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Besci Ö, Fırat SN, Özen S, Çetinkaya S, Akın L, Kör Y, Pekkolay Z, Özalkak Ş, Özsu E, Erdeve ŞS, Poyrazoğlu Ş, Berberoğlu M, Aydın M, Omma T, Akıncı B, Demir K, Oral EA. A National Multicenter Study of Leptin and Leptin Receptor Deficiency and Systematic Review. J Clin Endocrinol Metab 2023; 108:2371-2388. [PMID: 36825860 DOI: 10.1210/clinem/dgad099] [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: 08/22/2022] [Revised: 01/25/2023] [Accepted: 02/15/2023] [Indexed: 02/25/2023]
Abstract
CONTEXT Homozygous leptin (LEP) and leptin receptor (LEPR) variants lead to childhood-onset obesity. OBJECTIVE To present new cases with LEP and LEPR deficiency, report the long-term follow-up of previously described patients, and to define, based on all reported cases in literature, genotype-phenotype relationships. METHODS Our cohort included 18 patients (LEP = 11, LEPR = 7), 8 of whom had been previously reported. A systematic literature review was conducted in July 2022. Forty-two of 47 studies on LEP/LEPR were selected. RESULTS Of 10 new cases, 2 novel pathogenic variants were identified in LEP (c.16delC) and LEPR (c.40 + 5G > C). Eleven patients with LEP deficiency received metreleptin, 4 of whom had been treated for over 20 years. One patient developed loss of efficacy associated with neutralizing antibody development. Of 152 patients, including 134 cases from the literature review in addition to our cases, frameshift variants were the most common (48%) in LEP and missense variants (35%) in LEPR. Patients with LEP deficiency were diagnosed at a younger age [3 (9) vs 7 (13) years, P = .02] and had a higher median body mass index (BMI) SD score [3.1 (2) vs 2.8 (1) kg/m2, P = 0.02], which was more closely associated with frameshift variants (P = .02). Patients with LEP deficiency were more likely to have hyperinsulinemia (P = .02). CONCLUSION Frameshift variants were more common in patients with LEP deficiency whereas missense variants were more common in LEPR deficiency. Patients with LEP deficiency were identified at younger ages, had higher BMI SD scores, and had higher rates of hyperinsulinemia than patients with LEPR deficiency. Eleven patients benefitted from long-term metreleptin, with 1 losing efficacy due to neutralizing antibodies.
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Affiliation(s)
- Özge Besci
- Division of Pediatric Endocrinology, Faculty of Medicine, Dokuz Eylül University, İzmir 35340, Turkey
| | - Sevde Nur Fırat
- Division of Endocrinology and Metabolism, University of Health Sciences Ankara Training and Research Hospital, Ankara 06230, Turkey
| | - Samim Özen
- Division of Pediatric Endocrinology, Faculty of Medicine, Ege University, İzmir 35100, Turkey
| | - Semra Çetinkaya
- Division of Pediatric Endocrinology, Health Sciences University, Dr Sami Ulus Obstetrics and Gynecology, Children's Health and Disease, Health Implementation and Research Center, Ankara 06010, Turkey
| | - Leyla Akın
- Division of Pediatric Endocrinology, Faculty of Medicine, Ondokuz Mayıs University, Samsun 55030, Turkey
| | - Yılmaz Kör
- Division of Pediatric Endocrinology, Ministry of Health, Adana Public Hospitals Association, Adana City Hospital, Adana 01040, Turkey
| | - Zafer Pekkolay
- Division of Endocrinology and Metabolism, Dicle University Faculty of Medicine, Diyarbakır 21280, Turkey
| | - Şervan Özalkak
- Division Pediatric Endocrinology, Diyarbakir Gazi Yaşargil Training and Research Hospital, Diyarbakır 21070, Turkey
| | - Elif Özsu
- Department of Pediatric Endocrinology, Ankara University Faculty of Medicine, Ankara 06100, Turkey
| | - Şenay Savaş Erdeve
- Division of Pediatric Endocrinology, Health Sciences University, Dr Sami Ulus Obstetrics and Gynecology, Children's Health and Disease, Health Implementation and Research Center, Ankara 06010, Turkey
| | - Şükran Poyrazoğlu
- Department of Pediatric Endocrinology, Istanbul University Istanbul Faculty of Medicine, İstanbul 34098, Turkey
| | - Merih Berberoğlu
- Department of Pediatric Endocrinology, Ankara University Faculty of Medicine, Ankara 06100, Turkey
| | - Murat Aydın
- Division of Pediatric Endocrinology, Faculty of Medicine, Ondokuz Mayıs University, Samsun 55030, Turkey
| | - Tülay Omma
- Division of Endocrinology and Metabolism, University of Health Sciences Ankara Training and Research Hospital, Ankara 06230, Turkey
| | - Barış Akıncı
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dokuz Eylul University, İzmir 35340, Turkey
| | - Korcan Demir
- Division of Pediatric Endocrinology, Faculty of Medicine, Dokuz Eylül University, İzmir 35340, Turkey
| | - Elif Arioglu Oral
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48105, USA
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Ece Erik H, Fadıloğlu E, Hasçelik G, Akın L. Evaluation of pertussis antibody levels and related factors in maternal and cord blood, 2020. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.464] [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: 11/13/2022] Open
Abstract
Abstract
Background
Pregnancy immunization is recommended to protect babies against pertussis, which has a high mortality and morbidity during infancy, but whooping cough vaccine is not given to pregnant women in Turkey. In this study, pertussis antibodies in maternal and cord blood were investigated.
Methods
The study group was one hundred and fifty-four mothers who gave birth at Hacettepe University Hospitals in Ankara, from July to October 2020. The information of the mothers was collected by questionnaire and sera were taken. In this descriptive epidemiological study, anti-PT and anti-FHA were investigated with ELISA (EUROIMMUN B. Pertussis toxin (PT) IgG, Filamentous Hemagglutinin (FHA) IgG) method in maternal and cord-paired sera, the limit value was accepted as 10 IU/ml. Anti-ACT was investigated in the sera of 79 mothers who were anti-PT or anti-FHA positive by Immunblot (EUROIMMUN Adenylate Cyclase Toxin (ACT) IgG) method. Correlation analysis of continuous numerical variables was performed. The difference between categorical variables was evaluated with the Chi-Square test.
Results
Mean (SD) maternal age, gestational age and birth weight were 30.1 (5.1) years, 38.5 (0.9) weeks, 3307 (441) g, respectively. Anti-PT and anti-FHA are at protective levels in 18.8% and 48.1% of the mothers, respectively. Anti-PT and anti-FHA are at the protective level in 38.3% and 55.8% of the cord, respectively. Anti-FHA positivity is 63.3% between the ages of 25 and under, 38.6% between the ages of 26-35, and 69.6% at the age of 36 and over (p = 0.005). 72.4% of mothers with anti-PT positive and 67.6% of mothers with anti-FHA positive were anti-ACT antibody positive. Anti-ACT positive mothers were immunized by having the disease, not by vaccine. Anti-PT and anti-FHA antibody levels in maternal and cord blood are highly correlated.
Conclusions
Protective level of pertussis antibodies in maternal and cord blood is low. Most mothers are immunized with pertussis infection, not vaccine.
Key messages
The amount of pertussis antibodies in maternal and cord blood is low in Turkey and maternal immunization is needed. The addition of pertussis-containing vaccines to pregnant immunization is important to protect babies from whooping cough disease, which remains a major public health problem.
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Affiliation(s)
- H Ece Erik
- Hacettepe University Faculty of Medicine, Department of Public Health, Ankara, Turkey
| | - E Fadıloğlu
- Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - G Hasçelik
- Hacettepe University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - L Akın
- Hacettepe University Faculty of Medicine, Department of Public Health, Ankara, Turkey
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Kardaş F, Yücel AD, Kendirci M, Kurtoğlu S, Hatipoğlu N, Akın L, Gül Ü, Gökay S, Üstkoyuncu PS. Evaluation of micronutrient levels in children and adolescents with obesity and their correlation with the components of metabolic syndrome. Turk J Pediatr 2021; 63:48-58. [PMID: 33686826 DOI: 10.24953/turkjped.2021.01.006] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Obesity is a significant public health problem worldwide. Vitamin deficiencies, developing due to monotype nutrition, are more likely to be observed in patients than healthy children. The present study evaluates vitamin and micronutrient levels in children and adolescents with obesity and metabolic syndrome compared to healthy controls. METHODS The study included 73 patients with obesity, 64 patients with metabolic syndrome and 71 healthy children (control group) aged 10 to 16 years. Physical examinations were performed, and waist circumference and systolic blood pressure measurements were recorded. Fasting blood glucose, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, insulin, vitamin A, vitamin E, vitamin B1, vitamin B2, vitamin B6, vitamin B12, folic acid and free carnitine levels were analyzed. The homeostatic model of assessment-insulin resistance (HOMA-IR) index was calculated and recorded. RESULTS The mean age of all patients was 11.9±2.6 years. The serum insulin level and HOMA-IR index were found to be significantly higher in the obesity and metabolic syndrome groups. No significant difference was found between the groups in terms of vitamin A, vitamin B6 and free carnitine levels. Significantly decreased vitamin E, vitamin B2, vitamin B12 and folic acid and increased vitamin B1 levels were observed in the obesity and metabolic syndrome groups. CONCLUSIONS Compared to healthy children, children with obesity and metabolic syndrome may have varying degrees of micronutrient and vitamin deficiency due to poor and unbalanced eating habits. These deficiencies should also be considered in the treatment and follow-up of obesity and metabolic syndrome.
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Affiliation(s)
- Fatih Kardaş
- Divisions of Pediatric Nutrition and Metabolism, Erciyes University Faculty, Kayseri, Turkey
| | - Arife Derda Yücel
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Mustafa Kendirci
- Department of Pediatric Endocrinology, Erciyes University Faculty, Kayseri, Turkey
| | - Selim Kurtoğlu
- Department of Pediatric Endocrinology, Erciyes University Faculty, Kayseri, Turkey
| | - Nihal Hatipoğlu
- Department of Pediatric Endocrinology, Erciyes University Faculty, Kayseri, Turkey
| | - Leyla Akın
- Department of Pediatric Endocrinology, Erciyes University Faculty, Kayseri, Turkey
| | - Ülkü Gül
- Department of Pediatric Endocrinology, Erciyes University Faculty, Kayseri, Turkey
| | - Songül Gökay
- Deparment of Pediatric Metabolism, Ministry of Health, Kayseri City Hospital, Kayseri, Turkey
| | - Pembe Soylu Üstkoyuncu
- Deparment of Pediatric Metabolism, Ministry of Health, Kayseri City Hospital, Kayseri, Turkey
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Abstract
OBJECTIVE We aimed to investigate a possible role of the endocrine disruptors phthalates, di-2-ethylhexyl phthalate (DEHP) and mono (2-ethylhexyl) phthalate (MEHP), in polycystic ovary syndrome (PCOS) aetiopathogenesis. We also wished to evaluate the relationship between phthalates and metabolic disturbances in adolescents with PCOS. METHODS A total of 124 adolescents were included. Serum MEHP and DEHP levels were determined by high-performance liquid chromatography. Insulin resistance was evaluated using homeostasis model assessment-insulin resistance, quantitative Insulin Sensitivity Check Index, fasting glucose/insulin ratio, Matsuda index, and total insulin levels during oral glucose tolerance test. Participants were further subdivided into lean and obese subgroups according to body mass index (BMI). RESULTS Sixty-three PCOS and 61 controls, (mean age 15.2±1.5; range: 13-19 years) were enrolled. Serum DEHP and MEHP concentrations were not significantly different between PCOS and control groups. The mean (95% confidence interval) values of DEHP and MEHP were 2.62 (2.50-2.75) μg/mL vs 2.71 (2.52-2.90) μg/mL and 0.23 (0.19-0.29) μg/mL vs 0.36 (0.18-0.54) μg/mL in PCOS and the control groups respectively, p>0.05. Correlation analysis, adjusted for BMI, showed that both phthalates significantly correlated with insulin resistance indices and serum triglycerides in adolescents with PCOS. CONCLUSION Serum DEHP and MEHP concentrations were not different between adolescents with or without PCOS. However, these phthalates are associated with metabolic disturbances such as dyslipidemia and insulin resistance, independently of obesity, in girls with PCOS.
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Affiliation(s)
- Leyla Akın
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey,Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Endocrinology, Samsun, Turkey,* Address for Correspondence: Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Endocrinology, Samsun, Turkey Phone: +90 533 240 16 43 E-mail:
| | - Mustafa Kendirci
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
| | - Figen Narin
- Erciyes University Faculty of Medicine, Department of Biochemistry, Kayseri; İzmir Kâtip Çelebi University, Department of Medical Biochemistry, İzmir, Turkey
| | - Selim Kurtoglu
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
| | - Nihal Hatipoglu
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
| | - Ferhan Elmalı
- Erciyes University Faculty of Medicine, Department of Biochemistry, Kayseri; İzmir Kâtip Çelebi University, Department of Medical Biochemistry, İzmir, Turkey
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Şiraz ÜG, Ökdemir D, Direk G, Akın L, Hatipoğlu N, Kendirci M, Kurtoğlu S. ROHHAD Syndrome, a Rare Cause of Hypothalamic Obesity: Report of Two Cases. J Clin Res Pediatr Endocrinol 2018; 10:382-386. [PMID: 29553042 PMCID: PMC6280328 DOI: 10.4274/jcrpe.0027] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Rapid-onset obesity with hypoventilation, hypothalamic dysfunction and autonomic dysregulation (ROHHAD) syndrome is a rare disease that is difficult to diagnosis and distinguish from genetic obesity syndromes. The underlying causes of the disease have not been fully explained. Hypothalamic dysfunction causes endocrine problems, respiratory dysfunction and autonomic alterations. Currently there are around 80 reported patients although this is likely due to underdiagnosis due to lack of recognition. We present two female patients suspected of ROHHAD due to weight gain starting in early childhood. Clinical and biochemical findings such as respiratory and circulatory dysfunction, hypothalamic hypernatremia, central hypothyrodism, hyperprolactinemia and central early puberty in these patients matched the criteria for ROHHAD syndrome. ROHHAD syndrome should be considered in the differential diagnosis of monogenic obesity.
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Affiliation(s)
- Ülkü Gül Şiraz
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey,* Address for Correspondence: Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey Phone: +90 532 505 87 09 E-mail:
| | - Deniz Ökdemir
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
| | - Gül Direk
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
| | - Leyla Akın
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
| | - Nihal Hatipoğlu
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
| | - Mustafa Kendirci
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
| | - Selim Kurtoğlu
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
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Argun M, Baykan A, Hatipoğlu N, Akın L, Şahin Y, Narin N, Kurtoğlu S. Arrhythmia in thiamine responsive megaloblastic anemia syndrome. TurkJPediatr 2018; 60:348-351. [DOI: 10.24953/turkjped.2018.03.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ozcan A, Kendirci M, Kondolot M, Kardas F, Akın L. Evaluation of vitamin D prophylaxis in 3-36-month-old infants and children. J Pediatr Endocrinol Metab 2017; 30:543-549. [PMID: 28328529 DOI: 10.1515/jpem-2016-0223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 11/28/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Vitamin D (VD) deficiency (VDD) is still a population-based health problem that affects people at different ages. The aim of this study was to evaluate VD prophylaxis for the prevention of VDD in (3-36)-month-old infants and children. METHODS Infants and children aged between 3 and 36 months, with different etiologies, admitted to outpatient and inpatient clinics from October 2010 to October 2011 at the Children's Hospital of Erciyes University, were enrolled for the study. Their VD intake (if used; time of initiation, dosage and compliance) and nutritional status (breast-fed, formula or complementary fed) were noted. In order to study seasonal VD changes, the levels of serum calcium, phosphorus and magnesium, alkaline phosphatase activity (PLA), plasma parathyroid hormone (PTH) and 25 hydroxyvitamin 25(OH)D levels were measured at the beginning of VD supplementation during the four seasons. RESULTS A total of 316 subjects were enrolled in the study, consisting of 202 (63.9%) outpatient and 114 (26.1%) inpatient groups. From these subjects, 304 (96.2%) were supplemented with VD; whereas 12 (3.8%) were not. Out of the subjects supplemented with VD, 237 (75%) initiated VD after the second week of life, 267 (87.8%) were given three drops of VD daily and 209 (66.1%) had taken VD regularly. The plasma 25(OH)D levels were found to be lower in the inpatient group than the outpatient group (29.35 ng/mL and 34.35 ng/mL, respectively). The plasma 25(OH)D levels were lower during the spring and winter. VDD and VD insufficiency (VDI) was found in 31 (9.8%) and 30 (9.5%) subjects, respectively. CONCLUSIONS The plasma 25(OH)D levels were lower in inpatient and breast-fed only subjects and in winter and spring. The national VD augmentation program seems to be beneficial for the prevention of VDD, but VDD/VDI seems to still be an important health problem.
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Sari E, Bereket A, Yeşilkaya E, Baş F, Bundak R, Aydın BK, Darcan Ş, Dündar B, Büyükinan M, Kara C, Adal E, Akıncı A, Atabek ME, Demirel F, Çelik N, Özkan B, Özhan B, Orbak Z, Ersoy B, Doğan M, Ataş A, Turan S, Gökşen D, Tarım Ö, Yüksel B, Ercan O, Hatun Ş, Şimşek E, Ökten A, Abacı A, Döneray H, Özbek MN, Keskin M, Önal H, Akyürek N, Bulan K, Tepe D, Emeksiz HC, Demir K, Kızılay D, Topaloğlu AK, Eren E, Özen S, Demirbilek H, Abalı S, Akın L, Eklioğlu BS, Kaba S, Anık A, Baş S, Unuvar T, Sağlam H, Bolu S, Özgen T, Doğan D, Çakır ED, Şen Y, Andıran N, Çizmecioğlu F, Evliyaoğlu O, Karagüzel G, Pirgon Ö, Çatlı G, Can HD, Gürbüz F, Binay Ç, Baş VN, Fidancı K, Gül D, Polat A, Acıkel C, Cinaz P, Darendeliler F. Anthropometric findings from birth to adulthood and their relation with karyotpye distribution in Turkish girls with Turner syndrome. Am J Med Genet A 2016; 170A:942-8. [PMID: 26788866 DOI: 10.1002/ajmg.a.37498] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 10/06/2015] [Indexed: 11/10/2022]
Abstract
To evaluate the anthropometric features of girls with Turner syndrome (TS) at birth and presentation and the effect of karyotype on these parameters. Data were collected from 842 patients with TS from 35 different centers, who were followed-up between 1984 and 2014 and whose diagnosis age ranged from birth to 18 years. Of the 842 patients, 122 girls who received growth hormone, estrogen or oxandrolone were excluded, and 720 girls were included in the study. In this cohort, the frequency of small for gestational age (SGA) birth was 33%. The frequency of SGA birth was 4.2% (2/48) in preterm and 36% (174/483) in term neonates (P < 0.001). The mean birth length was 1.3 cm shorter and mean birth weight was 0.36 kg lower than that of the normal population. The mean age at diagnosis was 10.1 ± 4.4 years. Mean height, weight and body mass index standard deviation scores at presentation were -3.1 ± 1.7, -1.4 ± 1.5, and 0.4 ± 1.7, respectively. Patients with isochromosome Xq were significantly heavier than those with other karyotype groups (P = 0.007). Age at presentation was negatively correlated and mid-parental height was positively correlated with height at presentation. Mid-parental height and age at presentation were the only parameters that were associated with height of children with TS. The frequency of SGA birth was found higher in preterm than term neonates but the mechanism could not be clarified. We found no effect of karyotype on height of girls with TS, whereas weight was greater in 46,X,i(Xq) and 45,X/46,X,i(Xq) karyotype groups.
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Affiliation(s)
- Erkan Sari
- Department of Pediatric Endocrinology, Gulhane Military Medicine Academy, Turkey
| | - Abdullah Bereket
- Department of Pediatric Endocrinology, Marmara University Faculty of Medicine, Turkey
| | - Ediz Yeşilkaya
- Department of Pediatric Endocrinology, Gulhane Military Medicine Academy, Turkey
| | - Firdevs Baş
- Department of Pediatric Endocrinology, Istanbul University Istanbul Faculty of Medicine, Turkey
| | - Rüveyde Bundak
- Department of Pediatric Endocrinology, Istanbul University Istanbul Faculty of Medicine, Turkey
| | - Banu Küçükemre Aydın
- Department of Pediatric Endocrinology, Istanbul University Istanbul Faculty of Medicine, Turkey
| | - Şükran Darcan
- Department of Pediatric Endocrinology, Ege University Faculty of Medicine, Turkey
| | - Bumin Dündar
- Department of Pediatric Endocrinology, İzmir Katip Çelebi University Faculty of Medicine, Turkey
| | - Muammer Büyükinan
- Department of Pediatric Endocrinology, Konya Training and Research Hospital, Turkey
| | - Cengiz Kara
- Department of Pediatric Endocrinology, 19 Mayıs University Faculty of Medicine, Turkey
| | - Erdal Adal
- Department of Pediatric Endocrinology, Kanuni Sultan Süleyman University Faculty of Medicine, Turkey
| | - Ayşehan Akıncı
- Department of Pediatric Endocrinology, İnönü University Faculty of Medicine, Turkey
| | - Mehmet Emre Atabek
- Department of Pediatric Endocrinology, Necmettin Erbakan University Faculty of Medicine, Turkey
| | - Fatma Demirel
- Department of Pediatric Endocrinology, Yıldırım Beyazıt University, Turkey
| | - Nurullah Çelik
- Department of Pediatric Endocrinology, Gazi University Faculty of Medicine, Turkey
| | - Behzat Özkan
- Department of Pediatric Endocrinology, Dr. Behçet Uz Children Hospital, Turkey
| | - Bayram Özhan
- Department of Pediatric Endocrinology, Pamukkale University Faculty of Medicine, Turkey
| | - Zerrin Orbak
- Department of Pediatric Endocrinology, Atatürk University Faculty of Medicine, Turkey
| | - Betül Ersoy
- Department of Pediatric Endocrinology, Celal Bayar University Faculty of Medicine, Turkey
| | - Murat Doğan
- Department of Pediatric Endocrinology, Yüzüncü Yıl University Faculty of Medicine, Turkey
| | - Ali Ataş
- Department of Pediatric Endocrinology, Harran University Faculty of Medicine, Turkey
| | - Serap Turan
- Department of Pediatric Endocrinology, Marmara University Faculty of Medicine, Turkey
| | - Damla Gökşen
- Department of Pediatric Endocrinology, Ege University Faculty of Medicine, Turkey
| | - Ömer Tarım
- Department of Pediatric Endocrinology, Uludağ University Faculty of Medicine, Turkey
| | - Bilgin Yüksel
- Department of Pediatric Endocrinology, Çukurova University Faculty of Medicine, Turkey
| | - Oya Ercan
- Department of Pediatric Endocrinology, Istanbul University Cerrahpaşa Faculty of Medicine, Turkey
| | - Şükrü Hatun
- Department of Pediatric Endocrinology, Kocaeli University Faculty of Medicine, Turkey
| | - Enver Şimşek
- Department of Pediatric Endocrinology, Osmangazi University Faculty of Medicine, Turkey
| | - Ayşenur Ökten
- Department of Pediatric Endocrinology, Karadeniz Technical University Faculty of Medicine, Turkey
| | - Ayhan Abacı
- Department of Pediatric Endocrinology, 9 Eylül University Faculty of Medicine, Turkey
| | - Hakan Döneray
- Department of Pediatric Endocrinology, Atatürk University Faculty of Medicine, Turkey
| | - Mehmet Nuri Özbek
- Department of Pediatric Endocrinology, Diyarbakır Children's State Hospital, Turkey
| | - Mehmet Keskin
- Department of Pediatric Endocrinology, Gaziantep University Faculty of Medicine, Turkey
| | - Hasan Önal
- Department of Pediatric Endocrinology, Kanuni Sultan Süleyman University Faculty of Medicine, Turkey
| | - Nesibe Akyürek
- Department of Pediatric Endocrinology, Necmettin Erbakan University Faculty of Medicine, Turkey
| | - Kezban Bulan
- Department of Pediatric Endocrinology, Yüzüncü Yıl University Faculty of Medicine, Turkey
| | - Derya Tepe
- Department of Pediatric Endocrinology, Yıldırım Beyazıt University, Turkey
| | - Hamdi Cihan Emeksiz
- Department of Pediatric Endocrinology, Gazi University Faculty of Medicine, Turkey
| | - Korcan Demir
- Department of Pediatric Endocrinology, Dr. Behçet Uz Children Hospital, Turkey
| | - Deniz Kızılay
- Department of Pediatric Endocrinology, Celal Bayar University Faculty of Medicine, Turkey
| | - Ali Kemal Topaloğlu
- Department of Pediatric Endocrinology, Çukurova University Faculty of Medicine, Turkey
| | - Erdal Eren
- Department of Pediatric Endocrinology, Uludağ University Faculty of Medicine, Turkey
| | - Samim Özen
- Department of Pediatric Endocrinology, Ege University Faculty of Medicine, Turkey
| | - Hüseyin Demirbilek
- Department of Pediatric Endocrinology, Diyarbakır Children's State Hospital, Turkey
| | - Saygın Abalı
- Department of Pediatric Endocrinology, Marmara University Faculty of Medicine, Turkey
| | - Leyla Akın
- Department of Pediatric Endocrinology, Kanuni Sultan Süleyman University Faculty of Medicine, Turkey
| | - Beray Selver Eklioğlu
- Department of Pediatric Endocrinology, Necmettin Erbakan University Faculty of Medicine, Turkey
| | - Sultan Kaba
- Department of Pediatric Endocrinology, Yüzüncü Yıl University Faculty of Medicine, Turkey
| | - Ahmet Anık
- Department of Pediatric Endocrinology, 9 Eylül University Faculty of Medicine, Turkey
| | - Serpil Baş
- Department of Pediatric Endocrinology, Marmara University Faculty of Medicine, Turkey
| | - Tolga Unuvar
- Department of Pediatric Endocrinology, Kanuni Sultan Süleyman University Faculty of Medicine, Turkey
| | - Halil Sağlam
- Department of Pediatric Endocrinology, Uludağ University Faculty of Medicine, Turkey
| | - Semih Bolu
- Department of Pediatric Endocrinology, Düzce University Faculty of Medicine, Turkey
| | - Tolga Özgen
- Department of Pediatric Endocrinology, Kanuni Sultan Süleyman University Faculty of Medicine, Turkey
| | - Durmuş Doğan
- Department of Pediatric Endocrinology, Uludağ University Faculty of Medicine, Turkey
| | - Esra Deniz Çakır
- Department of Pediatric Endocrinology, Uludağ University Faculty of Medicine, Turkey
| | - Yaşar Şen
- Department of Pediatric Endocrinology, Selçuk University Faculty of Medicine, Turkey
| | - Nesibe Andıran
- Department of Pediatric Endocrinology, Yıldırım Beyazıt University, Turkey.,Department of Pediatric Endocrinology, Keçiören Training and Research Hospital, Turkey
| | - Filiz Çizmecioğlu
- Department of Pediatric Endocrinology, Kocaeli University Faculty of Medicine, Turkey
| | - Olcay Evliyaoğlu
- Department of Pediatric Endocrinology, Istanbul University Cerrahpaşa Faculty of Medicine, Turkey
| | - Gülay Karagüzel
- Department of Pediatric Endocrinology, Karadeniz Technical University Faculty of Medicine, Turkey
| | - Özgür Pirgon
- Department of Pediatric Endocrinology, Süleyman Demirel University Faculty of Medicine, Turkey
| | - Gönül Çatlı
- Department of Pediatric Endocrinology, 9 Eylül University Faculty of Medicine, Turkey
| | - Hatice Dilek Can
- Department of Pediatric Endocrinology, Uludağ University Faculty of Medicine, Turkey
| | - Fatih Gürbüz
- Department of Pediatric Endocrinology, Çukurova University Faculty of Medicine, Turkey
| | - Çiğdem Binay
- Department of Pediatric Endocrinology, Osmangazi University Faculty of Medicine, Turkey
| | - Veysel Nijat Baş
- Department of Pediatric Endocrinology, Eskisehir Public Hospital, Turkey
| | - Kürşat Fidancı
- Department of Pediatric Endocrinology, Gulhane Military Medicine Academy, Turkey
| | - Davut Gül
- Department of Pediatric Endocrinology, Gulhane Military Medicine Academy, Turkey
| | - Adem Polat
- Department of Pediatric Endocrinology, Gulhane Military Medicine Academy, Turkey
| | - Cengizhan Acıkel
- Department of Pediatric Endocrinology, Gulhane Military Medicine Academy, Turkey
| | - Peyami Cinaz
- Department of Pediatric Endocrinology, Gazi University Faculty of Medicine, Turkey
| | - Feyza Darendeliler
- Department of Pediatric Endocrinology, Istanbul University Istanbul Faculty of Medicine, Turkey
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9
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Abstract
Primary hyperparathyroidism (PHPT) in children and adolescents is a rare condition. PHPT is usually sporadic and caused by parathyroid adenoma. Patients may present with bone pain, proximal myopathy, bony deformities, fractures, renal calculi, mass on the neck, or acute pancreatitis. A sixteen-year-old boy presented to our outpatient clinic with difficulty in walking due to swelling of both ankles. Ultrasonography revealed intratendinous calcific nodules in both Achilles tendons. Serum biochemistry showed hypercalcemia and hypophosphatemia. Serum parathormone level was high (512 pg/mL). Parathyroid scanning revealed a suspected parathyroid adenoma. The patient underwent parathyroidectomy and the diagnosis of parathyroid adenoma was confirmed by histopathology. Serum levels of parathyroid hormone, phosphate, and calcium returned to normal, and the tenderness over the Achilles tendon and the flow pattern on Doppler examination disappeared as well. In conclusion, hyperparathyroidism should be kept in mind in the differential diagnosis of tendonopathies. Early diagnosis can be crucial for prevention of severe complications.
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Affiliation(s)
- Selim Kurtoğlu
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
| | - Leyla Akın
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey Phone: +90 533 240 16 43 E-mail:
| | - Mustafa Kendirci
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
| | - Sedat Çağlı
- Erciyes University Faculty of Medicine, Department of Ear Nose and Throat, Kayseri, Turkey
| | - Salih Özgöçmen
- Erciyes University Faculty of Medicine, Department of Rheumatology, Kayseri, Turkey
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10
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Darendeliler F, Yeşilkaya E, Bereket A, Baş F, Bundak R, Sarı E, Küçükemre Aydın B, Darcan Ş, Dündar B, Büyükinan M, Kara C, Mazıcıoğlu MM, Adal E, Akıncı A, Atabek ME, Demirel F, Çelik N, Özkan B, Özhan B, Orbak Z, Ersoy B, Doğan M, Ataş A, Turan S, Gökşen D, Tarım Ö, Yüksel B, Ercan O, Hatun Ş, Şimşek E, Ökten A, Abacı A, Döneray H, Özbek MN, Keskin M, Önal H, Akyürek N, Bulan K, Tepe D, Emeksiz HC, Demir K, Kızılay D, Topaloğlu AK, Eren E, Özen S, Demirbilek H, Abalı S, Akın L, Eklioğlu BS, Kaba S, Anık A, Baş S, Ünüvar T, Sağlam H, Bolu S, Özgen T, Doğan D, Çakır ED, Şen Y, Andıran N, Çizmecioğlu F, Evliyaoğlu O, Karagüzel G, Pirgon Ö, Çatlı G, Can HD, Gürbüz F, Binay Ç, Baş VN, Sağlam C, Gül D, Polat A, Açıkel C, Cinaz P. Growth curves for Turkish Girls with Turner Syndrome: Results of the Turkish Turner Syndrome Study Group. J Clin Res Pediatr Endocrinol 2015; 7:183-91. [PMID: 26831551 PMCID: PMC4677552 DOI: 10.4274/jcrpe.2023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Children with Turner syndrome (TS) have a specific growth pattern that is quite different from that of healthy children. Many countries have population-specific growth charts for TS. Considering national and ethnic differences, we undertook this multicenter collaborative study to construct growth charts and reference values for height, weight and body mass index (BMI) from 3 years of age to adulthood for spontaneous growth of Turkish girls with TS. METHODS Cross-sectional height and weight data of 842 patients with TS, younger than 18 years of age and before starting any therapy, were evaluated. RESULTS The data were processed to calculate the 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentile values for defined ages and to construct growth curves for height-for-age, weight-for-age and BMI-for-age of girls with TS. The growth pattern of TS girls in this series resembled the growth pattern of TS girls in other reports, but there were differences in height between our series and the others. CONCLUSION This study provides disease-specific growth charts for Turkish girls with TS. These disease-specific national growth charts will serve to improve the evaluation of growth and its management with growth-promoting therapeutic agents in TS patients.
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Affiliation(s)
- Feyza Darendeliler
- İstanbul University Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Ediz Yeşilkaya
- Gülhane Military Medicine Academy, Department of Pediatric Endocrinology, Ankara, Turkey Phone: +90 312 304 18 98 E-mail:
| | - Abdullah Bereket
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Firdevs Baş
- İstanbul University Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Rüveyde Bundak
- İstanbul University Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Erkan Sarı
- Gülhane Military Medicine Academy, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Banu Küçükemre Aydın
- İstanbul University Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Şükran Darcan
- Ege University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Bumin Dündar
- Katip Çelebi University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Muammer Büyükinan
- Konya Training and Research Hospital, Clinic of Pediatric Endocrinology, Konya, Turkey
| | - Cengiz Kara
- On Dokuz Mayıs University Faculty of Medicine, Department of Pediatric Endocrinology, Samsun, Turkey
| | - Mümtaz M. Mazıcıoğlu
- Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
| | - Erdal Adal
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Ayşehan Akıncı
- Inönü University Faculty of Medicine, Department of Pediatric Endocrinology, Malatya, Turkey
| | - Mehmet Emre Atabek
- Necmettin Erbakan University Faculty of Medicine, Department of Pediatric Endocrinology, Konya, Turkey
| | - Fatma Demirel
- Yıldırım Beyazıt University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Nurullah Çelik
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Behzat Özkan
- Dr. Behçet Uz Children Hospital, Clinic of Pediatric Endocrinology, İzmir, Turkey
| | - Bayram Özhan
- Pamukkale University Faculty of Medicine, Department of Pediatric Endocrinology, Denizli, Turkey
| | - Zerrin Orbak
- Atatürk University Faculty of Medicine, Department of Pediatric Endocrinology, Erzurum, Turkey
| | - Betül Ersoy
- Celal Bayar University Faculty of Medicine, Department of Pediatric Endocrinology, Manisa, Turkey
| | - Murat Doğan
- Yüzüncü Yıl University Faculty of Medicine, Department of Pediatric Endocrinology, Van, Turkey
| | - Ali Ataş
- Harran University Faculty of Medicine, Department of Pediatric Endocrinology, Şanlıurfa, Turkey
| | - Serap Turan
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Damla Gökşen
- Ege University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Ömer Tarım
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
| | - Bilgin Yüksel
- Çukurova University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey
| | - Oya Ercan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Şükrü Hatun
- Kocaeli University Faculty of Medicine, Department of Pediatric Endocrinology, Kocaeli, Turkey
| | - Enver Şimşek
- Osmangazi University Faculty of Medicine, Department of Pediatric Endocrinology, Eskişehir, Turkey
| | - Ayşenur Ökten
- Karadeniz Technical University Faculty of Medicine, Department of Pediatric Endocrinology, Trabzon, Turkey
| | - Ayhan Abacı
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Hakan Döneray
- Atatürk University Faculty of Medicine, Department of Pediatric Endocrinology, Erzurum, Turkey
| | - Mehmet Nuri Özbek
- Diyarbakır Training and Research Hospital, Clinic of Pediatric Endocrinology, Diyarbakır, Turkey
| | - Mehmet Keskin
- Gaziantep University Faculty of Medicine, Department of Pediatric Endocrinology, Gaziantep, Turkey
| | - Hasan Önal
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Nesibe Akyürek
- Necmettin Erbakan University Faculty of Medicine, Department of Pediatric Endocrinology, Konya, Turkey
| | - Kezban Bulan
- Necmettin Erbakan University Faculty of Medicine, Department of Pediatric Endocrinology, Konya, Turkey
| | - Derya Tepe
- Yıldırım Beyazıt University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Hamdi Cihan Emeksiz
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Korcan Demir
- Dr. Behçet Uz Children Hospital, Clinic of Pediatric Endocrinology, İzmir, Turkey
| | - Deniz Kızılay
- Celal Bayar University Faculty of Medicine, Department of Pediatric Endocrinology, Manisa, Turkey
| | - Ali Kemal Topaloğlu
- Çukurova University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey
| | - Erdal Eren
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
| | - Samim Özen
- Ege University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Hüseyin Demirbilek
- Diyarbakır Training and Research Hospital, Clinic of Pediatric Endocrinology, Diyarbakır, Turkey
| | - Saygın Abalı
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Leyla Akın
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Beray Selver Eklioğlu
- Necmettin Erbakan University Faculty of Medicine, Department of Pediatric Endocrinology, Konya, Turkey
| | - Sultan Kaba
- Yüzüncü Yıl University Faculty of Medicine, Department of Pediatric Endocrinology, Van, Turkey
| | - Ahmet Anık
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Serpil Baş
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Tolga Ünüvar
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Halil Sağlam
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
| | - Semih Bolu
- Düzce University Faculty of Medicine, Department of Pediatric Endocrinology, Düzce, Turkey
| | - Tolga Özgen
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Durmuş Doğan
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
| | - Esra Deniz Çakır
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
| | - Yaşar Şen
- Selçuk University Faculty of Medicine, Department of Pediatric Endocrinology, Konya, Turkey
| | - Nesibe Andıran
- Yıldırım Beyazıt University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
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Keçiören Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
| | - Filiz Çizmecioğlu
- Kocaeli University Faculty of Medicine, Department of Pediatric Endocrinology, Kocaeli, Turkey
| | - Olcay Evliyaoğlu
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Gülay Karagüzel
- Karadeniz Technical University Faculty of Medicine, Department of Pediatric Endocrinology, Trabzon, Turkey
| | - Özgür Pirgon
- Süleyman Demirel University Faculty of Medicine, Department of Pediatric Endocrinology, Isparta, Turkey
| | - Gönül Çatlı
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Hatice Dilek Can
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
| | - Fatih Gürbüz
- Çukurova University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey
| | - Çiğdem Binay
- Osmangazi University Faculty of Medicine, Department of Pediatric Endocrinology, Eskişehir, Turkey
| | - Veysel Nijat Baş
- Kayseri Training and Research Hospital, Clinic of Pediatric Endocrinology, Kayseri, Turkey
| | - Celal Sağlam
- Gülhane Military Medicine Academy, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Davut Gül
- Gülhane Military Medicine Academy, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Adem Polat
- Gülhane Military Medicine Academy, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Cengizhan Açıkel
- Gülhane Military Medicine Academy, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Peyami Cinaz
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
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11
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Ökdemir D, Hatipoğlu N, Akar HH, Gül Ü, Akın L, Tahan F, Kurtoğlu S. A patient developing anaphylaxis and sensitivity to two different GnRH analogues and a review of literature. J Pediatr Endocrinol Metab 2015; 28:923-5. [PMID: 25719301 DOI: 10.1515/jpem-2014-0402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 01/09/2015] [Indexed: 11/15/2022]
Abstract
Gonadotropin-releasing hormone analogues are used in the treatment of prostate cancer, breast cancer, endometriosis, and uterine leiomyomas in adults and often in the treatment of precocious puberty in children. Many adverse effects have been reported for gonadotropin-releasing hormone analogues, but anaphylaxis is rarely reported as an adverse effect. Frequent cross-reactions, particularly during childhood, and diversity of the time of onset of anaphylactic manifestations complicate the diagnosis. A patient who exhibited anaphylactic allergic reactions to two different agents used in the treatment of central precocious puberty presented here because the case has an atypical course and is the first in the literature.
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12
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Akın L, Kendirci M, Narin F, Kurtoglu S, Saraymen R, Kondolot M, Koçak S, Elmalı F. The endocrine disruptor bisphenol A may play a role in the aetiopathogenesis of polycystic ovary syndrome in adolescent girls. Acta Paediatr 2015; 104:e171-7. [PMID: 25469562 DOI: 10.1111/apa.12885] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [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: 11/21/2014] [Accepted: 11/28/2014] [Indexed: 01/19/2023]
Abstract
AIM Experimental in vitro studies have shown that bisphenol A affects steroidogenesis, folliculogenesis and ovarian morphology. The aim of this study was to investigate the role of the endocrine disruptor bisphenol A in the aetiopathogenesis of polycystic ovary syndrome (PCOS) in adolescents and its relationship with metabolic parameters, insulin resistance and obesity in this population. METHODS A total of 112 girls with PCOS and 61 controls between 13 and 19 years of age were enrolled in the study. Serum bisphenol A levels were measured by high-pressure liquid chromatography. An oral glucose tolerance test was also performed. RESULTS Adolescents with PCOS had markedly increased serum bisphenol A levels (mean: 1.1 ng/mL 95% CI: 1.0-1.2) than controls (mean: 0.8 ng/mL 95% CI: 0.6-0.9, p = 0.001). When we compared the subgroups according to obesity, the main factor determining the significant increase in bisphenol A was the presence of PCOS, but not obesity (p = 0.029). Bisphenol A was significantly correlated with total testosterone (r = 0.52), free testosterone (r = 0.44), dehydroepiandrosterone sulphate (r = 0.37) and Ferriman-Gallwey score (r = 0.43) (p < 0.05). CONCLUSION Adolescents with PCOS had higher serum bisphenol A levels than controls, independent of obesity. Bisphenol A concentrations were significantly correlated with androgen levels, leading us to consider that bisphenol A might play a role in the aetiopathogenesis of PCOS in adolescents.
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Affiliation(s)
- Leyla Akın
- Department of Pediatric Endocrinology; Faculty of Medicine; Erciyes University; Kayseri Turkey
| | - Mustafa Kendirci
- Department of Pediatric Endocrinology; Faculty of Medicine; Erciyes University; Kayseri Turkey
| | - Figen Narin
- Department of Biochemistry; Faculty of Medicine; Erciyes University; Kayseri Turkey
| | - Selim Kurtoglu
- Department of Pediatric Endocrinology; Faculty of Medicine; Erciyes University; Kayseri Turkey
| | - Recep Saraymen
- Department of Biochemistry; Faculty of Medicine; Erciyes University; Kayseri Turkey
| | - Meda Kondolot
- Department of Pediatrics; Faculty of Medicine; Erciyes University; Kayseri Turkey
| | - Selda Koçak
- Department of Pediatric Endocrinology; Faculty of Medicine; Erciyes University; Kayseri Turkey
| | - Ferhan Elmalı
- Department of Biostatistics; Faculty of Medicine; Erciyes University; Kayseri Turkey
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13
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Yeşilkaya E, Bereket A, Darendeliler F, Baş F, Poyrazoğlu Ş, Küçükemre Aydın B, Darcan Ş, Dündar B, Büyükinan M, Kara C, Sarı E, Adal E, Akıncı A, Atabek ME, Demirel F, Çelik N, Özkan B, Özhan B, Orbak Z, Ersoy B, Doğan M, Ataş A, Turan S, Gökşen D, Tarım Ö, Yüksel B, Ercan O, Hatun Ş, Şimşek E, Ökten A, Abacı A, Döneray H, Özbek MN, Keskin M, Önal H, Akyürek N, Bulan K, Tepe D, Emeksiz HC, Demir K, Kızılay D, Topaloğlu AK, Eren E, Özen S, Abalı S, Akın L, Selver Eklioğlu B, Kaba S, Anık A, Baş S, Ünüvar T, Sağlam H, Bolu S, Özgen T, Doğan D, Çakır ED, Şen Y, Andıran N, Çizmecioğlu F, Evliyaoğlu O, Karagüzel G, Pirgon Ö, Çatlı G, Can HD, Gürbüz F, Binay Ç, Baş VN, Fidancı K, Polat A, Gül D, Açıkel C, Demirbilek H, Cinaz P, Bondy C. Turner syndrome and associated problems in Turkish children: a multicenter study. J Clin Res Pediatr Endocrinol 2015; 7:27-36. [PMID: 25800473 PMCID: PMC4439889 DOI: 10.4274/jcrpe.1771] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population. METHODS Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014. RESULTS The most common karyotype was 45,X (50.7%), followed by 45,X/46,XX (10.8%), 46,X,i(Xq) (10.1%) and 45,X/46,X,i(Xq) (9.5%). Mean age at diagnosis was 10.2±4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45,X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosis) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto's thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%. CONCLUSION This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespan.
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Affiliation(s)
- Ediz Yeşilkaya
- Gülhane Military Medicine Academy, Department of Pediatric Endocrinology, Ankara, Turkey. E-mail:
| | - Abdullah Bereket
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Feyza Darendeliler
- İstanbul University Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Firdevs Baş
- İstanbul University Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Şükran Poyrazoğlu
- İstanbul University Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Banu Küçükemre Aydın
- İstanbul University Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Şükran Darcan
- Ege University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Bumin Dündar
- Katip Çelebi University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Muammer Büyükinan
- Konya Training and Research Hospital, Clinic of Pediatric Endocrinology, Konya, Turkey
| | - Cengiz Kara
- Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Endocrinology, Samsun, Turkey
| | - Erkan Sarı
- Gülhane Military Medicine Academy, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Erdal Adal
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Ayşehan Akıncı
- Inönü University Faculty of Medicine, Department of Pediatric Endocrinology, Malatya, Turkey
| | - Mehmet Emre Atabek
- Necmettin Erbakan University Faculty of Medicine, Department of Pediatric Endocrinology, Konya, Turkey
| | - Fatma Demirel
- Yıldırım Beyazıt University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Nurullah Çelik
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Behzat Özkan
- Dr. Behçet Uz Children Hospital, Clinic of Pediatric Endocrinology, İzmir, Turkey
| | - Bayram Özhan
- Pamukkale University Faculty of Medicine, Department of Pediatric Endocrinology, Denizli, Turkey
| | - Zerrin Orbak
- Atatürk University Faculty of Medicine, Department of Pediatric Endocrinology, Erzurum, Turkey
| | - Betül Ersoy
- Celal Bayar University Faculty of Medicine, Department of Pediatric Endocrinology, Manisa, Turkey
| | - Murat Doğan
- Yüzüncü Yıl University Faculty of Medicine, Department of Pediatric Endocrinology, Van, Turkey
| | - Ali Ataş
- Harran University Faculty of Medicine, Department of Pediatric Endocrinology, Şanlıurfa, Turkey
| | - Serap Turan
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Damla Gökşen
- Ege University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Ömer Tarım
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
| | - Bilgin Yüksel
- Çukurova University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey
| | - Oya Ercan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Şükrü Hatun
- Kocaeli University Faculty of Medicine, Department of Pediatric Endocrinology, Kocaeli, Turkey
| | - Enver Şimşek
- Osmangazi University Faculty of Medicine, Department of Pediatric Endocrinology, Eskişehir, Turkey
| | - Ayşenur Ökten
- Karadeniz Technical University Faculty of Medicine, Department of Pediatric Endocrinology, Trabzon, Turkey
| | - Ayhan Abacı
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Hakan Döneray
- Atatürk University Faculty of Medicine, Department of Pediatric Endocrinology, Erzurum, Turkey
| | - Mehmet Nuri Özbek
- Diyarbakır Children State Hospital, Clinic of Pediatric Endocrinology, Diyarbakır, Turkey
| | - Mehmet Keskin
- Gaziantep University Faculty of Medicine, Department of Pediatric Endocrinology, Gaziantep, Turkey
| | - Hasan Önal
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Nesibe Akyürek
- Necmettin Erbakan University Faculty of Medicine, Department of Pediatric Endocrinology, Konya, Turkey
| | - Kezban Bulan
- Yüzüncü Yıl University Faculty of Medicine, Department of Pediatric Endocrinology, Van, Turkey
| | - Derya Tepe
- Yıldırım Beyazıt University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Hamdi Cihan Emeksiz
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Korcan Demir
- Dr. Behçet Uz Children Hospital, Clinic of Pediatric Endocrinology, İzmir, Turkey
| | - Deniz Kızılay
- Celal Bayar University Faculty of Medicine, Department of Pediatric Endocrinology, Manisa, Turkey
| | - Ali Kemal Topaloğlu
- Çukurova University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey
| | - Erdal Eren
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
| | - Samim Özen
- Ege University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Saygın Abalı
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Leyla Akın
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Beray Selver Eklioğlu
- Necmettin Erbakan University Faculty of Medicine, Department of Pediatric Endocrinology, Konya, Turkey
| | - Sultan Kaba
- Yüzüncü Yıl University Faculty of Medicine, Department of Pediatric Endocrinology, Van, Turkey
| | - Ahmet Anık
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Serpil Baş
- Marmara University Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Tolga Ünüvar
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Halil Sağlam
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
| | - Semih Bolu
- Düzce University Faculty of Medicine, Department of Pediatric Endocrinology, Düzce, Turkey
| | - Tolga Özgen
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
| | - Durmuş Doğan
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
| | - Esra Deniz Çakır
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
| | - Yaşar Şen
- Selçuk University Faculty of Medicine, Department of Pediatric Endocrinology, Konya, Turkey
| | - Nesibe Andıran
- Yıldırım Beyazıt University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Filiz Çizmecioğlu
- Kocaeli University Faculty of Medicine, Department of Pediatric Endocrinology, Kocaeli, Turkey
| | - Olcay Evliyaoğlu
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, İstanbul, Turkey
| | - Gülay Karagüzel
- Karadeniz Technical University Faculty of Medicine, Department of Pediatric Endocrinology, Trabzon, Turkey
| | - Özgür Pirgon
- Süleyman Demirel University Faculty of Medicine, Department of Pediatric Endocrinology, Isparta, Turkey
| | - Gönül Çatlı
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Hatice Dilek Can
- Uludağ University Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey
| | - Fatih Gürbüz
- Çukurova University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey
| | - Çiğdem Binay
- Osmangazi University Faculty of Medicine, Department of Pediatric Endocrinology, Eskişehir, Turkey
| | - Veysel Nijat Baş
- Kayseri Training and Research Hospital, Clinic of Pediatric Endocrinology, Kayseri, Turkey
| | - Kürşat Fidancı
- Gülhane Military Medicine Academy, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Adem Polat
- Gülhane Military Medicine Academy, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Davut Gül
- Gülhane Military Medicine Academy, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Cengizhan Açıkel
- Gülhane Military Medicine Academy, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Hüseyin Demirbilek
- Diyarbakır Children State Hospital, Clinic of Pediatric Endocrinology, Diyarbakır, Turkey
| | - Peyami Cinaz
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Carolyn Bondy
- National Institute of Child Health and Human Development, Bethesda, Maryland, USA
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14
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Abstract
OBJECTIVE To assess the plasma Pentraxin 3 (PTX3) concentrations in obese children and to investigate the relationship between PTX3 levels and metabolic syndrome (MS) components. METHODS Seventy-seven obese patients aged 10-16 y (38 girls, 39 boys) were included in the study. PTX3 levels were compared between the groups with or without MS. In addition, PTX3 was analysed separately by subgroups according to the presence of specific MS components. RESULTS Plasma PTX3 concentrations were significantly higher in obese children and adolescents with metabolic syndrome than in those without MS (2.1 ± 1.2 ng/ml and 1.4 ± 0.9 ng/ml respectively; P = 0.02). Patients with low HDL levels (<40 mg/dl) had higher plasma PTX3 concentrations than those with normal HDL levels (P = 0.05). Similarly, those who had high triglyceride levels (≥ 150 mg/dl) had higher PTX3 levels (P = 0.01). PTX3 levels were negatively correlated with HDL cholesterol (r = -0.32, P = 0.003) among all patients. CONCLUSIONS PTX3 levels are higher in obese children and adolescents with metabolic syndrome than in those without MS. Thus, PTX3 levels might be a useful biomarker for children and adolescents with metabolic syndrome, dyslipidemia, and cardiovascular risks.
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Affiliation(s)
- Fatih Kardas
- Department of Pediatric Nutrition and Metabolism, Erciyes University, 38039, Kayseri, Turkey,
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15
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Okdemir D, Hatipoglu N, Kurtoglu S, Akın L, Kendirci M. Premature thelarche related to fennel tea consumption? J Pediatr Endocrinol Metab 2014; 27:175-9. [PMID: 24030028 DOI: 10.1515/jpem-2013-0308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 08/14/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND Isolated premature thelarche is the breast development in the absence of other secondary sex characteristics in prepubertal girls. Fennel is a plant which contains a phytoestrogen called anethole as an active ingredient. CASE Here, we report a case of a 12-month-old girl who showed breast development that became apparent in the last 3 months. Her medical history revealed that she was given two to three teaspoons of fennel tea by her mother every day for restlessness for the last 6 months. Isolated premature thelarche was diagnosed based on physical and laboratory findings. On follow-up, after cessation of fennel consumption, the breast development of the patient regressed gradually and became normal by the end of 1 year. CONCLUSION Reporting this case, we want to emphasize the importance of awareness of fennel tea, a commonly used plant in babies, as a preventable cause of premature thelarche.
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16
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Akın L, Kurtoglu S, Yikilmaz A, Kendirci M, Elmalı F, Mazicioglu M. Fatty liver is a good indicator of subclinical atherosclerosis risk in obese children and adolescents regardless of liver enzyme elevation. Acta Paediatr 2013. [PMID: 23190373 DOI: 10.1111/apa.12099] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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: 12/15/2022]
Abstract
AIM To investigate the presence of association between nonalcoholic fatty liver disease (NAFLD) and subclinical atherosclerosis using carotid intima media thickness (c-IMT) in obese children and adolescents. Additionally, we wished to investigate the relationship between fatty liver and elevated liver enzymes. METHODS A total of 157 obese patients (78 boys and 79 girls, mean age: 11.3 ± 2.6 years, age range: 6-16 years) were enrolled in the study. Aminotransferase, fasting glucose and lipid levels were determined. An oral glucose tolerance test was performed. The c-IMT was measured. Infectious and metabolic causes of elevated liver enzymes were excluded. The diagnosis of NAFLD was based on ultrasound scan. RESULTS Obese patients with NAFLD had markedly increased carotid IMT (mean: 0.48 mm, 95% CI: 0.47-0.49) than those without NAFLD (mean: 0.45 mm 95% CI: 0.44-0.45, p < 0.001). The presence of NAFLD significantly increased c-IMT whether the patient had elevated liver enzyme or not (ANOVA, p < 0.001). In a multiple-regression model, only the presence of NAFLD was associated with increased c-IMT (β = 0.031, SE (β) = 0.008, p < 0.001). CONCLUSION Obese children and adolescents with NAFLD are at risk of early atherosclerotic changes. As liver function tests are not sufficient to identify patients with fatty liver, ultrasonographic evaluation of NAFLD might be considered in all obese children and adolescents.
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Affiliation(s)
- Leyla Akın
- Department of Pediatric Endocrinology; Faculty of Medicine; Erciyes University; Kayseri; Turkey
| | - Selim Kurtoglu
- Department of Pediatric Endocrinology; Faculty of Medicine; Erciyes University; Kayseri; Turkey
| | - Ali Yikilmaz
- Department of Pediatric Radiology; Faculty of Medicine; Erciyes University; Kayseri; Turkey
| | - Mustafa Kendirci
- Department of Pediatric Endocrinology; Faculty of Medicine; Erciyes University; Kayseri; Turkey
| | - Ferhan Elmalı
- Department of Biostatistics; Faculty of Medicine; Erciyes University; Kayseri; Turkey
| | - Mümtaz Mazicioglu
- Department of Family Medicine; Faculty of Medicine; Erciyes University; Kayseri; Turkey
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17
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Gündüz Z, Dursun İ, Tülpar S, Baştuğ F, Baykan A, Yıkılmaz A, Patıroğlu T, Poyrazoglu HM, Akın L, Yel S, Düşünsel R. Increased endothelial microparticles in obese and overweight children. J Pediatr Endocrinol Metab 2012; 25:1111-7. [PMID: 23329757 DOI: 10.1515/jpem-2012-0194] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 08/17/2012] [Indexed: 01/05/2023]
Abstract
BACKGROUND Obesity in children increases the risk of atherosclerosis. Endothelial dysfunction is an important factor in the pathogenesis of atherosclerosis, and endothelial microparticles (EMPs) are considered as markers of endothelial dysfunction. In this study, we aimed to evaluate circulating EMPs in obese and overweight children and to disclose the measure of obesity with the strongest relation with circulating microparticles and carotid atherosclerosis. METHODS This prospective study included 55 obese and overweight children and 23 healthy controls. Insulin resistance was studied. Both in vivo and in vitro human umbilical vein endothelial cell evaluations were used for the study. Circulating EMPs (CD144 and CD146) were measured by flow cytometry. The carotid artery intima-media thickness (cIMT) and left ventricular mass index (LVMI) were measured using ultrasound and echocardiography, respectively. Study groups were compared for anthropometric measurement, insulin resistance, circulating EMP, cIMT, and LVMI. The relationship among overweight, obesity, and circulating EMPs were investigated. RESULTS Blood pressure, CD144+EMP levels, and LVMI were statistically higher in the patients group than in the control group. The multiple logistic regression analysis and the backward elimination method showed that CD144+EMP and systolic blood pressure had a linear relationship with overweight and obesity. CONCLUSION Our results suggest that endothelial damage starts in the early stage of childhood obesity and that obese and overweight children have increased circulating CD144+EMPs, showing that endothelial dysfunction and increased CD144+EMPs may be related to obesity.
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Affiliation(s)
- Zübeyde Gündüz
- Faculty of Medicine, Department of Pediatric Nephrology, Erciyes University, 38039 Kayseri, Turkey
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18
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Abstract
Subcutaneous fat necrosis of the newborn (ScFN) is an uncommon condition caused by generalized and/or local tissue hypoperfusion. The skin lesions of ScFN tend to improve spontaneously. However, ScFN may also lead to complications which cause serious problems. The severity of the etiologic factors contributing to the development of the disease determines the severity of complications. Therefore, these patients should be closely monitored for complications, especially for hypercalcemia which may be life-threatening. The severity and duration of hypercalcemia are associated with the extensity of skin lesions. We present a newborn who developed ScFN as a result of systemic hypotension. The ScFN resolved after the first few weeks of life, but the patient developed mild hypercalcemia during the 4-month follow-up period. The infant was breast-fed during follow-up, and vitamin D prophylaxis was not initiated. The hypercalcemia resolved within four months without any complications. We would like to draw attention to the need to monitor serum calcium levels in these infants and to refrain from initiating vitamin D prophylaxis in the first months of life.
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Affiliation(s)
- Mustafa Ali Akın
- Erciyes University, Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kayseri, Turkey.
| | - Leyla Akın
- Erciyes University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Kayseri, Turkey
| | - Dilek Sarıcı
- Erciyes University, Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kayseri, Turkey
| | - İbrahim Yılmaz
- Erciyes University, Faculty of Medicine, Department of Pediatrics, Kayseri, Turkey
| | - Süleyman Balkanlı
- Erciyes University, Faculty of Medicine, Department of Pathology, Kayseri, Turkey
| | - Selim Kurtoğlu
- Erciyes University, Faculty of Medicine, Department of Pediatrics, Division of Neonatology and Pediatric Endocrinology, Kayseri, Turkey
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19
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Akın L, Kurtoğlu S, Kendirci M, Akın MA, Karakükçü M. Does early treatment prevent deafness in thiamine-responsive megaloblastic anaemia syndrome? J Clin Res Pediatr Endocrinol 2011; 3:36-9. [PMID: 21448333 PMCID: PMC3065315 DOI: 10.4274/jcrpe.v3i1.08] [Citation(s) in RCA: 17] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 11/25/2010] [Indexed: 01/19/2023] Open
Abstract
Thiamine-responsive megaloblastic anaemia (TRMA; OMIM 249270) syndrome is an autosomal recessive disorder characterized by diabetes mellitus, megaloblastic anaemia, and sensorineural deafness. Progressive hearing loss is one of the cardinal findings of the syndrome and is known to be irreversible. Whether the deafness in TRMA syndrome can be prevented is not yet known. Here, we report a four-month-old female infant diagnosed with TRMA syndrome at an early age. There was no hearing loss at the time of diagnosis. The patient's initial auditory evoked brainstem response measurements were normal. Although she was given thiamine supplementation regularly following the diagnosis, the patient developed moderate sensorineural hearing loss at 20 months of age, indicating that early diagnosis and treatment with oral thiamine (100 mg/day) could not prevent deafness in TRMA syndrome. It would be premature to draw general conclusions from one case, but we believe that further patient-based observations can shed light on the pathophysiology of this rare syndrome as well as prediction of its prognosis.
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Affiliation(s)
- Leyla Akın
- Erciyes University, Faculty of Medicine Department of Pediatric Endocrinology, Kayseri, Turkey.
| | - Selim Kurtoğlu
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Mustafa Kendirci
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Mustafa Ali Akın
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Musa Karakükçü
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
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20
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Akın MA, Güneş T, Akın L, Çoban D, Kara Oncu S, Kiraz A, Kurtoğlu S. Thyroid hypoplasia as a cause of congenital hypothyroidism in monozygotic twins concordant for Rubinstein-Taybi syndrome. J Clin Res Pediatr Endocrinol 2011; 3:32-5. [PMID: 21448332 PMCID: PMC3065314 DOI: 10.4274/jcrpe.v3i1.07] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2011] [Accepted: 01/20/2011] [Indexed: 12/01/2022] Open
Abstract
Rubinstein-Taybi syndrome (RSTS), a genetic disorder characterized by growth retardation, mental deficiency, dysmorphic face, broad thumbs and large toes, generally affects monozygotic twins concordantly. Thyroid hypoplasia (TH) is a common cause of congenital hypothyroidism (CH) and often accompanies dysmorphic syndromes. A pair of female twins were admitted to our neonatology unit 16 hours after delivery. They were born at 35 weeks of gestation. Both twins had an unusual dysmorphic facial appearance with microcephaly, as well as broad short thumbs and large toes. Based on the presence of characteristic dysmorphic features, the twins were diagnosed as RSTS. Thyroid function tests in the first twin revealed the following results: free thyroxine (T4) 8.4 pg/mL, thyrotropin (TSH) 4.62 mIU/L, thyroglobulin (TG) 213.24 ng/mL and a normal level of urinary iodine excretion (UIE). Thyroid function test results in the second twin in the second week were: free T4 5.9 pg/mL, TSH 9.02 mIU/L, TG 204.87 ng/mL, and normal UIE levels. Thyroid volumes were 0.36 mL and 0.31 mL in the first and second twin, respectively. TH was confirmed by technetium 99 m pertechnetate thyroid scans in both infants. Thyroid function tests normalized with L-thyroxine replacement therapy (10 μg/kg/day) around the end of the 3(rd) week of life. The infants were discharged planning their follow-up by both endocrinology and cardiology units. The rarity of cases of twins with RSTS (concordant) co-existing with CH led us to present this report.
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Affiliation(s)
- Mustafa Ali Akın
- Erciyes University, Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kayseri, Turkey
| | - Tamer Güneş
- Erciyes University, Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kayseri, Turkey
| | - Leyla Akın
- Erciyes University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Kayseri, Turkey
| | - Dilek Çoban
- Erciyes University, Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kayseri, Turkey
| | - Sena Kara Oncu
- Erciyes University, Faculty of Medicine, Department of Pediatrics, Kayseri, Turkey
| | - Aslıhan Kiraz
- Erciyes University, Faculty of Medicine, Department of Medical Genetics, Kayseri, Turkey
| | - Selim Kurtoğlu
- Erciyes University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology and Neonatology, Kayseri, Turkey
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21
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Akın L, Kurtoglu S, Muhtaroğlu S, Yikilmaz A, Kendirci M, Mazicioglu M. The Association of Serum Sialic Acid with Carotid Intima-Media Thickness and Anthropometric and Metabolic Parameters in Obese Children and Adolescents. Ann Nutr Metab 2011; 59:139-44. [DOI: 10.1159/000334070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Accepted: 09/14/2011] [Indexed: 11/19/2022]
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22
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Akın L, Kurtoğlu S, Yıldız A, Akın MA, Kendirici M. Vitamin D deficiency rickets mimicking pseudohypoparathyroidism. J Clin Res Pediatr Endocrinol 2010; 2:173-5. [PMID: 21274319 PMCID: PMC3005691 DOI: 10.4274/jcrpe.v2i4.173] [Citation(s) in RCA: 25] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Accepted: 10/07/2010] [Indexed: 12/01/2022] Open
Abstract
Vitamin D deficiency rickets (VDDR) is a disorder biochemically characterized by elevated serum alkaline phosphatase (ALP) activity, normal or decreased serum calcium (Ca) and inorganic phosphate concentrations, secondary hyperparathyroidism and decreased serum 25-hydroxyvitamin D (25(OH)D) levels. In stage 1 VDDR, urinary amino acid and phosphate excretion are normal with minimal or no findings of rickets on radiographs. Pseudohypoparathyroidism (PHP) is an inherited disorder characterized by end-organ resistance to parathormone (PTH). VDDR occasionally resembles PHP type 2 in clinical presentation and biochemical features, creating difficulties in the differential diagnosis of these two entities. Here we report an infant diagnosed with VDDR. In addition to inadequate vitamin D intake, usage of antiepileptic drugs (AED) may have led to the worsening of the vitamin D deficiency. The patient presented with a history of febrile convulsions, for which he received phenobarbital treatment. The initial findings of hypocalcemia, hyperphosphatemia and normal tubular reabsorption of phosphate, mimicking PHP 2, responded well to vitamin D and oral Ca treatment with normalization of serum Ca, phosphorus (P), ALP and PTH levels.
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Affiliation(s)
- Leyla Akın
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey.
| | - Selim Kurtoğlu
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Aysel Yıldız
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Mustafa Ali Akın
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Mustafa Kendirici
- Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
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23
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Abstract
Familial glucocorticoid deficiency (FGD) is a rare autosomal recessive disease resulting from resistance to the action of adrenocorticotropic hormone (ACTH) on the adrenal cortex, which leads to isolated glucocorticoid deficiency with normal mineralocorticoid secretion. It may present in infancy or early childhood with hyperpigmentation, failure to thrive, recurrent infections, hypoglycemic attacks and convulsions that may result in coma or death. Laboratory investigations reveal low cortisol and androgen levels with high ACTH associated with normal reninaldosterone axis. The disorder may be caused by mutations in the gene of ACTH receptor (MC2R), or mutations in the newly described melanocortin- 2 receptor accessory protein (MRAP) namely, FGD type 1 and FGD type 2, respectively. Twenty five percent of FGD cases are due to the mutations of the ACTH receptor, while FGD type 2 accounts for approximately 15-20% of FGD cases. Here, we report a six-month-old male infant, who presented with recurrent hypoglycemic convulsions. Serum hormone analysis showed low cortisol and androgen levels associated with a high ACTH concentration. No mutation was found in the NR0B1 and MC2R genes excluding congenital adrenal hypoplasia and FGD type 1. We found a homozygous deletion (c. 106+1delG) in intron 3 of MRAP gene. To our knowledge, this is the first Turkish patient reported with FGD type 2 due to a known MRAP mutation.
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Affiliation(s)
- Leyla Akın
- Erciyes University, Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey.
| | - Selim Kurtoğlu
- Erciyes University, Faculty of Medicine Department of Pediatric Endocrinology, Kayseri, Turkey
| | - Mustafa Kendirici
- Erciyes University, Faculty of Medicine Department of Pediatric Endocrinology, Kayseri, Turkey
| | - Mustafa Ali Akın
- Erciyes University, Faculty of Medicine Department of Neonatology, Kayseri, Turkey
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24
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Akın MA, Akın L, Özbek S, Tireli G, Kavuncuoğlu S, Sander S, Akçakuş M, Güneş T, Öztürk MA, Kurtoğlu S. Fetal-neonatal ovarian cysts--their monitoring and management: retrospective evaluation of 20 cases and review of the literature. J Clin Res Pediatr Endocrinol 2010; 2:28-33. [PMID: 21274333 PMCID: PMC3005663 DOI: 10.4274/jcrpe.v2i1.28] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Accepted: 12/19/2009] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Neonatal ovarian cysts (NOC) are usually self-limiting structures. However, large or complex cysts may lead to severe complications. A standard guide to management, treatment and follow-up of NOC is not yet available. The aim of this study was to evaluate retrospectively the records of NOC patients from two medical centers. METHODS A total of 20 newborns with NOC were included in the study. The size and localization of the cyst, the age, the signs and symptoms at presentation, and the possible maternal and fetal-neonatal etiologic factors were recorded. Follow-up procedures and treatment modalities were evaluated. RESULTS The mean age at diagnosis was 34 gestational weeks. The cysts (mean size 53±15 mm) were predominantly in the right ovary (75%) and were evaluated as large cysts in 16 (80%) of the patients. In 5 of the patients with large cysts and in 1 of the 4 patients with small cysts, the cysts were evaluated as complex cysts. Torsion of the ovary was detected in five (25%) cases and these cases were treated surgically. Patients with simple cysts were closely followed by ultrasonography until the cysts disappeared. CONCLUSION To date, there is no precise guide for the monitoring and treatment of NOCs. Surgical treatment should always be performed in a way to protect the ovaries and to ensure future fertility. In our NOC series, it has been possible to apply a non-invasive follow-up program and minimally invasive surgical procedures.
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Affiliation(s)
- Mustafa Ali Akın
- Erciyes University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, 38039 Kayseri, Turkey.
| | - Leyla Akın
- Erciyes University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Kayseri, Turkey
| | - Sibel Özbek
- Bakırköy Maternity and Children Hospital, Department of Pediatrics, Division of Neonatology, İstanbul, Turkey
| | - Gülay Tireli
- Bakırköy Maternity and Children Hospital, Department of Pediatric Surgery, İstanbul, Turkey
| | - Sultan Kavuncuoğlu
- Bakırköy Maternity and Children Hospital, Department of Pediatrics, Division of Neonatology, İstanbul, Turkey
| | - Serdar Sander
- Bakırköy Maternity and Children Hospital, Department of Pediatric Surgery, İstanbul, Turkey
| | - Mustafa Akçakuş
- Erciyes University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kayseri, Turkey
| | - Tamer Güneş
- Erciyes University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kayseri, Turkey
| | - M. Adnan Öztürk
- Erciyes University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kayseri, Turkey
| | - Selim Kurtoğlu
- Erciyes University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Kayseri, Turkey
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25
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Abstract
Iodine overload frequently leads to transient hyperthyrotropinemia or hypothyroidism, and rarely to hyperthyroidism in neonates. Iodine exposure can be prenatal, perinatal or postnatal. Herein we report two newborn infants who developed severe hypothyroidism due to iodine overload. The overloading was caused by excessive use of an iodinated antiseptic for umbilical care in the first case, and as a result of maternal exposure and through breast milk with a high iodine level in the second case. Presenting the two cases, we wanted to draw attention to these preventable causes of hypothyroidism in infants.
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Affiliation(s)
- Selim Kurtoğlu
- Erciyes University, Faculty of Medicine, Department of Pediatrics, Division of Neonatology, 38039 Kayseri, Turkey.
| | - Leyla Akın
- Erciyes University, Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
| | - Mustafa Ali Akın
- Erciyes University, Faculty of Medicine, Department of Neonatology, Kayseri, Turkey
| | - Dilek Çoban
- Erciyes University, Faculty of Medicine, Department of Neonatology, Kayseri, Turkey
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Akın L, Adal E, Akın MA, Kurtoğlu S. Melnick-Needles syndrome associated with growth hormone deficiency: a case report. J Clin Res Pediatr Endocrinol 2009; 1:248-51. [PMID: 21274303 PMCID: PMC3005751 DOI: 10.4274/jcrpe.v1i5.248] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2009] [Accepted: 07/20/2009] [Indexed: 12/01/2022] Open
Abstract
Melnick-Needles syndrome is an X-linked dominant bone dysplasia characterized by a typical facies (exophthalmos, full cheeks, micrognathia, and malalignment of teeth), flaring of the metaphyses of long bones, s-like curvature of the lower extremities, irregular constriction in the ribs, and sclerosis of base of the skull. The phenotype of affected individuals varies, even within families. About fifty cases of Melnick-Needles syndrome have been reported to date. Short stature is not a well-known component of the disorder. There is only one reported case of Melnick-Needles syndrome associated with growth hormone deficiency. A six-year-old girl who presented to our clinic with short stature was diagnosed as Melnick-Needles syndrome based upon characteristic clinical and radiological findings. Two different stimulation tests demonstrated growth hormone deficiency. Presenting this second case of Melnick-Needles syndrome associated with growth hormone deficiency, we suggest that this association may be coincidental, but that it may also be a consequence of craniofacial abnormalities or an independent component of the disorder.
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Affiliation(s)
- Leyla Akın
- Department of Pediatric Endocrinology, Erciyes University, Faculty of Medicine, Kayseri, Turkey.
| | - Erdal Adal
- Department of Pediatric Endocrinology, Bakırköy Maternity and Children’s Hospital, İstanbul, Turkey
| | - Mustafa Ali Akın
- Department of Pediatrics, Erciyes University, Faculty of Medicine, Kayseri, Turkey
| | - Selim Kurtoğlu
- Department of Pediatric Endocrinology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
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Kurtoğlu S, Çoban D, Akın MA, Akın L, Yıkılmaz A. Neonatal sludge: a finding of congenital hypothyroidism. J Clin Res Pediatr Endocrinol 2009; 1:197-200. [PMID: 21274296 PMCID: PMC3005657 DOI: 10.4274/jcrpe.v1i4.54] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2009] [Accepted: 04/11/2009] [Indexed: 12/01/2022] Open
Abstract
Congenital hypothyroidism is one of the most urgent diseases of the neonate. When diagnosed and treated at an early stage, its most important complication, mental retardation, is preventable. The signs of congenital hypothyroidism are nonspecific in neonates. Only 5% of the cases have characteristic clinical findings. One of the most important and earliest signs is prolonged jaundice during the neonatal period. We report herein a case of congenital hypothyroidism, who presented with icterus accompanied with sludge formation into the gallbladder, which disappeared after treatment with L-thyroxine.
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Affiliation(s)
- Selim Kurtoğlu
- Erciyes University, Department of Neonatology, Kayseri
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Erciyes University, Department of Pediatric Endocrinology, Kayseri
| | - Dilek Çoban
- Erciyes University, Department of Neonatology, Kayseri
| | | | - Leyla Akın
- Erciyes University, Department of Pediatric Endocrinology, Kayseri
| | - Ali Yıkılmaz
- Erciyes University, Department of Radiology, Kayseri
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