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Öğe Autoantibody Positivity in Children with Chronic Diarrhea(2020) Tuhan, Hale; Aslan, Aslı; Ecevit, Çiğdem Ömür; Azarsız, Elif; Karaca, Neslihan Edeer; Çetin, Funda; Aksu, GüzideAim: We aimed to determine the frequency of autoantibody antinuclear (ANA), peripheral anti-neutrophil cytoplasmic antibody (p-ANCA), antisaccharomyces cerevisiae antibody (ASCA), anti-pancreatic exocrine gland antibody (PAb), goblet cell antibody (GAb) positivities in children with the complaint of chronic diarrhea and inflammatory bowel disease (IBD). We also purposed to explore the role of these autoantibodies in the differential diagnosis of IBD. Materials and Methods: In our study, serum samples of 51 patients with the complaint of chronic diarrhea and 35 healthy controls were analyzed. Clinical and laboratory data at the time of serum sampling were collected and a differential diagnosis was made as the results of performed tests were recorded. For all patients, ANA, p-ANCA, ASCA, GAb, PAb positivities were evaluated by indirect immunofluorescence. The chronic diarrhea group was divided into two groups, namely, the IBD group and non-IBD group. Results: In the chronic diarrhea group, 11 (21.6%) patients had ANA, 3 (5.9%) had p-ANCA, 1 (2%) had PAb, 1 (2%) had Gab and 1 (2%) had ASCA positivity. From the 35 cases of the control group, 8 (22.9%) had ANA, 7 (20%) had ASCA positivity. In the control group, ASCA was found to be high (p=0.007). Six cases were diagnosed as IBD; 1 (16.7%) had ANA, 1 (16.7%) had p-ANCA, 1 (2%) had Gab and 1 (2%) had ASCA positivity. ASCA and GAb positivities were significantly more frequent in the IBD group (p=0.006, p=0.006, respectively). Conclusion: ASCA was determined to be significantly higher in the control group. High positivity in the control group showed that the percentage of nonspecific positivity may be high for this test. ASCA and GAb of those patients with a diagnosis of IBD were found significantly higher. The serologic tests which depend on p-ANCA, ASCA, PAb, GAb can be supportive of diagnoses and differential diagnoses of IBD. Autoantibodies in IBD may be used as a supportive diagnostic tool in selected cases, rather than as the diagnosis of IBD as routine practice.Öğe Liver Transplants for Pediatric Metabolic Diseases in the Last Ten Years: Immediate and Long-Term Results(2023) Umman, Veysel; Gümüş, Tufan; Barut, Doğan; Karakoyun, Miray; Çetin, Funda; Ergün, Orkan; Ulukaya, SezginObjective: Liver transplantation is an accepted treatment modality in the pediatric patient group due to metabolic diseases. Patients are a more special population due to the presence of concomitant metabolic problems and the pediatric age group. There is no con- sensus on the long-term prognosis of pediatric patients with various rare liver diseases and inherited metabolic diseases. For this reason, we retrospectively evaluated our pediatric patients who underwent liver transplantation for pediatric metabolic liver diseases between 2012 and 2021. Methods: Seventeen patients were included in the study. The mean Pediatric End-Stage Liver Disease (PELD) score was 21.47 (±8.47). Eight (47,1%) children received cadaveric, and 9 (52,9%) children received living liver transplantation. The mean age was 8.03 years (±6.37) (13 months-18 years). Left lateral graft was used in 11 patients (64%), right lobe graft in 3 patients (18%) and left lobe graft in 3 patients (18%). Six patients had biliary strictures out of which, 5 (29.4%) had percutaneous transhepatic biliary dilatation, and ERCP was performed in 1 (5.8%) patient. Results: Our early survival rate was 100% and 2 patients (11,7%) were exitus in the late period for reasons unrelated to liver trans- plantation. Our mean follow-up period after transplantation was 70,6 months (±20.75) and no additional metabolic crisis was detected during the follow-up of the patients, including patients whose donors were relatives. Conclusion: Metabolic liver diseases have severe systemic effects, and it is important to be evaluated by a multidisciplinary team in their diagnosis and treatment and to perform planned liver transplants rapidly without delay. Liver transplantation performed at the right time can prevent permanent additional organ damage.Öğe Orofacial Crohn’s Disease: A Case Report(2019) Karakoyun, Miray; Taşcı, Ezgi Kiran; Sezak, Murat; Yaşar, Burçe Emine; Çetin, FundaCrohn’s disease (CD) is a chronic disease of the digestive system. It is characterized by lesions predominantly located in the small intestine and colon, although they may also occur in any segment of the gut, including the oral cavity. the involvement of oral mucosa in CD may be underreported, as up to 42% of pediatric patients with CD were found to have oral lesions after undergoing a thorough oral examination. Here, we present a case of CD in which the patient was referred to a dentist due to non-healing aphthous ulcers in the mouth. Our patient, a 16-year-old boy, was admitted to the dentistry clinic with swelling of the oral mucosa and the lips which had been ongoing for 3 months. the patient was referred to our department due to the non-response of the mucosal lesions to repeated cycles of medical treatment. Colonoscopy revealed a cobblestone appearance especially in the left colon, partly normal mucosa, and exudative ulcers. Biopsy samples showed increased inflammatory cell infiltration in the lamina propria and cryptitis in some of the crypts. A close collaboration between gastroenterologists and dentists is useful when addressing the diagnosis and appropriate management of these patientsÖğe Pediatric Liver Transplantation Outcomes for Metabolic and Non-metabolic Diseases in Turkey: A Single Center Experience(2019) Karakoyun, Miray; Canda, Ebru; Kızılcan, Sirmen; Ergün, Orkan; Kılıç, Murat; Çetin, Funda; Aydoğdu, SemaAim: Liver transplantation (LT) is performed for several indications in the pediatric population, including malignancy and acute hepatic failure among others. LT has become an important treatment alternative for metabolic diseases. In most pediatric transplant centers, metabolic liver disease is the second most common indication for LT after biliary atresia. Our studies aim is to compare the post-transplant outcomes of those patients with metabolic and other liver diseases in our transplant program. Materials and Methods: One hundred eighty-nine patients who underwent LT between 1997 and 2015 due to metabolic diseases and acute or chronic liver failure were included in the study. This study was performed retrospectively. Results: We enrolled 189 patients in our study. 54% (n=102) male and 46% (n=87) female patients were included in the study. The metabolic disease group included 56 patients and the non-metabolic disease group contained 133 patients. Progressive familial intrahepatic cholestasis is the most common disease among metabolic diseases resulting in LT and Wilson disease is the second most common. Post-transplant immunosuppression was similar for both groups. There was no difference in both groups regarding the onset of post-transplant complications for graft type or recipient age. Biliary and portal vein complications were most particularly defined in the group with non-metabolic diseases. There was no significant difference in survival between the two groups. Conclusion: LT is an important treatment option for acute hepatic failure and end-stage liver diseases. In addition, LT is an alternative treatment option for some metabolic diseases.Öğe Pediatric Liver Transplantation Outcomes for Metabolic and Non-metabolic Diseases in Turkey: A Single Center Experience(2019) Karakoyun, Miray; Canda, Ebru; Kızılcan, Sirmen; Ergün, Orkan; Kılıç, Murat; Çetin, Funda; Aydoğdu, SemaAim: Liver transplantation (LT) is performed for several indications in the pediatric population, including malignancy and acute hepatic failure among others. LT has become an important treatment alternative for metabolic diseases. in most pediatric transplant centers, metabolic liver disease is the second most common indication for LT after biliary atresia. Our studies aim is to compare the post-transplant outcomes of those patients with metabolic and other liver diseases in our transplant program. Materials and Methods: One hundred eighty-nine patients who underwent LT between 1997 and 2015 due to metabolic diseases and acute or chronic liver failure were included in the study. This study was performed retrospectively. Results: We enrolled 189 patients in our study. 54% (n=102) male and 46% (n=87) female patients were included in the study. the metabolic disease group included 56 patients and the non-metabolic disease group contained 133 patients. Progressive familial intrahepatic cholestasis is the most common disease among metabolic diseases resulting in LT and Wilson disease is the second most common. Post-transplant immunosuppression was similar for both groups. There was no difference in both groups regarding the onset of post-transplant complications for graft type or recipient age. Biliary and portal vein complications were most particularly defined in the group with non-metabolic diseases. There was no significant difference in survival between the two groups. Conclusion: LT is an important treatment option for acute hepatic failure and end-stage liver diseases. in addition, LT is an alternative treatment option for some metabolic diseases.
