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Aktekin EH, Kütük MÖ, Sangün Ö, Yazıcı N, Çaylaklı F, Erol İ, Sarıalioğlu F. Late effects of medulloblastoma treatment: multidisciplinary approach of survivors. Childs Nerv Syst 2024; 40:417-425. [PMID: 37698649 DOI: 10.1007/s00381-023-06146-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE Medulloblastoma is one of the brain tumors with increased life expectancy due to improvements in treatment approaches. Besides the promising results, various undesirable effects can be encountered. This study's aim is to review long-term follow-up outcomes of our cases with medulloblastoma. METHODS Age at diagnosis, histological type of medulloblastoma, resection extension, chemotherapy and radiotherapy schemes, follow-up duration, and endocrinological, neuropsychiatric, cardiological, auditory, and visual examination results were evaluated in 20 patients diagnosed between 2007 and 2018 and followed 5 years and more. RESULTS Twenty of 53 patients were included to the study. Eleven (55%) were male. Mean age at diagnosis was 6.95 years; mean age at the time of the study was 14 years. Mean follow-up time was 8.95 years. In terms of surgery, 14 (70%) were gross total, 1 (5%) was near total, and 2 (10%) were subtotal resection. In histopathological examination, 14 (70%) were classical medulloblastoma, 4 (20%) were desmoplastic medulloblastoma, and 1 (5%) was anaplastic medulloblastoma. With regard to endocrinological evaluation, 15 (75%) patients had hypothyroidism, 5 (25%) had growth hormone deficiency, 7 (35%) had clinical growth hormone deficiency, and 5 (25%) had sex hormone disorders. In neuropsychiatric examination, 11 (55%) patients had neurological sequelae, 18 (90%) patients had psychiatric issues, and 14 (70%) patients had two or more neuropsychiatric problems simultaneously. One (5%) patient had mitral valve insufficiency. Twelve patients (60%) had hearing loss. According to visual examination, 6 (30%) patients had refraction problem, 4 (20%) had cataract, and 1 (5%) had dry eye. CONCLUSION Careful monitoring of long-term side effects is important for improving the quality of life of medulloblastoma patients. Besides endocrinological and other somatic sequelae of the disease and treatment, increased neuropsychiatric problems showed us that only cure is not the issue while treating childhood medulloblastoma.
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Affiliation(s)
- Elif Habibe Aktekin
- Department of Pediatrics Division of Pediatric Hematology-Oncology, Baskent University, Adana, Turkey.
| | - Meryem Özlem Kütük
- Department of Child and Adolescent Psychiatry, Baskent University, Adana, Turkey
| | - Özlem Sangün
- Department of Pediatric Division of Pediatric Endocrinology, Baskent University, Adana, Turkey
| | - Nalan Yazıcı
- Department of Pediatrics Division of Pediatric Hematology-Oncology, Baskent University, Adana, Turkey
| | - Fatma Çaylaklı
- Department of Ear-Nose and Throat, Baskent University, Adana, Turkey
| | - İlknur Erol
- Department of Pediatrics Division of Pediatric Neurology, Baskent University, Adana, Turkey
| | - Faik Sarıalioğlu
- Department of Pediatrics Division of Pediatric Hematology-Oncology, Baskent University, Adana, Turkey
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Çelik T, Sangün Ö, Ünal Ş, Balcı A, Motor S. Assessment of biochemical bone markers of osteoporosis in children with thalassemia major. Ital J Pediatr 2022; 48:105. [PMID: 35725492 PMCID: PMC9210807 DOI: 10.1186/s13052-022-01290-x] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 06/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Beta thalassemia major (β-TM) is a common cause of skeletal morbidity and is associated with increased bone fracture risk, particularly in inadequately transfused children. The aim of this study was to investigate some potential biochemical markers as possible early predictors of BMD variations in children with β-TM. METHODS The study included 38 children with β-TM and 40 sex-age matched controls. All patients were subjected to BMD assessment by dual-energy X-ray absorptiometry (DEXA). Serum beta-crosslaps (beta-CTx), osteoprotegerin (OPG), receptor activator of nuclear factor-kappa B ligand (RANKL), urinary deoxypyridinoline (DPD) and ferritin levels were compared between the groups. RESULTS Serum OPG levels were significantly lower in thalassemic children than in controls. The mean ratio of RANKL/OPG was significantly higher in the thalassemic patients than in the control group. Osteoporosis was detected in 10 (3 female and 7 male) of 38 patients (26.3%) according to the femur Z score and in 6 of them (4 male and 2 female) (15.8%) according to the spine Z score. CONCLUSIONS Serum OPG concentrations can be used as a biochemical marker in screening patients with beta-thalassemia major for the development of osteoporosis.
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Affiliation(s)
- Tanju Çelik
- School of Medicine, Pediatrics, Mustafa Kemal University, Hatay, Turkey. .,Department of Pediatrics, University of Health Sciences Dr. Behçet Uz Children's Hospital, İzmir, Turkey.
| | - Özlem Sangün
- Department of Pediatric Endocrinology, Antakya State Hospital, Hatay, Turkey
| | - Şule Ünal
- Department of Pediatric Hematology and Oncology, Antakya State Hospital, Hatay, Turkey.,Department of Pediatrics, Division of Hematology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ali Balcı
- School of Medicine, Department of Radiology, 9 Eylul University, Hatay, Turkey
| | - Sedat Motor
- School of Medicine, Department of Biochemistry, Mustafa Kemal University, Hatay, Turkey
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Tekin Orgun L, Besen Ş, Sangün Ö, Bisgin A, Alkan Ö, Erol İ. First pediatric case with primary familial brain calcification due to a novel variant on the MYORG gene and review of the literature. Brain Dev 2021; 43:789-797. [PMID: 33958240 DOI: 10.1016/j.braindev.2021.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 11/25/2020] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 11/08/2022]
Abstract
Variants in the myogenesis-regulating glycosidase (MYORG) gene which is known as the first autosomal recessive gene that has been associated with primary familial brain calcification (AR-PFBC). Although adult patients have been reported, no pediatric case has been reported until now. Herein, we review the clinical and radiological features of all AR- PFBC patients with biallelic variants in the MYORG gene who were reported until now, and we report the youngest patient who has a novel homozygous variant. Since the first identification of the MYORG gene in 2018, 74cases of MYORG variants related to AR-PFBC were evaluated. The ages of symptom onset of the patients ranged between 7.5 and 87 years. The most frequent clinical courses were speech impairment, movement disorder and cerebellar signs. All patients showed basal ganglia calcification usually bilaterally with different severities. Conclusion; herein, we reported the first pediatric patient in the literature who had a novel homozygous variant in the MYORG gene with mild clinic findings.
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Affiliation(s)
- Leman Tekin Orgun
- Baskent University, Faculty of Medicine, Department of Pediatric Neurology, Adana Dr. Noyan Teaching and Medical Research Center, Adana, Turkey.
| | - Şeyda Besen
- Baskent University, Faculty of Medicine, Department of Pediatric Neurology, Adana Dr. Noyan Teaching and Medical Research Center, Adana, Turkey
| | - Özlem Sangün
- Baskent University, Faculty of Medicine, Department of Pediatric Endocrinology, Adana Dr. Noyan Teaching and Medical Research Center, Adana, Turkey
| | - Atıl Bisgin
- Cukurova University AGENTEM (Adana Genetic Disease Diagnosis and Treatment Center) & Medical Genetics Department of Medical Faculty, Adana, Turkey.
| | - Özlem Alkan
- Baskent University, Faculty of Medicine, Department of Radiodiagnosis, Adana Dr. Noyan Teaching and Medical Research Center, Adana, Turkey
| | - İlknur Erol
- Baskent University, Faculty of Medicine, Department of Pediatric Neurology, Adana Dr. Noyan Teaching and Medical Research Center, Adana, Turkey
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Akıncı A, Türkkahraman D, Tekedereli İ, Özer L, Evren B, Şahin İ, Kalkan T, Çürek Y, Çamtosun E, Döğer E, Bideci A, Güven A, Eren E, Sangün Ö, Çayır A, Bilir P, Törel Ergür A, Ercan O. Novel Mutations in Obesity-related Genes in Turkish Children with Non-syndromic Early Onset Severe Obesity: A Multicentre Study. J Clin Res Pediatr Endocrinol 2019; 11:341-349. [PMID: 30991789 PMCID: PMC6878344 DOI: 10.4274/jcrpe.galenos.2019.2019.0021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Non syndromic monogenic obesity is a rare cause of early onset severe obesity in the childhood period. This form may not be distinguishable from other forms of severe obesity without genetic analysis, particularly if patients do not exibit any physical abnormalities or developmental delay. The aim of this study was to screen 41 different obesity-related genes in children with non-syndromic early onset severe obesity. METHODS Children with severe (body mass index-standard deviation score >3) and early onset (<7 years) obesity were screened by next-generation sequencing based, targeted DNA custom panel for 41 known-obesity-related genes and the results were confirmed by Sanger technique. RESULTS Six novel variants were identified in five candidate genes in seven out of 105 children with severe obesity; two in SIM1 (p.W306C and p.Q36X), one in POMC (p.Y160H), one in PCSK1 (p.W130G fs Ter8), two in MC4R (p.D126E) and one in LEPR (p.Q4H). Additionally, two previously known variations in MC4R were identified in four patients (p.R165W in three, and p.V166I in one). CONCLUSION We identified six novel and four previously described variants in six obesity-related genes in 11 out of 105 childrens with early onset severe obesity. The prevalence of monogenic obesity was 10.4% in our cohort.
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Affiliation(s)
- Ayşehan Akıncı
- nönü University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Malatya, Turkey,* Address for Correspondence: İnönü University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Malatya, Turkey Phone: +90 532 643 53 50 E-mail:
| | - Doğa Türkkahraman
- Antalya Training and Research Hospital, Clinic of Pediatric Endocrinology and Diabetes, Antalya, Turkey
| | - İbrahim Tekedereli
- İnönü University Faculty of Medicine, Department of Molecular Genetics, Malatya, Turkey
| | - Leyla Özer
- Yüksek İhtisas University Faculty of Medicine, Department of Molecular Genetics, Ankara, Turkey
| | - Bahri Evren
- İnönü University Faculty of Medicine, Department of Endocrinology and Diabetes, Malatya, Turkey
| | - İbrahim Şahin
- İnönü University Faculty of Medicine, Department of Endocrinology and Diabetes, Malatya, Turkey
| | - Tarkan Kalkan
- Antalya Training and Research Hospital, Clinic of Molecular Genetics, Antalya, Turkey
| | - Yusuf Çürek
- Antalya Training and Research Hospital, Clinic of Pediatric Endocrinology and Diabetes, Antalya, Turkey
| | - Emine Çamtosun
- nönü University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Malatya, Turkey
| | - Esra Döğer
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Ankara, Turkey
| | - Aysun Bideci
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Ankara, Turkey
| | - Ayla Güven
- Göztepe Training and Research Hospital, Clinic of Pediatric Endocrinology and Diabetes, İstanbul, Turkey
| | - Erdal Eren
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Bursa, Turkey
| | - Özlem Sangün
- Başkent University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Adana, Turkey
| | - Atilla Çayır
- Erzurum Training and Reseach Hospital, Clinic of Pediatric Endocrinology and Diabetes, Erzurum, Turkey
| | - Pelin Bilir
- Ankara University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Ankara, Turkey
| | - Ayça Törel Ergür
- Ufuk University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Ankara, Turkey
| | - Oya Ercan
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Departments of Pediatric Endocrinology and Diabetes, and Adolescent, İstanbul, Turkey
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Sangün Ö, Dündar B, Çömlekçi S, Büyükgebiz A. The Effects of Electromagnetic Field on the Endocrine System in Children and Adolescents. Pediatr Endocrinol Rev 2015; 13:531-545. [PMID: 26841641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Children are exposed to various kind of non-ionizan radiation in their daily life involuntarily. The potential sensitivity of developing organism to the effects of radiofrequency (RF) signals, the higher estimated specific absorption rate (SAR) values of children and greater lifetime cumulative risk raised the scientific interest for children's vulnerability to electromagnetic fields (EMFs). In modern societies, children are being exposed to EMFs in very early ages. There are many researches in scientific literature investigating the alterations of biological parameters in living organisms after EMFs. Although the international guidelines did not report definite, convincing data about the causality, there are unignorable amount of studies indicating the increased risk of cancer, hematologic effects and cognitive impairment. Although they are less in amount; growing number of studies reveal the impacts on metabolism and endocrine function. Reproductive system and growth look like the most challenging fields. However there are also some concerns on detrimental effects of EMFs on thyroid functions, adrenal hormones, glucose homeostasis and melatonin levels. It is not easy to conduct a study investigating the effects of EMFs on a fetus or child due to ethical issues. Hence, the studies are usually performed on virtual models or animals. Although the results are conflicting and cannot be totally matched with humans; there is growing evidence to distress us about the threats of EMF on children.
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Sangün Ö, Demirci S, Dündar N, Pirgon Ö, Koca T, Doğan M, Dündar B. The Effects of Six-Month L-Thyroxine Treatment on Cognitive Functions and Event-Related Brain Potentials in Children with Subclinical Hypothyroidism. J Clin Res Pediatr Endocrinol 2015; 7:102-8. [PMID: 26316431 PMCID: PMC4563180 DOI: 10.4274/jcrpe.1684] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the cognitive status of children with subclinical hypothyroidism (SH) before and after L-thyroxine (L-T4) treatment using event-related potentials (ERPs) and neuropsychological tests. METHODS This prospective study was conducted on a series of 20 children with mild SH (free T4 normal and thyroid-stimulating hormone level within 5-10 µIU/L) who underwent clinical and cognitive assessment before L-T4 treatment and 6 months afterwards. The recordings of ERPs were done at the time of diagnosis and after 6 months of euthyroid state. Neuropsychiatric tests for attention, perception, close and remote memory were performed on all patients and on the control group which consisted of 20 healthy children of normal intelligence. RESULTS While pretreatment verbal memory (VM) and verbal recall (VR) scores of the SH group were significantly lower than those of the control group (p=0.004 and 0.012, respectively), no significant differences between the post-treatment and control groups were found in these scores after 6 months of L-T4 treatment. Post-treatment VM and VR scores were significantly higher than the pretreatment scores in the SH group (p=0.008 and p=0.0001). There were no significant differences between the pre-and post-treatment values of electrophysiological evaluation in N1, P2, P3 latencies or P3 amplitude (p>0.05), although there was a significant decrease in N2 latency in the post-treatment group (p=0.03). CONCLUSION SH affects cognition in children and L-T4 replacement therapy leads to normalization of cognitive functions. Neuropsychological tests can be used as complementary measures in the evaluation of children with SH. Determining the association between ERPs and SH would contribute to the comprehensive evaluation of these children.
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Affiliation(s)
- Özlem Sangün
- Başkent University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey
| | - Serpil Demirci
- Suleyman Demirel University Faculty of Medicine, Department of Neurology, Isparta, Turkey
| | - Nihal Dündar
- Katip Çelebi University Faculty of Medicine, Department of Pediatric Neurology, İzmir, Turkey
| | - Özgür Pirgon
- Süleyman Demirel University Faculty of Medicine, Department of Pediatric Endocrinology, Isparta, Turkey
| | - Tuğba Koca
- Süleyman Demirel University Faculty of Medicine, Department of Pediatric Endocrinology, Isparta, Turkey
| | - Melike Doğan
- Suleyman Demirel University Faculty of Medicine, Department of Neurology, Isparta, Turkey
| | - Bumin Dündar
- Katip Çelebi University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey Phone: +90 232 329 35 35 E-mail:
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Acıpayam C, Kaya S, Sangün Ö, İlhan G, Altunay C, Oktay G. Hepatit A Enfeksiyonunda İmmün Trombositopenik Purpura. Cukurova Medical Journal 2014. [DOI: 10.17826/cutf.33459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Çelik T, Savaş N, Kurtoğlu S, Sangün Ö, Aydın Z, Mustafa D, Öztürk OH, Mısırlıoğlu S, Öktem M. Iodine, copper, zinc, selenium and molybdenum levels in children aged between 6 and 12 years in the rural area with iodine deficiency and in the city center without iodine deficiency in Hatay. Turk Arch Pediatr 2014; 49:111-6. [PMID: 26078645 DOI: 10.5152/tpa.2014.1209] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 08/27/2013] [Indexed: 12/16/2022]
Abstract
AIM Thyroid diseases related with iodine deficiency are observed commonly in our country and in the world. In this study, we aimed to investigate iodine deficiency in urine and selenium, zinc, copper or molybdenum deficiency which may accompany this in children aged between 6 and 12 years in two schools in the province of Hatay (endemic goitre region). MATERIAL AND METHODS This study is a case-control field-study in which students aged between 6 and 12 years were included. One hundred fourteen subjects from the village of Tanışma related to the center of our province and 100 subjects from the city center of Hatay (Antakya) were included in the study. Iodine, selenium, zinc, copper and molybdenum levels were measured in the urine samples of the students included in the study. RESULTS Iodine deficiency was found with a severe (5%), moderate (18.4%) and mild degree (43%), respectively in the village of Tanışma. Mild iodine deficiency (7%) was found in the center of Hatay. No moderate and severe iodine deficiency was found in the control group. A significant difference was found between the groups in terms of urine iodine excretion (p<0.001). A significant correlation was found between the levels of iodine, selenium, zinc and molybdenum (p<0.05). A moderately positive correlation was found between iodine and selenium (p<0.001). A moderately positive correlation was found between iodine and zinc levels (p<0.001) and a weak correlation was found between iodine and molybdenum (p<0.01). No significant correlation was found between iodine level and copper level (p>0.05). CONCLUSIONS Selenium and zinc deficiency may accompany iodine deficiency. Selenium and zinc deficiency should be considered in individuals who are found to have iodine deficiency especially in endemic goitre regions.
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Affiliation(s)
- Tanju Çelik
- Department of Pediatrics, Mustafa Kemal University, Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
| | - Nazan Savaş
- Department of Public Health, Mustafa Kemal University, Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
| | - Selim Kurtoğlu
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Özlem Sangün
- Clinic of Pediatrics, Hatay Public Hospital, Hatay, Turkey
| | - Zeki Aydın
- Division of Chemistry, Mustafa Kemal University Faculty of Arts and Sciences, Hatay, Turkey
| | - Didin Mustafa
- Department of Biochemistry, Mustafa Kemal University, Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
| | - Oktay Hasan Öztürk
- Division of Food, Mustafa Kemal University Faculty of Agriculture, Hatay, Turkey
| | - Seher Mısırlıoğlu
- Department of Biochemistry, Mustafa Kemal University, Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
| | - Murat Öktem
- Düzen Laboratory, Biochemistry, Ankara, Turkey
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Özdemir ÖMA, Cağlar M, Koçyiğit A, Dündar NO, Sangün Ö, Dündar B. Primary hypogonadism in a case with XLAG syndrome. J Pediatr Endocrinol Metab 2012; 25:1161-3. [PMID: 23329764 DOI: 10.1515/jpem-2012-0266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 08/14/2012] [Accepted: 08/17/2012] [Indexed: 11/15/2022]
Abstract
Patients with X-linked lissencephaly with ambiguous genitalia (XLAG) syndrome present with lissencephaly, agenesis of the corpus callosum, refractory epilepsy of neonatal onset, microcephaly, and male genotype with ambiguous genitalia. The basis of the ambiguous genitalia in XLAG syndrome is not well-known. We report a case of the fourth child of healthy consanguineous parents who was presented to the hospital because of non-febrile seizures at 2 months of life. On physical examination, microcephaly, some dysmorphic face features, and ambiguous genitalia were determined. The cranial magnetic resonance imaging of the patient showed lissencephaly, agenesis of the corpus callosum, and enlarged ventricles. His karyotype was 46, XY. He had undetectable testosterone levels and elevated gonadotropins. Neither testicular tissue nor any testosterone response to human chorionic gonadotropin stimulation test was observed. These findings suggest that the hypogonadism in this patient with XLAG syndrome is primary hypogonadism due to gonadal agenesis or dysgenesis.
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Affiliation(s)
- Özmert M A Özdemir
- Department of Pediatrics, School of Medicine, Pamukkale University, Çocuk Poliklinik Binası, Kat: 2, Kınıklı, 20070, Denizli, Turkey.
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Dündar B, Boyacı A, Sangün Ö, Dündar N. Çocuk ve ergenlerde Hashimoto tiroiditi: klinik ve laboratuvar bulgularının değerlendirilmesi. Turk Arch Pediatr 2011. [DOI: 10.4274/tpa.358.1338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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