi Karaca
- Izmir Biomedicine and Genome Center, Dokuz Eylul Health Campus, Izmir, Turkey; Izmir International Biomedicine and Genome Institute, Dokuz Eylul University, Izmir, Turkey
| | - Burcu Özden
- Izmir Biomedicine and Genome Center, Dokuz Eylul Health Campus, Izmir, Turkey; Izmir International Biomedicine and Genome Institute, Dokuz Eylul University, Izmir, Turkey
| | - Semra Hız Kurul
- Department of Pediatrics, Division of Child Neurology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Izmir Biomedicine and Genome Center, Dokuz Eylul Health Campus, Izmir, Turkey
| | - Erhan Bayram
- Department of Pediatrics, Division of Child Neurology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Bradley P Coe
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Deborah A Nickerson
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Evan E Eichler
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA; Howard Hughes Medical Institute, University of Washington, Seattle, WA, USA
| |
Collapse
|
13
|
Polat İ, Karaoğlu P, Şişman AR, Yiş U, Hız Kurul S. Inflammation and endothelial dysfunction in pediatric migraine patients. Pediatr Int 2022; 64:e14946. [PMID: 34358404 DOI: 10.1111/ped.14946] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/07/2021] [Accepted: 07/27/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Inflammation and endothelial dysfunction are the suggested underlying mechanisms in migraine. Pentraxins, C-reactive protein, erythrocyte sedimentation rate, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio are good indicators of inflammation. Alterations in insulin levels and insulin sensitivity may trigger endothelial dysfunction. This study evaluates the association between migraine and serum biomarkers of inflammation and endothelial dysfunction in children. METHODS Children with migraine and healthy subjects were recruited. Serum samples were obtained in an attack-free period. We collected data on serum levels of complete blood cell count, C-reactive protein, erythrocyte sedimentation rate, pentraxin-3, and data from biochemical investigations. We compared these with clinical data such as age, sex, disease duration, attack frequency, attack duration, analgesic use, family history, and Pediatric Migraine Disability Assessment Questionnaire scores. RESULTS We assessed samples from 32 children (11 boys, 21 girls) with migraine and 19 healthy controls (8 boys, 11 girls). We found significantly higher pentraxin-3, insulin, and insulin resistance in patients with migraine (P = 0.001, P = 0.032, and P = 0.008, respectively). A positive directional correlation is found between pentraxin-3 and Pediatric Migraine Disability Assessment Questionnaire scores. The best cut-off values for pentraxin-3 is determined between 12.75 pg/mL to 15 pg/mL in migraineurs. CONCLUSIONS In conclusion increased pentraxin-3 levels support the suggestions that inflammation plays a role in pediatric migraine. The vascular endothelial dysfunction is observed by a rise in insulin and insulin resistance levels. Our findings support the idea that ongoing inflammation and vascular endothelial dysfunction between attacks may play a role in migraine pathogenesis in children.
Collapse
Affiliation(s)
- İpek Polat
- Department of Pediatric Neurology, Dokuz Eylül University, School of Medicine, Izmir, Turkey.,Izmir International Biomedicine and Genom Institute, Dokuz Eylül University, Izmir, Turkey
| | - Pakize Karaoğlu
- Department of Pediatric Neurology, Dokuz Eylül University, School of Medicine, Izmir, Turkey
| | - Ali Rıza Şişman
- Department of Biochemistry, Dokuz Eylül University, School of Medicine, Izmir, Turkey
| | - Uluç Yiş
- Department of Pediatric Neurology, Dokuz Eylül University, School of Medicine, Izmir, Turkey
| | - Semra Hız Kurul
- Department of Pediatric Neurology, Dokuz Eylül University, School of Medicine, Izmir, Turkey.,Izmir International Biomedicine and Genom Institute, Dokuz Eylül University, Izmir, Turkey
| |
Collapse
|
14
|
Paketçi C, Edem P, Okur D, Sarıoğlu FC, Güleryüz H, Bayram E, Kurul SH, Yiş U. Rotavirus encephalopathy with concomitant acute cerebellitis: report of a case and review of the literature. Turk J Pediatr 2021; 62:119-124. [PMID: 32253876 DOI: 10.24953/turkjped.2020.01.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Rotavirus is a leading cause of gastroenteritis in children under 5 years of age. It is known that neurological manifestations like seizures, encephalopathy and encephalitis can rarely be seen due to rotavirus infections. Cerebellar involvement is extremely rare. We present an uncommon neurological manifestation of rotavirus infection in a 4-year-old Turkish child who presented with hypotonia, reduced consciousness and mutism. Magnetic resonance imaging revealed diffusion abnormalities in the splenium of corpus callosum and nucleus dentatus bilaterally. She was diagnosed with rotavirus cerebellitis. She improved well with dexamethasone and intravenous immunoglobulin but still has dysarthria and poor fine motor coordination.
Collapse
Affiliation(s)
- Cem Paketçi
- Divisions of Pediatric Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Pınar Edem
- Divisions of Pediatric Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Derya Okur
- Divisions of Pediatric Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Fatma Ceren Sarıoğlu
- Pediatric Radiology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Handan Güleryüz
- Pediatric Radiology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Erhan Bayram
- Divisions of Pediatric Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Semra Hız Kurul
- Divisions of Pediatric Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Uluç Yiş
- Divisions of Pediatric Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| |
Collapse
|
15
|
Polat İ, Yiş U, Ayanoğlu M, Okur D, Edem P, Paketçi C, Bayram E, Hız Kurul S. Risk Factors of Post-Stroke Epilepsy in Children; Experience from a Tertiary Center and a Brief Review of the Literature. J Stroke Cerebrovasc Dis 2020; 30:105438. [PMID: 33197802 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105438] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 10/02/2020] [Accepted: 10/29/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Acute seizures and post-stroke epilepsy have been reported more frequently in patients with pediatric stroke than adults. Acute seizures in the first days of a stroke may deteriorate stroke and ischemia-related neurodegeneration and contribute to the development of post-stroke epilepsy. In this study, we aimed to investigate risk factors for the development of post-stroke epilepsy in children with arterial ischemic stroke. MATERIALS AND METHODS We recruited 86 children with arterial ischemic stroke. We analyzed variables, including age at admission, gender, complaints at presentation, focal or diffuse neurologic signs, neurologic examination findings, laboratory investigations that were conducted at admission with stroke (complete blood cell count, biochemical-infectious-metabolic-immunological investigations, vitamin B12 levels, vitamin D levels), neuroimaging results, etiologies, time of the first seizure, time of remote seizures, and development of neurologic deficit retrospectively. Seizures during the first six hours after stroke onset were defined as 'very early seizures'. 'Early seizures' were referred to seizures during the first 48 h. Patients who experienced two or more seizures that occurred after the acute phase of seizures were classified as 'epileptic.' A binary logistic regression analysis was used to estimate risk factors. RESULTS An acute seizure was detected in 59% and post-stroke epilepsy developed in 41% of our cohort. Binary logistic regression analysis demonstrated that 'very early seizures' increased epilepsy risk six-fold. Epilepsy was 16 times higher in patients with 'early seizures'. Low vitamin D levels were defined as a risk factor for post-stroke epilepsy. CONCLUSION Seizures in the very early period (within the first six hours) are the most significant risk factors for the development of post-stroke epilepsy Further studies regarding seizure prevention and neuroprotective therapies are needed because post-stroke epilepsy will affect long term prognosis in patients with pediatric stroke.
Collapse
Affiliation(s)
- İpek Polat
- Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey.
| | - Uluç Yiş
- Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey.
| | - Müge Ayanoğlu
- Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey.
| | - Derya Okur
- Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey.
| | - Pınar Edem
- Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey.
| | - Cem Paketçi
- Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey.
| | - Erhan Bayram
- Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey.
| | - Semra Hız Kurul
- Department of Pediatric Neurology, Dokuz Eylul University, Faculty of Medicine, İzmir, Narlıdere, Turkey.
| |
Collapse
|
16
|
Gürsoy S, Ataman E, Bozkaya ÖG, Köse E, Ayanoğlu M, Polat Aİ, Arslan N, Kurul SH, Erçal D. Identification of the largest homozygous glycine decarboxylase gene deletion in a Turkish infant. Pediatr Neonatol 2018; 59:632-633. [PMID: 29398553 DOI: 10.1016/j.pedneo.2018.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 07/12/2017] [Accepted: 01/12/2018] [Indexed: 10/18/2022] Open
Affiliation(s)
- Semra Gürsoy
- Department of Pediatric Genetics, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey.
| | - Esra Ataman
- Department of Medical Genetics, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| | - Özlem Giray Bozkaya
- Department of Pediatric Genetics, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| | - Engin Köse
- Department of Pediatric Metabolism, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| | - Müge Ayanoğlu
- Department of Pediatric Neurology, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| | - Ayşe İpek Polat
- Department of Pediatric Neurology, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| | - Nur Arslan
- Department of Pediatric Metabolism, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| | - Semra Hız Kurul
- Department of Pediatric Neurology, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| | - Derya Erçal
- Department of Pediatric Genetics, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| |
Collapse
|
17
|
Yılmaz Ü, Anlar B, Gücüyener K, Cansu A, Ünalp A, Aksoy A, Bayram AK, Kartal A, Tosun A, Serdaroğlu A, Konuşkan B, Sarıoğlu B, Yüzbaşı BK, Kılıç B, Taşkın BD, Bulut C, Yılmaz C, Yarar C, Okuyaz Ç, Gençsel Ç, Yüksel D, Arslan EA, Gürkaş E, Faruk incecik, Serdaroğlu G, Deda G, Gürbüz G, Gümüş H, Acer H, Tekgül H, Çaksen H, Per H, Erol İ, Çarman KB, Canpolat M, Özkan M, Direk MÇ, Kutluk MG, Arslan M, Sönmez FM, Dündar NO, Koçak O, Aydın ÖF, Toptaş Ö, Duman Ö, Hergüner Ö, Bozkurt Ö, Arıcan P, Yılmaz S, Gökben S, Işıkay S, Kumandaş S, Edizer S, Kurul SH, Saygı S, Teber S, Güngör S, Altunbaşak Ş, Haspolat Ş, Sezer T, Yılmaz TS, Yiş U, Öztoprak Ü, Aydoğmuş Ü, Topçu Y, Öztürk Z, Karalök ZS. Characteristics of pediatric multiple sclerosis: The Turkish pediatric multiple sclerosis database. Eur J Paediatr Neurol 2017; 21:864-872. [PMID: 28694135 DOI: 10.1016/j.ejpn.2017.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 06/29/2016] [Revised: 05/26/2017] [Accepted: 06/20/2017] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To document the clinical and paraclinical features of pediatric multiple sclerosis (MS) in Turkey. METHODS Data of MS patients with onset before age 18 years (n = 193) were collected from 27 pediatric neurology centers throughout Turkey. Earlier-onset (<12 years) and later-onset (≥12 years) groups were compared. RESULTS There were 123 (63.7%) girls and 70 (36.3%) boys aged 4-17 years, median 14 years at disease onset. Family history of MS was 6.5%. The first presentation was polysymptomatic in 55.4% of patients, with brainstem syndromes (50.3%), sensory disturbances (44%), motor symptoms (33.2%), and optic neuritis (26.4%) as common initial manifestations. Nineteen children had facial paralysis and 10 had epileptic seizures at first attack; 21 (11%) were initially diagnosed with acute disseminated encephalomyelitis (ADEM). Oligoclonal bands were identified in 68% of patients. Magnetic resonance imaging revealed periventricular (96%), cortical/juxtacortical (64.2%), brainstem (63%), cerebellum (51.4%), and spinal cord (67%) involvement. Visual evoked potentials (VEP) were abnormal in 52%; serum 25-hydroxyvitamin D levels were low in 68.5% of patients. The earlier-onset group had a higher rate of infection/vaccination preceding initial attack, initial diagnosis of ADEM, longer interval between first 2 attacks, and more disability accumulating in the first 3 years of the disease. CONCLUSION Brainstem and cerebellum are common sites of clinical and radiological involvement in pediatric-onset MS. VEP abnormalities are frequent even in patients without history of optic neuropathy. Vitamin D status does not appear to affect the course in early disease. MS beginning before 12 years of age has certain characteristics in history and course.
Collapse
Affiliation(s)
- Ünsal Yılmaz
- Department of Pediatric Neurology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.
| | - Banu Anlar
- Department of Pediatric Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kıvılcım Gücüyener
- Department of Pediatric Neurology, Gazi University Faculty of Medicine, Ankara, Turkey
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Yiş U, Becker K, Kurul SH, Uyanik G, Bayram E, Haliloğlu G, Polat Aİ, Ayanoğlu M, Okur D, Tosun AF, Serdaroğlu G, Yilmaz S, Topaloğlu H, Anlar B, Cirak S, Engel AG. Genetic Landscape of Congenital Myasthenic Syndromes From Turkey: Novel Mutations and Clinical Insights. J Child Neurol 2017; 32:759-765. [PMID: 28464723 PMCID: PMC5655993 DOI: 10.1177/0883073817705252] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Congenital myasthenic syndromes are clinically and genetically heterogeneous disorders of neuromuscular transmission. Most are treatable, but certain subtypes worsen with cholinesterase inhibitors. This underlines the importance of genetic diagnosis. Here, the authors report on cases with genetically proven congenital myasthenic syndromes from Turkey. The authors retrospectively reviewed their experience of all patients with congenital myasthenic syndromes, referred over a 5-year period (2011-2016) to the Child Neurology Department of Dokuz Eylül University, Izmir, Turkey. In addition, PubMed was searched for published cases of genetically proven congenital myasthenic syndromes originating from Turkey. In total, the authors identified 43 (8 new patients, 35 recently published patients) cases. Defects in the acetylcholine receptor (n = 15; 35%) were the most common type, followed by synaptic basal-lamina associated (n = 14; 33%) and presynaptic syndromes (n = 10; 23%). The authors had only 3 cases (7%) who had defects in endplate development. One patient had mutation GFPT1 gene (n = 1; 2%). Knowledge on congenital myasthenic syndromes and related genes in Turkey will lead to prompt diagnosis and treatment of these rare neuromuscular disorders.
Collapse
Affiliation(s)
- Uluç Yiş
- Dokuz Eylül University, School of Medicine, Department of Pediatrics, Division of Child Neurology, İzmir, TURKEY
| | - Kerstin Becker
- Cologne University, Department of Pediatrics, Center for Molecular Medicine Cologne, Cologne, GERMANY
| | - Semra Hız Kurul
- Dokuz Eylül University, School of Medicine, Department of Pediatrics, Division of Child Neurology, İzmir, TURKEY
| | - Gökhan Uyanik
- Center for Medical Genetics, Hanusch Hospital, Vienna, AUSTRIA
- Medical Faculty, Sigmund Freud University, Vienna, AUSTRIA
| | - Erhan Bayram
- Dokuz Eylül University, School of Medicine, Department of Pediatrics, Division of Child Neurology, İzmir, TURKEY
| | - Göknur Haliloğlu
- Hacettepe University, School of Medicine, Department of Pediatrics, Division of Child Neurology, Ankara, TURKEY
| | - Ayşe İpek Polat
- Dokuz Eylül University, School of Medicine, Department of Pediatrics, Division of Child Neurology, İzmir, TURKEY
| | - Müge Ayanoğlu
- Dokuz Eylül University, School of Medicine, Department of Pediatrics, Division of Child Neurology, İzmir, TURKEY
| | - Derya Okur
- Dokuz Eylül University, School of Medicine, Department of Pediatrics, Division of Child Neurology, İzmir, TURKEY
| | - Ayşe Fahriye Tosun
- Adnan Menderes University, School of Medicine, Department of Pediatrics, Division of Child Neurology, Aydın, TURKEY
| | - Gül Serdaroğlu
- Ege University, School of Medicine, Department of Pediatrics, Division of Child Neurology, İzmir, TURKEY
| | - Sanem Yilmaz
- Ege University, School of Medicine, Department of Pediatrics, Division of Child Neurology, İzmir, TURKEY
| | - Haluk Topaloğlu
- Hacettepe University, School of Medicine, Department of Pediatrics, Division of Child Neurology, Ankara, TURKEY
| | - Banu Anlar
- Hacettepe University, School of Medicine, Department of Pediatrics, Division of Child Neurology, Ankara, TURKEY
| | - Sebahattin Cirak
- Cologne University, Department of Pediatrics, Center for Molecular Medicine Cologne, Cologne, GERMANY
| | - Andrew G. Engel
- Mayo Clinic, Rochester, Department of Neurology, MN 55905, USA
| |
Collapse
|
19
|
Polat İ, Yiş U, Karaoğlu P, Ayanoğlu M, Öztürk T, Güleryüz H, Kurul SH. Myelin Oligodendrocyte Glycoprotein Antibody Persistency in a Steroid-Dependent ADEM Case. Pediatrics 2016; 137:peds.2015-1958. [PMID: 27244783 DOI: 10.1542/peds.2015-1958] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2016] [Indexed: 11/24/2022] Open
Abstract
Myelin oligodendrocyte glycoprotein (MOG) is a candidate target antigen in demyelinating central nervous system diseases, including acute disseminated encephalomyelitis (ADEM), neuromyelitis optica, and multiple sclerosis. It may give prognostic information regarding monophasic or recurrent course of the disease. MOG antibodies have been shown to be positive in high titers during the first episode of ADEM with rapidly decreasing to undetectable limits after recovery. However, persistent MOG antibodies are considered as a predicting factor for multiple sclerosis, optic neuritis relapses, and incomplete recovery of ADEM. Here we report a unique case with persistent MOG antibodies presented with multiphasic ADEM-like attacks. A 6-year-old girl was consulted with encephalopathy, gait disturbance, and oculomotor nerve palsy. Periventricular white matter lesions were seen on cranial magnetic resonance imaging studies. ADEM was diagnosed and treated with steroid. During follow-up, she experienced repeated episodes after steroid therapy termination. We were able to search MOG antibody at the ninth attack. The positivity of this antibody remained. It was thought to be associated with steroid-dependent course, and azathioprine and intravenous human immunoglobulin treatment were added. Patients with persistent MOG antibodies may benefit from addition of immunosuppressant agents, which may decrease the number of attacks.
Collapse
Affiliation(s)
| | - Uluç Yiş
- Departments of Pediatric Neurology, and
| | | | | | - Tülay Öztürk
- Pediatric Radiology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Handan Güleryüz
- Pediatric Radiology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | | |
Collapse
|
20
|
Yiş U, Ayanoğlu M, Polat Aİ, Güleryüz H, Kurul SH. An infant with hypomotor seizures and cutaneous lesions. Acta Neurol Belg 2015; 115:687-8. [PMID: 25549608 DOI: 10.1007/s13760-014-0414-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 12/17/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Uluç Yiş
- Division of Child Neurology, Department of Pediatrics, School of Medicine, Dokuz Eylül University, İzmir, Turkey.
| | - Müge Ayanoğlu
- Division of Child Neurology, Department of Pediatrics, School of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Ayşe İpek Polat
- Division of Child Neurology, Department of Pediatrics, School of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Handan Güleryüz
- Department of Pediatric Radiology, School of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Semra Hız Kurul
- Division of Child Neurology, Department of Pediatrics, School of Medicine, Dokuz Eylül University, İzmir, Turkey
| |
Collapse
|
21
|
Yiş U, Ezgü FS, Karakaya P, Polat İ, Arslan N, Çankaya T, Bozkaya ÖG, Kurul SH. A novel mutation in the mitochondrial DNA cytochrome b gene (MTCYB) in a patient with Prader Willi syndrome. J Child Neurol 2015; 30:378-81. [PMID: 24771578 DOI: 10.1177/0883073814530499] [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] [Indexed: 11/17/2022]
Abstract
In recent years, it has been suggested that defects in energy metabolism may accompany Prader Willi syndrome. Mutations in the mitochondrial cytochrome b gene have been commonly associated isolated mitochondrial myopathy and exercise intolerance, rarely with multisystem disorders. The authors describe a novel mutation (mt. 15209T>C) in mitochondrial cytochrome b gene in a 2-year-old girl with Prader-Willi syndrome with a clinical history of lactic acidosis attacks, renal sodium loss, hepatopathy, progressive cerebral atrophy, and sudden death. The authors suggest that atypical clinical findings in patients with Prader-Willi syndrome should direct the physician to search for a mitochondrial disease.
Collapse
Affiliation(s)
- Uluç Yiş
- Department of Pediatrics, Division of Child Neurology, Dokuz Eylül University, School of Medicine, İzmir, Turkey
| | - Fatih Süheyl Ezgü
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Gazi University, School of Medicine, Ankara, Turkey
| | - Pakize Karakaya
- Department of Pediatrics, Division of Child Neurology, Dokuz Eylül University, School of Medicine, İzmir, Turkey
| | - İpek Polat
- Department of Pediatrics, Division of Child Neurology, Dokuz Eylül University, School of Medicine, İzmir, Turkey
| | - Nur Arslan
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Dokuz Eylül University, School of Medicine, Ankara, Turkey
| | - Tufan Çankaya
- Department of Pediatrics, Division of Genetics, Dokuz Eylül University, School of Medicine, Ankara, Turkey
| | - Özlem Giray Bozkaya
- Department of Pediatrics, Division of Genetics, Dokuz Eylül University, School of Medicine, Ankara, Turkey
| | - Semra Hız Kurul
- Department of Pediatrics, Division of Child Neurology, Dokuz Eylül University, School of Medicine, İzmir, Turkey
| |
Collapse
|
22
|
Yiş U, Tüfekçi UK, Genç Ş, Çarman KB, Bayram E, Topçu Y, Kurul SH. Expression patterns of micro-RNAs 146a, 181a, and 155 in subacute sclerosing panencephalitis. J Child Neurol 2015; 30:69-74. [PMID: 24789113 DOI: 10.1177/0883073814531329] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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] [Indexed: 11/15/2022]
Abstract
Subacute sclerosing panencephalitis is caused by persistent brain infection of mutated virus, showing inflammation, neurodegeneration, and demyelination. Although many factors are emphasized in the pathogenesis of subacute sclerosing panencephalitis, the exact mechanism of neurodegeneration remains unknown. Micro-RNAs are small, noncoding RNAs that regulate gene expression at the posttranscriptional levels. Micro-RNAs are essential for normal immune system development; besides they are also implicated in the pathogenesis of many chronic inflammatory disorders. The aim of this study is to investigate the expression patterns of micro-RNAs 146a, 181a, and 155 in peripheral blood mononuclear cells of patients with subacute sclerosing panencephalitis. We enrolled 39 patients with subacute sclerosing panencephalitis and 41 healthy controls. Quantitative analysis of micro-RNAs 146a, 181a, and 155 were performed using specific stem-loop primers followed by real-time polymerase chain reaction. All of 3 micro-RNAs were upregulated in subacute sclerosing panencephalitis patients. In addition, the level of micro-RNA 155 expression was higher in stage 3 patients. But, micro-RNA 146a and 181a expression levels showed no association or correlation with clinically relevant data. Alteration of peripheral blood mononuclear cell micro-RNAs in subacute sclerosing panencephalitis may shed new light on the pathogenesis of disease and may contribute to the aberrant systemic rise in mRNA levels in subacute sclerosing panencephalitis.
Collapse
Affiliation(s)
- Uluç Yiş
- School of Medicine, Department of Pediatrics, Division of Child Neurology, Dokuz Eylül University, İzmir, Turkey
| | - Uğur Kemal Tüfekçi
- Health Science Institute, Department of Neuroscience, Dokuz Eylül University, İzmir, Turkey
| | - Şermin Genç
- Health Science Institute, Department of Neuroscience, Dokuz Eylül University, İzmir, Turkey
| | - Kürşat Bora Çarman
- Gaziantep Children's Hospital, Division of Child Neurology, Gaziantep, Turkey
| | - Erhan Bayram
- School of Medicine, Department of Pediatrics, Division of Child Neurology, Dokuz Eylül University, İzmir, Turkey
| | - Yasemin Topçu
- School of Medicine, Department of Pediatrics, Division of Child Neurology, Dokuz Eylül University, İzmir, Turkey
| | - Semra Hız Kurul
- School of Medicine, Department of Pediatrics, Division of Child Neurology, Dokuz Eylül University, İzmir, Turkey
| |
Collapse
|
23
|
Topçu Y, Bayram E, Karaoğlu P, Yiş U, Kurul SH. Importance of acylcarnitine profile analysis for disorders of lipid metabolism in adolescent patients with recurrent rhabdomyolysis: Report of two cases. Ann Indian Acad Neurol 2014; 17:437-40. [PMID: 25506168 PMCID: PMC4251020 DOI: 10.4103/0972-2327.144031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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: 01/19/2014] [Revised: 02/12/2014] [Accepted: 03/16/2014] [Indexed: 11/06/2022] Open
Abstract
Metabolic myopathies due to disorders of lipid metabolism are a heterogeneous group of diseases. Newborns may present with hypotonia and convulsions, while progressive proximal muscle weakness or recurrent episodes of muscle weakness accompanied by rhabdomyolysis/myoglobinuria may be seen in older ages. There is little knowledge on detection of disorders of lipid metabolism by acylcarnitine profile (ACP) analysis by tandem mass spectrometry outside the neonatal period particularly in cases with recurrent rhabdomyolysis first presenting in adolescence and adulthood. Two adolescent female cases presented with episodes of rhabdomyolysis and muscle weakness. A 13-year-old patient had five episodes of rhabdomyolysis triggered by infections. Tandem mass spectrometry was normal. A 16-year-old female patient was hospitalized eight times due to recurrent rhabdomyolysis. Increased levels of C14:2, C14:1, and C14 were determined in tandem mass spectrometry. Final diagnoses were carnitine palmitoyltransferase II (CPT II) deficiency and very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency. Increased serum levels of long-chain acylcarnitine can guide to the diagnosis of lipid metabolism disorders. Serum ACP should be performed before enzyme assay and genetic studies.
Collapse
Affiliation(s)
- Yasemin Topçu
- Department of Pediatrics, Division of Pediatric Neurology, Dokuz Eylul University Medical Faculty, Izmir, Turkey
| | - Erhan Bayram
- Department of Pediatrics, Division of Pediatric Neurology, Dokuz Eylul University Medical Faculty, Izmir, Turkey
| | - Pakize Karaoğlu
- Department of Pediatrics, Division of Pediatric Neurology, Dokuz Eylul University Medical Faculty, Izmir, Turkey
| | - Uluç Yiş
- Department of Pediatrics, Division of Pediatric Neurology, Dokuz Eylul University Medical Faculty, Izmir, Turkey
| | - Semra Hız Kurul
- Department of Pediatrics, Division of Pediatric Neurology, Dokuz Eylul University Medical Faculty, Izmir, Turkey
| |
Collapse
|
24
|
Topçu Y, Bayram E, Ozbal S, Yiş U, Tuğyan K, Karaoğlu P, Kumral A, Yılmaz O, Kurul SH. Zonisamide attenuates hyperoxia-induced apoptosis in the developing rat brain. Neurol Sci 2014; 35:1769-75. [PMID: 24916835 DOI: 10.1007/s10072-014-1834-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 05/13/2014] [Indexed: 11/29/2022]
Abstract
Oxygen therapy used in the treatment of perinatal hypoxia induces neurodegeneration in babies with immature antioxidant mechanisms. Zonisamide is a new antiepileptic drug used in childhood intractable seizures. Many studies demonstrated its neuroprotective effects. There is no study evaluating its effect on hyperoxic brain injury. The aim of this study was to investigate the neuroprotective effect of zonisamide on hyperoxia-induced neonatal brain injury. A total of 21 Wistar rat pups were used. The animals were divided into three groups: control group, hyperoxia group, and zonisamide-treated group. The zonisamide-treated group received an intraperitoneal injection of zonisamide. Zonisamide significantly preserved the number of neurons in CA1 and dentate gyrus parts of hippocampus, prefrontal, and parietal cortex. Zonisamide treatment also decreased the number of apoptotic neurons in all examined parts of hippocampus, prefrontal, and parietal cortex. We suggest that zonisamide treatment may be used as a neuroprotective agent in hyperoxic brain injury.
Collapse
Affiliation(s)
- Yasemin Topçu
- Division of Pediatric Neurology, Department of Pediatrics, Dokuz Eylul University Medical Faculty, İzmir, Turkey,
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Affiliation(s)
- Yasemin Topcu
- Department of Pediatrics, Division of Child Neurology, School of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Erhan Bayram
- Department of Pediatrics, Division of Child Neurology, School of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Pakize Karaoglu
- Department of Pediatrics, Division of Child Neurology, School of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Uluc Yis
- Department of Pediatrics, Division of Child Neurology, School of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Semra Hız Kurul
- Department of Pediatrics, Division of Child Neurology, School of Medicine, Dokuz Eylül University, İzmir, Turkey
| |
Collapse
|
26
|
Yiş U, Kalemci O, Polat I, Karaoğlu P, Oztura I, Güleryüz H, Kurul SH. Chronic spinal epidural hematoma. J Pediatr 2014; 164:215-215.e1. [PMID: 24119875 DOI: 10.1016/j.jpeds.2013.08.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 08/21/2013] [Indexed: 11/15/2022]
Affiliation(s)
- Uluç Yiş
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University, School of Medicine, İzmir, Turkey
| | - Orhan Kalemci
- Department of Neurosurgery, Dokuz Eylül University, School of Medicine, İzmir, Turkey
| | - Ipek Polat
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University, School of Medicine, İzmir, Turkey
| | - Pakize Karaoğlu
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University, School of Medicine, İzmir, Turkey
| | - Ibrahim Oztura
- Department of Neurology, Dokuz Eylül University, School of Medicine, İzmir, Turkey
| | - Handan Güleryüz
- Department of Pediatric Radiology, Dokuz Eylül University, School of Medicine, İzmir, Turkey
| | - Semra Hız Kurul
- Division of Child Neurology, Department of Pediatrics, Dokuz Eylül University, School of Medicine, İzmir, Turkey
| |
Collapse
|
27
|
Yiş U, Topçu Y, Özbal S, Tuğyan K, Bayram E, Karakaya P, Yilmaz O, Kurul SH. Caffeic acid phenethyl ester prevents apoptotic cell death in the developing rat brain after pentylenetetrazole-induced status epilepticus. Epilepsy Behav 2013; 29:275-80. [PMID: 24012504 DOI: 10.1016/j.yebeh.2013.08.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [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: 04/23/2013] [Revised: 07/30/2013] [Accepted: 08/04/2013] [Indexed: 12/29/2022]
Abstract
Population-based studies suggest that seizure incidence is highest during the first year of life, and early-life seizures frequently result in the development of epilepsy and behavioral alterations later in life. The early-life insults like status epilepticus often lead to epileptogenesis, a process in which initial brain injury triggers cascades of molecular, cellular, and network changes and eventually spontaneous seizures. Caffeic acid phenethyl ester is an active component of propolis obtained from honeybees and has neuroprotective properties. The aim of this study was to investigate whether caffeic acid phenethyl ester exerts neuroprotective effects on the developing rat brain after status epilepticus. Twenty-one dams reared Wistar male rats, and 21-day-old rats were divided into three groups: control group, pentylenetetrazole-induced status epilepticus group, and caffeic acid phenethyl ester-treated group. Status epilepticus was induced on the first day of experiment. Caffeic acid phenethyl ester injections (30 mg/kg intraperitoneally) started 40 min after the tonic phase of status epilepticus was reached, and the injections of caffeic acid phenethyl ester were repeated over 5 days. Rats were sacrificed, and brain tissues were collected on the 5th day of experiment after the last injection of caffeic acid phenethyl ester. Apoptotic cell death was evaluated. Histopathological examination showed that caffeic acid phenethyl ester significantly preserved the number of neurons in the CA1, CA3, and dentate gyrus regions of the hippocampus and the prefrontal cortex. It also diminished apoptosis in the hippocampus and the prefrontal cortex. In conclusion, this experimental study suggests that caffeic acid phenethyl ester administration may be neuroprotective in status epilepticus in the developing rat brain.
Collapse
Affiliation(s)
- Uluç Yiş
- Dokuz Eylül University, School of Medicine, Department of Pediatrics, Division of Pediatric Neurology, İzmir, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Yiş U, Bayram E, Topçu Y, Karakaya P, Hız Kurul S. A case of atypical Miller Fisher syndrome with negative anti-GQ1b immunoglobulin G and importance of H reflex. Turk J Pediatr 2013; 55:235-236. [PMID: 24192691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Uluç Yiş
- Division of Pediatric Neurology, Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey.
| | | | | | | | | |
Collapse
|
29
|
Sözmen SÇ, Kurul SH, Yiş U, Tuğyan K, Baykara B, Yılmaz O. Neuroprotective effects of recombinant human erythropoietin in the developing brain of rat after lithium-pilocarpine induced status epilepticus. Brain Dev 2012; 34:189-95. [PMID: 21600713 DOI: 10.1016/j.braindev.2011.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Revised: 05/01/2011] [Accepted: 05/02/2011] [Indexed: 10/18/2022]
Abstract
Status epilepticus triggers a mixture of apoptotic and necrotic cell death within the hippocampus. This neuronal loss may result in the development of epilepsy and cognitive deficits. Erythropoietin mediates a number of biological actions within the central nervous system and has been shown to be neuroprotective. In the present study, we investigated the effects of recombinant human erythropoietin on hippocampus of rat after lithium-pilocarpine induced status epilepticus. Twenty-one dam reared Wistar male rats, 21-day-old were divided into three groups: control group, lithium-pilocarpine induced status epilepticus and lithium-pilocarpine induced status epilepticus and erythropoietin treated group. Erythropoietin treated group received recombinant human erythropoietin 10 U/g intraperitoneally 40 min after pilocarpine injection for 5 days. Rats were sacrificed and brain tissues were collected at 5th day of experiment. Neuronal cell death and apoptosis were evaluated. Histopathological examination showed that erythropoietin significantly decreased neuronal cell death in CA1, CA2, CA3 and dentate gyrus regions of hippocampus. It also diminished apoptosis in the CA1 and dentate gyrus regions of hippocampus. In conclusion, erythropoietin may preserve the number of neurons and decrease apoptosis in model of status epilepticus induced by lithium-pilocarpine. This experimental study suggests that erythropoietin administration may be neuroprotective in status epilepticus.
Collapse
Affiliation(s)
- Sule Çağlayan Sözmen
- Department of Pediatrics, School of Medicine, Dokuz Eylül University, İzmir, Turkey
| | | | | | | | | | | |
Collapse
|
30
|
Böhm J, Yiş U, Ortaç R, Cakmakçı H, Kurul SH, Dirik E, Laporte J. Case report of intrafamilial variability in autosomal recessive centronuclear myopathy associated to a novel BIN1 stop mutation. Orphanet J Rare Dis 2010; 5:35. [PMID: 21129173 PMCID: PMC3014877 DOI: 10.1186/1750-1172-5-35] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Accepted: 12/03/2010] [Indexed: 11/10/2022] Open
Abstract
Centronuclear myopathies (CNM) describe a group of rare muscle diseases typically presenting an abnormal positioning of nuclei in muscle fibers. To date, three genes are known to be associated to a classical CNM phenotype. The X-linked neonatal form (XLCNM) is due to mutations in MTM1 and involves a severe and generalized muscle weakness at birth. The autosomal dominant form results from DNM2 mutations and has been described with early childhood and adult onset (ADCNM). Autosomal recessive centronuclear myopathy (ARCNM) is less characterized and has recently been associated to mutations in BIN1, encoding amphiphysin 2. Here we present the first clinical description of intrafamilal variability in two first-degree cousins with a novel BIN1 stop mutation. In addition to skeletal muscle defects, both patients have mild mental retardation and the more severely affected male also displays abnormal ventilation and cardiac arrhythmia, thus expanding the phenotypic spectrum of BIN1-related CNM to non skeletal muscle defects. We provide an up-to-date review of all previous cases with ARCNM and BIN1 mutations.
Collapse
Affiliation(s)
- Johann Böhm
- Department of Neurobiology and Genetics, IGBMC (Institut de Génétique et de Biologie Moléculaire et Cellulaire), Illkirch, France
| | | | | | | | | | | | | |
Collapse
|
31
|
Yiş U, Seçkin E, Kurul SH, Kuralay F, Dirik E. Effects of epilepsy and valproic acid on oxidant status in children with idiopathic epilepsy. Epilepsy Res 2009; 84:232-7. [DOI: 10.1016/j.eplepsyres.2009.02.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2008] [Revised: 01/27/2009] [Accepted: 02/01/2009] [Indexed: 11/15/2022]
|
32
|
Kurul SH, Yiş U, Kumral A, Tuğyan K, Cilaker S, Kolatan E, Yilmaz O, Genç S. Protective effects of topiramate against hyperoxic brain injury in the developing brain. Neuropediatrics 2009; 40:22-7. [PMID: 19639524 DOI: 10.1055/s-0029-1224101] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Recent studies have shown that exposure to hyperoxia in infant rats leads to extensive apoptotic degeneration in the cortex and white matter of the developing brain. Besides its antiepileptic effects, topiramate exerts neuroprotective effects in animal models of stroke, hypoxia ischemia, excitotoxic insults, and status epilepticus. In the present study, we investigated the effects of topiramate against hyperoxia-induced neurodegeneration in the developing brain. Eighteen Wistar rat pups were divided into three groups: control group, hyperoxia+phosphate buffered saline treated group and hyperoxia+topiramate treated group. Hyperoxia groups were exposed to 80% oxygen (n=12) in plexiglas chambers in which the oxygen concentration was monitored twice daily from birth until postnatal day five. The hyperoxia+topiramate group received an intraperitoneal injection of topiramate at a dose of 80 mg/kg/day. At postnatal day 5, all animals were killed. Neuronal cell death and apoptosis were evaluated. Histopathological examination showed that topiramate significantly diminished apoptosis in the CA1 region and dentate gyrus of hippocampus. Topiramate may offer a therapeutic potential for neuroprotection under conditions of hyperoxic brain injury.
Collapse
Affiliation(s)
- S H Kurul
- Department of Pediatric Neurology, School of Medicine, Dokuz Eylül University, Inciralti, Izmir, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|