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Özcabı B, Durmaz A, Aykut A, Önal H, Özen S. A Rare Case of Monogenic Obesity due to a Novel Variant in the ADCY3 Gene: Challenges in Follow-up and Treatment. J Clin Res Pediatr Endocrinol 2023. [PMID: 37855273 DOI: 10.4274/jcrpe.galenos.2023.2023-7-2] [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] [Indexed: 10/20/2023] Open
Abstract
Adenylate cyclase 3 (ADCY3) gene alterations have been found to be associated with obesity. However, few patients with homozygous mutations have been reported so far, and the follow-up procedure and treatment options have not been clarified. A 10-month-old female presented with increased appetite and weight gain. She was born from a consanguineous marriage. Weight, height, head circumference measurements and standard deviation scores (SDS) were 19 kg (+6.98 SDS), 82 cm (+3.53 SDS), and 49 cm (+3.07 SDS), respectively. Laboratory tests revealed a fasting glucose level of 103 mg/dL (5.7 mmol/L), insulin level of 25.39 µIU/mL, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) value of 6.43. Whole-exome sequencing revealed a novel, homozygous c.1102G>A(p.Asp368Asn) variant in ADCY3. Her parents and healthy sister were heterozygous for the variant. At the age of 2.5 years, neurodevelopmental delay was observed. At the age of 3.5 years, the patient's weight, height, and body mass index values were 49.5 kg (+8.16 SDS), 111 cm (+2.59 SDS), and 40.18 kg/m2 (+6.48 SDS), respectively. Signs of Blount's disease and acanthosis nigricans were distinctive, and she had hyperphagia. She was undergoing speech therapy. Homozygous ADCY3 variants may present with early onset, severe obesity, insulin resistance, and neurodevelopmental delay in children. Severe complications may occur even at young ages. More data regarding the follow-up process and treatment of these patients are needed.
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Affiliation(s)
- Bahar Özcabı
- Department of Pediatric Endocrinology, Acibadem Atasehir Hospital, Istanbul, Türkiye
| | - Asude Durmaz
- Department of Medical Genetics, Ege University School of Medicine, Izmir, Türkiye
| | - Ayça Aykut
- Department of Medical Genetics, Ege University School of Medicine, Izmir, Türkiye
| | - Hasan Önal
- Department of Pediatric Endocrinology, University of Health Science Cam and Sakura City Hospital, Istanbul, Türkiye
| | - Samim Özen
- Department of Pediatric Endocrinology, Ege University School of Medicine, Izmir, Türkiye
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Söbü E, Düzkalır HG, Özcabı B, Kaya Özçora GD. The association between vitamin B12, folate, homocysteine levels, and carotid intima-media thickness in children with obesity: a cross-sectional study. J Pediatr Endocrinol Metab 2022; 35:1051-1058. [PMID: 35822708 DOI: 10.1515/jpem-2022-0250] [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: 05/07/2022] [Accepted: 06/15/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES We aimed to evaluate the association between vitamin B12, folate, homocysteine levels, and carotid intima-media thickness (CIMT) among children with obesity in whom vitamin deficiencies are more frequent. METHODS Herein, 100 children with obesity (58 girls) were included (age, 5-18 years). Height, weight, body mass index (BMI), waist circumference (WC), puberty stage, blood pressure, and biochemical values were collected from medical records; standard deviations (SDS) and percentiles were calculated. Obesity was defined as BMI SDS of >+2SDS. Vitamin B12 and folate levels of <300 pg/mL and <4.8 ng/mL, respectively, were considered deficient. A radiologist quantified measurements from the carotid artery. RESULTS Mean patient age was 12.52 ± 3.63 years. The mean weight SDS, BMI SDS, and WC/height were +3.37 ± 0.93, +2.93 ± 0.55, and 0.65 ± 0.05, respectively. In pubertal cases, insulin (p<0.001), the homeostatic model assessment for insulin resistance (HOMA-IR) (p=0.001) and homocysteine (p=0.002) levels were higher; vitamin B12 (p<0.001) and folate (p<0.001) levels were lower than those in prepubertal ones. WC and HOMA-IR correlated with CIMT; however, homocysteine levels were not correlated with CIMT. CONCLUSIONS In our study, pubertal cases had lower vitamin B12 and folate levels as well as higher homocysteine levels. Although no correlation was identified between homocysteine levels and CIMT, this condition may be related to our study group comprising children, who had a shorter duration of obesity than those in adults. As CIMT was higher in children/adolescents with increased WC, it is proposed that they need central obesity more frequently and carefully follow-up.
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Affiliation(s)
- Elif Söbü
- Department of Pediatric Endocrinology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | | | - Bahar Özcabı
- Department of Pediatric Endocrinology, Memorial Bahçelievler Hospital, İstanbul, Turkey
| | - Gül Demet Kaya Özçora
- Gaziantep Hasan Kalyoncu University, Faculty of Medical Sciences Pediatric Neurology Department, Gaziantep, Turkey
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Dağdeviren Çakır A, Baş F, Akın O, Şıklar Z, Özcabı B, Berberoğlu M, Kardelen AD, Bayramoğlu E, Poyrazoğlu Ş, Aydın M, Törel Ergür A, Gökşen D, Bolu S, Aycan Z, Tüysüz B, Ercan O, Evliyaoğlu O. Clinical Characteristics and Growth Hormone Treatment in Patients with Prader-Willi Syndrome. J Clin Res Pediatr Endocrinol 2021; 13:308-319. [PMID: 33565750 PMCID: PMC8388048 DOI: 10.4274/jcrpe.galenos.2021.2020.0228] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To investigate clinical characteristics and response to growth hormone (GH) treatment in patients with Prader-Willi syndrome (PWS) in Turkey. METHODS The data of 52 PWS patients from ten centers was retrospectively analyzed. A nation-wide, web-based data system was used for data collection. Demographic, clinical, genetic, and laboratory data and follow-up information of the patients were evaluated. RESULTS The median age of patients at presentation was 1.5 years, and 50% were females. Genetic analysis showed microdeletion in 69.2%, uniparental disomy in 11.5%, imprinting defect in 1.9% and methylation abnormality in 17.3%. Hypotonia (55.7%), feeding difficulties (36.5%) and obesity (30.7%) were the most common complaints. Cryptorchidism and micropenis were present in 69.2% and 15.3% of males, respectively. At presentation, 25% had short stature, 44.2% were obese, 9.6% were overweight and 17.3% were underweight. Median age of obese patients was significantly higher than underweight patients. Central hypothyroidism and adrenal insufficiency were present in 30.7% and 4.7%, respectively. Hypogonadism was present in 75% at normal age of puberty. GH treatment was started in 40% at a mean age of 4.7±2.7 years. After two years of GH treatment, a significant increase in height SDS was observed. However, body mass index (BMI) standard deviation (SDS) remained unchanged. CONCLUSION The most frequent complaints were hypotonia and feeding difficulty at first presentation. Obesity was the initial finding in 44.2%. GH treatment was started in less than half of the patients. While GH treatment significantly increased height SDS, BMI SDS remained unchanged, possibly due to the relatively older age at GH start.
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Affiliation(s)
- Aydilek Dağdeviren Çakır
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Firdevs Baş
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Onur Akın
- University of Health Sciences Turkey, Gülhane Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
| | - Zeynep Şıklar
- Ankara University, Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Bahar Özcabı
- University of Health Sciences Turkey, Zeynep Kamil Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Merih Berberoğlu
- Ankara University, Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Aslı Derya Kardelen
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Elvan Bayramoğlu
- University of Health Sciences Turkey, Ankara Dr. Sami Ulus Obstetrics and Gynecology and Child Health and Diseases Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
| | - Şükran Poyrazoğlu
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Murat Aydın
- Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Endocrinology, Samsun, Turkey
| | - Ayça Törel Ergür
- Ufuk University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Damla Gökşen
- Ege University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Semih Bolu
- Düzce University Faculty of Medicine, Department of Pediatric Endocrinology, Düzce, Turkey
| | - Zehra Aycan
- University of Health Sciences Turkey, Ankara Dr. Sami Ulus Obstetrics and Gynecology and Child Health and Diseases Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
| | - Beyhan Tüysüz
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Genetics, İstanbul, Turkey
| | - Oya Ercan
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Olcay Evliyaoğlu
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey,* Address for Correspondence: İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey Phone: +90 533 633 15 64 E-mail:
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Özcabı B, Vatansever M, Güven A. Hypogonadism: Is It Always Hypogonadotropic in an Adolescent With a Cleft Palate? A Surprising Case of Klinefelter Syndrome. Cleft Palate Craniofac J 2020; 58:787-790. [PMID: 33107323 DOI: 10.1177/1055665620967601] [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] [Indexed: 11/15/2022] Open
Abstract
Pituitary hormone deficiencies may occur in children with midline defects; in these cases, hypogonadism is usually hypogonadotropic. Herein, we report a boy at the age of 13.8 years with mild mental retardation, previously operated for complete cleft palate (isolated) and presented with hypoglycemia due to isolated secondary adrenal insufficiency, who further had a decrease in testicular size with increased follicle-stimulating hormone level (hypergonadotropic hypogonadism) and diagnosed with Klinefelter syndrome. Klinefelter syndrome in childhood is rarely diagnosed and cases are observed in a wide spectrum. Although some regional duplications of the X chromosome also show midline defects such as spina bifida-neural tube defects, mental retardation, hypopituitarism (mostly growth hormone deficiency); coexistence of Klinefelter syndrome and isolated secondary adrenal deficiency/midline defect in our case may also be coincidental. However, to our knowledge, this is the first case in literature with this association in a patient with a 47, XXY karyotype.
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Affiliation(s)
- Bahar Özcabı
- HSU, Division of Pediatric Endocrinology, Department of Pediatrics, 147023Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey.,Department of Pediatrics, Yeni Yuzyil Medical School, Istanbul, Turkey
| | - Meriç Vatansever
- HSU, Division of Pediatric Endocrinology, Department of Pediatrics, 147023Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey
| | - Ayla Güven
- HSU, Division of Pediatric Endocrinology, Department of Pediatrics, 147023Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey
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Özcabı B, Demirhan S, Akyol M, Öztürkmen Akay H, Güven A. Lipid accumulation product is a predictor of nonalcoholic fatty liver disease in childhood obesity. Korean J Pediatr 2019; 62:450-455. [PMID: 31870087 PMCID: PMC6933305 DOI: 10.3345/kjp.2019.00248] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 03/13/2019] [Accepted: 10/21/2019] [Indexed: 01/30/2023]
Abstract
Background Lipid accumulation product (LAP) is associated with the presence and severity of nonalcoholic fatty liver disease (NAFLD) in adults. Purpose Here we evaluated the ability of LAP to predict NAFLD in obese children. Methods Eighty obese children (38 girls; age 6–18 years) were included. Anthropometric measurements and biochemical values were obtained from the patients’ medical records. LAP was calculated as [waist circumference (WC) (cm) – 58]×triglycerides (mmol/L) in girls; [WC (cm) – 65]×triglycerides (mmol/ L) in boys. The minLAP and adjLAP were described (3% and 50% of WC values, respectively) and the total/high-density lipoprotein cholesterol index (TC/HDL-C) was calculated. NAFLD was observed on ultrasound, and patients were divided into 3 groups by steatosis grade (normal, grade 0; mild, grade 1; moderate-severe, grade 2–3). The area under the curve (AUC) and appropriate index cutoff points were calculated by receiver operator characteristic analysis. Results LAP was positively correlated with puberty stage (rho=0.409; P<0.001), fasting insulin (rho= 0.507; P<0.001), homeostasis model assessment of insulin resistance (rho=0.470; P<0.001), uric acid (rho=0.522; P<0.001), and TC/HDL-C (rho=0.494; P<0.001) and negatively correlated with HDL-C (rho=-3.833; P<0.001). LAP values could be used to diagnose hepatosteatosis (AUC=0.698; P=0.002). The LAP, adjLAP, and minLAP cutoff values were 42.7 (P=0.002), 40.05 (P=0.003), and 53.47 (P= 0.08), respectively. For LAP, the differences between the normal and mild groups (P=0.035) and the normal and moderate-severe groups were statistically significant (P=0.037), whereas the difference between the mild and moderate-severe groups was not (P>0.005). There was a statistically significant difference between the normal and mild groups for adjLAP (P=0.043) but not between the other groups (P>0.005). There was no significant intergroup difference in minLAP (P>0.005). Conclusion LAP is a powerful and easy tool to predict NAFLD in childhood. If LAP is ≥42.7, NAFLD should be suspected. This is the first study to assess LAP diagnostic accuracy for childhood obesity.
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Affiliation(s)
- Bahar Özcabı
- Division of Pediatric Endocrinology, Health Science University Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, Istanbul, Turkey
| | - Salih Demirhan
- Department of Pediatrics, Health Science University Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, Ìstanbul, Turkey
| | - Mesut Akyol
- Department of Biostatistics, Yıldırım Beyazıt University, Ankara, Turkey
| | - Hatice Öztürkmen Akay
- Department of Radiology, Health and Science University Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, Istanbul, Turkey
| | - Ayla Güven
- Division of Pediatric Endocrinology, Health Science University Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, Istanbul, Turkey
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Esen İ, Bayramoğlu E, Yıldız M, Aydın M, Karakılıç Özturhan E, Aycan Z, Bolu S, Önal H, Kör Y, Ökdemir D, Ünal E, Önder A, Evliyaoğlu O, Çayır A, Taştan M, Yüksel A, Kılınç A, Büyükinan M, Özcabı B, Akın O, Binay Ç, Kılınç S, Yıldırım R, Hatun Aytaç E, Sağsak E. Management of Thyrotoxicosis in Children and Adolescents: A Turkish Multi-center Experience. J Clin Res Pediatr Endocrinol 2019; 11:164-172. [PMID: 30488822 PMCID: PMC6571539 DOI: 10.4274/jcrpe.galenos.2018.2018.0210] [Citation(s) in RCA: 7] [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 To determine the demographic and biochemical features of childhood and juvenile thyrotoxicosis and treatment outcome. METHODS We reviewed the records of children from 22 centers in Turkey who were diagnosed with thyrotoxicosis between 2007 to 2017. RESULTS A total of 503 children had been diagnosed with thyrotoxicosis at the centers during the study period. Of these, 375 (74.6%) had been diagnosed with Graves’ disease (GD), 75 (14.9%) with hashitoxicosis and 53 (10.5%) with other less common causes of thyrotoxicosis. The most common presenting features in children with GD or hashitoxicosis were tachycardia and/or palpitations, weight loss and excessive sweating. The cumulative remission rate was 17.6% in 370 patients with GD who had received anti-thyroid drugs (ATDs) for initial treatment. The median (range) treatment period was 22.8 (0.3-127) months. No variables predictive of achieving remission were identified. Twenty-seven received second-line treatment because of poor disease control and/or adverse events associated with ATDs. Total thyroidectomy was performed in 17 patients with no recurrence of thyrotoxicosis and all became hypothyroid. Ten patients received radioiodine and six became hypothyroid, one remained hyperthyroid and restarted ATDs and one patient achieved remission. Two patients were lost to follow up. CONCLUSION This study has demonstrated that using ATDs is the generally accepted first-line approach and there seems to be low remission rate with ATDs in pediatric GD patients in Turkey.
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Affiliation(s)
- İhsan Esen
- Fırat University Faculty of Medicine, Department of Pediatric Endocrinology, Elazığ, Turkey,* Address for Correspondence: Fırat University Faculty of Medicine, Department of Pediatric Endocrinology, Elazığ, Turkey Phone: +90 424 233 35 55-2365 E-mail:
| | - Elvan Bayramoğlu
- Dr. Sami Ulus Maternity and Children’s Disease Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
| | - Melek Yıldız
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Murat Aydın
- Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Endocrinology, Samsun, Turkey
| | - Esin Karakılıç Özturhan
- İstanbul University İstanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Zehra Aycan
- Dr. Sami Ulus Maternity and Children’s Disease Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
| | - Semih Bolu
- Düzce University Faculty of Medicine, Department of Pediatric Endocrinology, Düzce, Turkey
| | - Hasan Önal
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Yılmaz Kör
- Adana City Hospital, Clinic of Pediatric Endocrinology, Adana, Turkey
| | - Deniz Ökdemir
- Fırat University Faculty of Medicine, Department of Pediatric Endocrinology, Elazığ, Turkey
| | - Edip Ünal
- Dicle University Faculty of Medicine, Department of Pediatric Endocrinology, Diyarbakır, Turkey
| | - Aşan Önder
- Göztepe Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Olcay Evliyaoğlu
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Atilla Çayır
- Erzurum Bölge Training and Research Hospital, Clinic of Pediatric Endocrinology, Erzurum, Turkey
| | - Mehmet Taştan
- Çukurova University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey
| | - Ayşegül Yüksel
- Derince Training and Research Hospital, Clinic of Pediatric Endocrinology, Kocaeli, Turkey
| | - Aylin Kılınç
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Muammer Büyükinan
- Konya Training and Research Hospital, Clinic of Pediatric Endocrinology, Konya, Turkey
| | - Bahar Özcabı
- Zeynep Kamil Maternity and Children’s Disease Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Onur Akın
- Gülhane Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
| | - Çiğdem Binay
- Çorlu State Hospital, Clinic of Pediatric Endocrinology, Tekirdağ, Turkey
| | - Suna Kılınç
- Bağcılar Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Ruken Yıldırım
- Diyarbakır Pediatric Hospital, Clinic of Pediatric Endocrinology, Diyarbakır, Turkey
| | - Emel Hatun Aytaç
- Gaziantep University Faculty of Medicine, Department of Pediatric Endocrinology, Gaziantep, Turkey
| | - Elif Sağsak
- Gaziosmanpaşa Taksim Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
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Poyrazoğlu Ş, Bundak R, Yavaş Abalı Z, Önal H, Sarıkaya S, Akgün A, Baş S, Abalı S, Bereket A, Eren E, Tarım Ö, Güven A, Yıldız M, Karaman Aksakal D, Yüksel A, Seymen Karabulut G, Hatun Ş, Özgen T, Cesur Y, Azizoğlu M, Dilek E, Tütüncüler F, Papatya Çakır E, Özcabı B, Evliyaoğlu O, Karadeniz S, Dursun F, Bolu S, Arslanoğlu İ, Yeşiltepe Mutlu G, Kırmızıbekmez H, İşgüven P, Üstyol A, Adal E, Uçar A, Cebeci N, Bezen D, Binay Ç, Semiz S, Korkmaz HA, Memioğlu N, Sağsak E, Peltek HN, Yıldız M, Akçay T, Turan S, Güran T, Atay Z, Akcan N, Çizmecioğlu F, Ercan O, Dağdeviren A, Baş F, İşsever H, Darendeliler F. Incidence of Type 1 Diabetes in Children Aged Below 18 Years during 2013-2015 in Northwest Turkey. J Clin Res Pediatr Endocrinol 2018; 10:336-342. [PMID: 29789274 PMCID: PMC6280322 DOI: 10.4274/jcrpe.0025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/22/2018] [Indexed: 02/07/2023] Open
Abstract
Objective To assess the incidence of type 1 diabetes mellitus (T1DM) in children under 18 years of age in the northwest region of Turkey during 2013-2015. Methods All newly diagnosed T1DM cases were recorded prospectively during 2013-2015. Total, as well as gender and age group specific (0-4, 5-9, 10-14 and 15-17 age) mean incidences per 100,000 per year were calculated. Results There were 1,773 patients diagnosed during 2013-2015 (588 cases in 2013, 592 cases in 2014, 593 cases in 2015). Of these, 862 (48.6%) were girls and 911 (51.4%) were boys. The mean age at diagnosis was 9.2±4.2 years and it was not significantly different between girls (9.0±4.1 years) and boys (9.4±4.4 years) (p=0.052). The crude mean incidence was 8.99/100.000 confidence interval (CI) (95% CI: 8.58-9.42). Although mean incidence was similar between boys [8.98/100.000 (CI: 8.40 to 9.58)] and girls [9.01/100.000 (CI: 8.42 to 9.63)], there was male predominance in all groups except for 5-9 year age group. The standardized mean incidence was 9.02/100.000 according to the World Health Organization standard population. The mean incidence for the 0-4, 5-9, 10-14 and 15-17 age groups was 6.13, 11.68, 11.7 and 5.04/100.000 respectively. The incidence of T1DM was similar over the course of three years (p=0.95). A significant increase in the proportion of cases diagnosed was observed in the autumn-winter seasons. Conclusion The northwest region of Turkey experienced an intermediate incidence of T1DM over the period of the study.
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Affiliation(s)
- Şükran Poyrazoğlu
- İstanbul University İstanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Rüveyde Bundak
- İstanbul University İstanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
- University of Kyrenia Faculty of Medicine, Department of Pediatric Endocrinology, Kyrenia, Turkish Republic of North Cyprus
| | - Zehra Yavaş Abalı
- İstanbul University İstanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Hasan Önal
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology and Metabolic Disease, İstanbul, Turkey
| | - Sevil Sarıkaya
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology and Metabolic Disease, İstanbul, Turkey
| | - Abdurrahman Akgün
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology and Metabolic Disease, İstanbul, Turkey
| | - Serpil Baş
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Saygın Abalı
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
- Kartal Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Abdullah Bereket
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Erdal Eren
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
| | - Ömer Tarım
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
| | - Ayla Güven
- Amasya University Faculty of Medicine, Department of Pediatric Endocrinology, Amasya, Turkey
- Göztepe Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Metin Yıldız
- Göztepe Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Derya Karaman Aksakal
- Göztepe Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Ayşegül Yüksel
- Kocaeli University Faculty of Medicine, Department of Pediatric Endocrinology, Kocaeli, Turkey
| | - Gülcan Seymen Karabulut
- Kocaeli University Faculty of Medicine, Department of Pediatric Endocrinology, Kocaeli, Turkey
| | - Şükrü Hatun
- Kocaeli University Faculty of Medicine, Department of Pediatric Endocrinology, Kocaeli, Turkey
- Koç University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Tolga Özgen
- Bezmialem Vakıf University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Yaşar Cesur
- Bezmialem Vakıf University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Mehmet Azizoğlu
- Trakya University Faculty of Medicine, Department of Pediatric Endocrinology, Edirne, Turkey
| | - Emine Dilek
- Trakya University Faculty of Medicine, Department of Pediatric Endocrinology, Edirne, Turkey
| | - Filiz Tütüncüler
- Trakya University Faculty of Medicine, Department of Pediatric Endocrinology, Edirne, Turkey
| | - Esra Papatya Çakır
- Bakırköy Dr. Sadi Konuk Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
- Şevket Yılmaz Training and Research Hospital, Clinic of Pediatric Endocrinology, Bursa, Turkey
| | - Bahar Özcabı
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
- Zeynep Kamil Women’s and Children’s Disease Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Olcay Evliyaoğlu
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Songül Karadeniz
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Fatma Dursun
- Ümraniye Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Semih Bolu
- Düzce University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - İlknur Arslanoğlu
- Düzce University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Gül Yeşiltepe Mutlu
- Kocaeli University Faculty of Medicine, Department of Pediatric Endocrinology, Kocaeli, Turkey
- Zeynep Kamil Women’s and Children’s Disease Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Heves Kırmızıbekmez
- Zeynep Kamil Women’s and Children’s Disease Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Pınar İşgüven
- Sakarya University Faculty of Medicine, Department of Pediatric Endocrinology, Sakarya, Turkey
| | - Ala Üstyol
- Haseki Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Erdal Adal
- Medipol University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Ahmet Uçar
- Şişli Etfal Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Nurcan Cebeci
- Derince Training and Research Hospital, Clinic of Pediatric Endocrinology, Kocaeli, Turkey
| | - Didem Bezen
- Okmeydanı Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Çiğdem Binay
- Çorlu State Hospital, Clinic of Pediatric Endocrinology, Tekirdağ, Turkey
| | - Serap Semiz
- Acıbadem University Faculty of Medicine, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Hüseyin Anıl Korkmaz
- Balıkesir Atatürk State Hospital, Clinic of Pediatric Endocrinology, Balıkesir, Turkey
| | - Nihal Memioğlu
- American Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Elif Sağsak
- Gaziosmanpaşa Taksim Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Havva Nur Peltek
- Edirne Sultan 1. Murat State Hospital, Clinic of Pediatric Endocrinology, Edirne, Turkey
| | - Melek Yıldız
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology and Metabolic Disease, İstanbul, Turkey
| | - Teoman Akçay
- Medical Park Gaziosmanpaşa Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Serap Turan
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Tülay Güran
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Zeynep Atay
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
- Medipol University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Neşe Akcan
- Göztepe Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
- University of Near East Faculty of Medicine, Department of Pediatric Endocrinology, Nicosia, Turkish Republic of North Cyprus
| | - Filiz Çizmecioğlu
- Kocaeli University Faculty of Medicine, Department of Pediatric Endocrinology, Kocaeli, Turkey
| | - Oya Ercan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Aydilek Dağdeviren
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Firdevs Baş
- İstanbul University İstanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Halim İşsever
- İstanbul University İstanbul Faculty of Medicine, Department of Public Health, İstanbul, Turkey
| | - Feyza Darendeliler
- İstanbul University İstanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
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8
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Şendur R, Özcabı B, Mutlu GY, Bozaykut A. Effective sociodemographic and clinical factors in weight loss in childhood obesity. Turk Arch Pediatr 2018; 53:169-176. [PMID: 30459516 DOI: 10.5152/turkpediatriars.2018.6210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 04/12/2018] [Indexed: 11/22/2022]
Abstract
Aim Obesity is a more common and important health problem in childhood. We aimed to determine sociodemographic and clinical factors contributing weight loss. Material and Methods Medical records of 120 obese patients (6-18 years old) applied at least twice for follow-up between 2012 (January)-2016 (September) were reviewed. Age, gender, socioeconomic status, family obesity, comorbidities, medications, operations, exercise frequency, screen time, physical examination findings and biochemical/hormone values [thyroid hormone, fasting insulin/glucose, cholesterol levels, Homeostasis model assesment insulin resistance (HOMA-IR), oral glucose tolerance test results (if applied) were recorded. Patients with a difference between the initial and last body mass index standart deviation higher than -0.2 were defined as "the good losing weight" group; the rest as "the poorly losing weight" group. The SPSS 22.0 program was used for analyzes. Results Puberty stage showed a significant difference (p=0,019); 65% of patients in the poorly losing weight group but 54% of other group were at stage 4-5. The initial body mass index standart deviation and exercise frequency were higher in the good losing weight group, the last measured body mass index standart deviation was lower (p=0). In the other group, baseline HOMA-IR was higher (p=0.037); there were more metformin-initiated patients but the difference was not significant. Conclusion We observed that exercise frequency was higher in cases with good weight loss; therefore, we consider that increasing physical activity is an important step. Other crucial outcomes are that the initial body mass index standart deviation is higher while HOMA-IR is lower in those cases and that puberty stage is higher in poorly weight losing patients.
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Affiliation(s)
- Ruba Şendur
- Clinic of Pediatrics, Zeynep Kamil Women's and Children's Diseases Training and Research Hospital, İstanbul, Turkey
| | - Bahar Özcabı
- Division of Pediatric Endocrinology, Zeynep Kamil Women's and Children's Diseases Training and Research Hospital, İstanbul, Turkey
| | - Gül Yeşiltepe Mutlu
- Division of Pediatric Endocrinology, Zeynep Kamil Women's and Children's Diseases Training and Research Hospital, İstanbul, Turkey.,Division of Pediatric Endocrinology, Koç Univeristy School of Medicine, İstanbul, Turkey
| | - Abdulkadir Bozaykut
- Clinic of Pediatrics, Zeynep Kamil Women's and Children's Diseases Training and Research Hospital, İstanbul, Turkey
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Evliyaoğlu O, Ercan O, Ataloğlu E, Zübarioğlu Ü, Özcabı B, Dağdeviren A, Erdoğan H, De Franco E, Ellard S. Neonatal Diabetes: Two Cases with Isolated Pancreas Agenesis due to Homozygous PTF1A Enhancer Mutations and One with Developmental Delay, Epilepsy, and Neonatal Diabetes Syndrome due to KCNJ11 Mutation. J Clin Res Pediatr Endocrinol 2018; 10:168-174. [PMID: 28943513 PMCID: PMC5985387 DOI: 10.4274/jcrpe.5162] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 09/23/2017] [Indexed: 12/01/2022] Open
Abstract
Neonatal diabetes mellitus is a rare form of monogenic diabetes which is diagnosed in the first six months of life. Here we report three patients with neonatal diabetes; two with isolated pancreas agenesis due to mutations in the pancreas-specific transcription factor 1A (PTF1A) enhancer and one with developmental delay, epilepsy, and neonatal diabetes (DEND) syndrome, due to a KCNJ11 mutation. The two cases with mutations in the distal enhancer of PTF1A had a homozygous g.23508363A>G and a homozygous g.23508437A>G mutation respectively. Previous functional analyses showed that these mutations can decrease expression of PTF1A which is involved in pancreas development. Both patients were born small for gestational age to consanguineous parents. Both were treated with insulin and pancreatic enzymes. One of these patients’ fathers was also homozygous for the PTF1A mutation, whilst his partner and the parents of the other patient were heterozygous carriers. In the case with DEND sydrome, a previosly reported heterozygous KCNJ11 mutation, p.Cys166Tyr (c.497G>A), was identified. This patient was born to nonconsanguineous parents with normal birth weight. The majority of neonatal diabetes patients with KCNJ11 mutations will respond to sulphonylurea treatment. Therefore Glibenclamide, an oral antidiabetic of the sulphonylurea group, was started. This treatment regimen relatively improved blood glucose levels and neurological symptoms in the short term. Because we could not follow the patient in the long term, we are not able to draw conclusions about the efficacy of the treatment. Although neonatal diabetes mellitus can be diagnosed clinically, genetic analysis is important since it is a guide for the treatment and for prognosis.
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Affiliation(s)
- Olcay Evliyaoğlu
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Oya Ercan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Emel Ataloğlu
- University of Health Science, Haseki Training and Research Hospital, Newborn Intensive Unit, İstanbul, Turkey
| | - Ümit Zübarioğlu
- Şişli Hamidiye Etfal Training and Research Hospital, Newborn Intensive Unit, İstanbul, Turkey
| | - Bahar Özcabı
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Aydilek Dağdeviren
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Hande Erdoğan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Elisa De Franco
- University of Exeter Medical School, Institute of Biomedical and Clinical Science, Exeter, United Kingdom
| | - Sian Ellard
- University of Exeter Medical School, Institute of Biomedical and Clinical Science, Exeter, United Kingdom
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10
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Özcabı B, Tahmiscioğlu Bucak F, Jaferova S, Oruç Ç, Adrovic A, Ceylaner S, Ercan O, Evliyaoğlu O. A Case of Vitamin D-Dependent Rickets Type 1A with a Novel Mutation in the Uzbek Population. J Clin Res Pediatr Endocrinol 2016; 8:484-489. [PMID: 27353739 PMCID: PMC5198011 DOI: 10.4274/jcrpe.3128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Vitamin D-dependent rickets type 1A (VDDR-1A) (Online Mendelian Inheritance in Man #264700) is a rare, autosomal recessively inherited disorder due to inactivating mutations in CYP27B1. It is characterized by early onset of rickets with hypocalcemia. We aimed to describe the clinical and laboratory findings in a VDDR-1A case and to report a novel homozygote truncating mutation NM_000785.3 c.403C>T (p.Q135*) in CYP27B1 which to our knowledge is the first described mutation in the Uzbek population. The patient was admitted with tetany at the age of 12 months. He was a healthy Uzbek boy until 9 months of age when he had a seizure due to hypocalcemia. Vitamin D treatment was given orally in Turkmenistan (no data available for dose and duration). The patient was the product of a consanguineous marriage. His brother had died with hypocalcemia and pneumonia. At physical examination, anthropometric measurements were within normal limits; he had caput quadratum, enlarged wrists, and carpopedal spasm. Blood calcium, phosphorus, alkaline phosphatase, and parathormone (PTH) levels were 5.9 mg/dL, 3.5 mg/dL, 987 IU/L, and 182.8 pg/mL (12-72), respectively. Radiological findings included cupping and fraying of the radial and ulnar metaphyses. Renal ultrasound revealed nephrocalcinosis (grade 1). Despite high serum PTH and 25-hydroxyvitamin D3 levels, 1,25-dihydroxyvitamin D3 level was low, suggesting a diagnosis of VDDR-1A. The patient was treated with calcium carbonate and calcitriol. DNA sequencing revealed a novel homozygous mutation of NM_000785.3 c.403C>T (p.Q135*) in CYP27B1. VDDR-1A is a rare disorder which needs to be considered even in countries where nutritional vitamin D deficiency is still common.
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Affiliation(s)
- Bahar Özcabı
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Feride Tahmiscioğlu Bucak
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Sevinç Jaferova
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Çiğdem Oruç
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Amra Adrovic
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Serdar Ceylaner
- Intergen Genetic Center and Yüksek İhtisas University Faculty of Medicine, Department of Medical Genetics, Ankara, Turkey
| | - Oya Ercan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Olcay Evliyaoğlu
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey, E-mail:
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11
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Özcabı B, Tahmiscioğlu Bucak F, Ceylaner S, Özcan R, Büyükünal C, Ercan O, Tüysüz B, Evliyaoğlu O. Testotoxicosis: Report of Two Cases, One with a Novel Mutation in LHCGR Gene. J Clin Res Pediatr Endocrinol 2015; 7:242-8. [PMID: 26831561 PMCID: PMC4677562 DOI: 10.4274/jcrpe.2067] [Citation(s) in RCA: 16] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Testotoxicosis is a rare disorder which presents as isosexual peripheral precocious puberty in males. Despite the pattern of autosomal dominant inheritance, sporadic cases also may occur. Due to activating mutation in luteinizing hormone (LH))/choriogonadotropin receptor (LHCGR) gene, early virilization and advancement in bone age are common with increased serum testosterone levels above adult ranges, despite low LH and follicular-stimulating hormone (FSH) levels. There are different treatment regimens, such as combination of bicalutamide (antiandrogen agent) and a third-generation aromatase inhibitor, that are reported to be well-tolerated and successful in slowing bone age advancement and preventing progression of virilization. We report here two patients who presented with peripheral precocious puberty and an activating mutation in the LHCGR gene: one with a family history and previously determined mutation and the other without family history and with a novel mutation (c.830G>T). Combination of bicalutamide+anastrozole was ineffective in slowing pubertal progression and bone age. Short-term results were better with ketoconazole.
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Affiliation(s)
- Bahar Özcabı
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Feride Tahmiscioğlu Bucak
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | | | - Rahşan Özcan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Surgery, İstanbul, Turkey
| | - Cenk Büyükünal
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Surgery, İstanbul, Turkey
| | - Oya Ercan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Beyhan Tüysüz
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Genetic, İstanbul, Turkey
| | - Olcay Evliyaoğlu
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey Phone: +90 212 414 30 00 E-mail:
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12
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Evliyaoğlu O, Acar M, Özcabı B, Erginöz E, Bucak F, Ercan O, Kucur M. Vitamin D Deficiency and Hashimoto's Thyroiditis in Children and Adolescents: a Critical Vitamin D Level for This Association? J Clin Res Pediatr Endocrinol 2015; 7:128-33. [PMID: 26316435 PMCID: PMC4563184 DOI: 10.4274/jcrpe.2011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [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: 01/10/2023] Open
Abstract
OBJECTIVE Vitamin D has been suggested to be active as an immunomodulator in autoimmune diseases such as Hashimoto's thyroiditis (HT). The goal of the present study was to investigate the vitamin D status in HT patients. METHODS This prevalence case-control study was conducted on 90 patients with HT (of ages 12.32 ± 2.87 years) and 79 age-matched healthy controls (11.85 ± 2.28 years). Serum 25-hydroxyvitamin D3 [25(OH)D3] levels were measured in all 169 subjects. RESULTS The prevalence of vitamin D deficiency in HT patients (64 of 90; 71.1%) was significantly higher than that in the control group (41 of 79; 51.9%) (p=0.025). Mean serum 25(OH)D3 level in the HT group was significantly lower compared to the control group (16.67 ± 11.65 vs. 20.99 ± 9.86 ng/mL, p=0.001). HT was observed 2.28 times more frequently in individuals with 25(OH)D3 levels <20 ng/mL (OR: 2.28, CI: 1.21-4.3). CONCLUSION Vitamin D deficiency is associated with HT in children and adolescents. Levels lower than 20 ng/mL seem to be critical. The mechanism for this association is not clear.
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Affiliation(s)
- Olcay Evliyaoğlu
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey Phone: +90 533 633 15 64 E-mail:
| | - Manolya Acar
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Bahar Özcabı
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Ethem Erginöz
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Public Health, İstanbul, Turkey
| | - Feride Bucak
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Oya Ercan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Mine Kucur
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Biochemistry, İstanbul, Turkey
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13
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Abstract
Adrenal hypoplasia congenita (AHC) is a rare disorder. The X-linked form is related to mutations in the DAX1 (NROB1) gene. Here, we report a newborn who had a novel hemizygous frameshift mutation in DAX1(c.543delA) and presented with primary adrenal failure that was initially misdiagnosed as congenital adrenal hyperplasia. This report highlights the value of genetic testing for definite diagnosis in children with primary adrenal failure due to abnormal adrenal gland development, providing the possibility both for presymptomatic, and in cases with a sibling with this condition, for prenatal diagnosis.
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Affiliation(s)
- Olcay Evliyaoğlu
- Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul University Cerrahpaşa, İstanbul, Turkey.
| | - İpek Dokurel
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Feride Bucak
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Bahar Özcabı
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Oya Ercan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Serdar Ceylaner
- Intergen, Genetic Diagnosis Research and Application Center, Ankara, Turkey
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