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Öğe Congenital Disorder of Glycosylation: Clinical and Molecular Characteristics of 9 Patients from Turkey(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2020) Kose, Melis; Kose, Engin; Kagnici, Mehtap; Tekin, Hande Gazeteci; Ozen, Burcin; Ozdemir, Taha Resid; Unalp, AycanObjective: Congenital defects of glycosylation (CDG) belongs to a group of genetic diseases that lead to impairment in protein, lipid glycosylation and glycosylphosphatidylinositol synthesis. More than 140 types of CDG have been identified and the number is increasing day by day. Since glycosylation is very important for post-translational process and glycosylation is required for half of the proteins in human organism to be able to exert an effect, causes the disease to have an extremely wide clinical spectrum in affected patients. Our aim is to share the clinical features of our patients with CDG and contribute to increase in the awareness of this disease group with highly heterogeneous clinical spectrum. Method: Nine patients from 9 families whose molecular and biochemical diagnosis was confirmed were included in the study. All patients were evaluated by a specialist.in pediatric metabolism Laboratory analysis results and clinical features were obtained from hospital records. Our study presents clinical, biochemical and molecular properties of 9 patients. Results: The patients were detected as having PMM2-CDG (CDG Ia) (n=4), MPI-CDG (CDG Ib) (n=1), ALG3CDG (CDG Id) (n=1), ALG1-CDG (CDG Ik) (n=1), DOLK-CDG (CDG Im) (n=1) and COG4-CDG (CDG IIj) (n=1). Sialotransferrin electrophoresis could be performed in 8 of 9 patients. Six patients were diagnosed using high-throughout next -generation sequencing technologies. in all of our patients previously indentified variants have been detected. Conclusion: Our study is one of the first CDG case series presented in our country. CDG should be kept in mind as an important preliminary diagnosis in patients with multisystemic involvement and neurological findings.Öğe Evaluation of the relationship between migraine disorder and oral comorbidities: multicenter randomized clinical trial(Tubitak Scientific & Technical Research Council Turkey, 2016) Peskersoy, Cem; Peker, Sule; Kaya, Aysegul; Unalp, Aycan; Gokay, NecmiBackground/aim: Although migraine is a common disorder, there is a lack of research investigating the possible relationship between migraine and oral health. The aim of the present study was to explore the relationship between temporomandibular disorders, bruxism, dental caries, periodontal status, and migraine disorder in a multicenter, parallel, case-controlled clinical study. Materials and methods: A total of 2001 participants were divided into two groups: migraineurs (nm = 998) and nonmigraineurs (nh = 1003). International Headache Society's Second Edition of International Classification of Headache Disorders and modified Migraine Disability Assessment surveys were administered to evaluate the level of migraine; a pretreatment questionnaire and the World Health Organization oral health assessment form were used to determine the oral comorbidities and their possible effects on DMFT index, gingival plaque index, existence of temporomandibular disorders, bruxism, and consistency of daily oral hygiene habits. Results: The mean age was 39.6 +/- 10.5 years. Female patients seemed to experience migraine attacks more than male patients (64%). The frequency of gastroesophageal reflux was higher in migraineurs in comparison with nonmigraineurs (47%) and tooth wear and abrasion also seemed more frequent (76%). DMFT and plaque index scores showed significant differences for both groups. Conclusion: There is a strong relationship between migraine and oral health status. The existence of reflux in addition to migraine leads to higher dental problems.Öğe Neuronal ceroid lipofuscinosis: genetic and phenotypic spectrum of 14 patients from Turkey(Springer-Verlag Italia Srl, 2021) Kose, Melis; Kose, Engin; Unalp, Aycan; Yilmaz, Unsal; Edizer, Selvinaz; Tekin, Hande Gazeteci; Yildirim, Eser SozmenIntroduction and purpose Neuronal ceroid lipofuscinoses (NCLs) is a group of congenital metabolic diseases where the neurodegenerative process with the accumulation of ceroid and lipofuscin autofluorescent storage materials is at the forefront. According to the age of presentation, NCLs are classified as congenital, infantile (INCL), late infantile (LINCL), juvenile (JNCL), and adult (ANCL) NCLs. in our study, it was aimed to discuss the clinical and molecular characteristics of our patients diagnosed with NCL. Material and method This is a descriptive cross-sectional study which was conducted in 14 patients from 10 unrelated families who were diagnosed with different types of NCL based on clinical presentation, neuroimaging, biochemical measurements, and molecular analyses, at the department of pediatric metabolism between June 2015 and June 2020. Results A total of 14 patients were diagnosed with different types of NCL. of those, 4 patients were diagnosed with NCL7 (4/14; 30%), 3/14 (23%) with NCL1, 3/14 (23%) with NCL2, 2/14 (14.2%) with NCL13, and 1/14 (7.1%) with NCL10. Eleven pathogenic variants were detected, 5 of which are novel (c.721G>T [p.Gly241Ter] and c.301G>C [p.Ala146Pro] in MFDS8 gene; c.316C>T [p.Gln106Ter] in PPT1 gene; c.341C>T [p.Ala114Val] in TPP1 gene; c.686A>T [p.Glu229Val] in CTSD gene) Conclusion This study is one of the pioneer comprehensive researches from Turkey that provides information about disease-causing variants and clinical presentation of different and rare types of NCLs. The identification of novel variants and phenotypic expansion is important for genetic counselling in Turkey and expected to improve understanding of NCLs.Öğe Serum nerve growth factor levels in autistic children in Turkish population: A preliminary study(Indian Council Medical Res, 2013) Dincel, Nida; Unalp, Aycan; Kutlu, Ayse; Ozturk, Aysel; Uran, Nedret; Ulusoy, SadikBackground & objectives: It has been hypothesized that abnormal levels of serum nerve growth factor (NGF) may represent a serological marker for autistic children who may develop cognitive impairment, regression and finally epilepsy. The objective of this preliminary study was to measure serum NGF concentrations of autistic children and compare these levels with those of healthy children. Methods: Consecutive children who were referred to the Paediatric Neurology and Child Psychiatry Policlinics of Dr. Behcet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Turkey between February and September 2008 were included in the study. Serum samples were analyzed for NGF levels using ChemiKine NGF Sandwich ELISA Kit. Comparisons between the study and the control groups were made using student's t test and Chi-square test. Results: Forty-nine autistic children and an equal number of healthy children (control group) were included in the study. No significant difference was found between the study and the control groups in terms of children's age, while number of boys was significantly higher (P<0.05) in the study group. Average serum NGF concentrations were 46.94 +/- 51.40 and 32.94 +/- 12.48 pg/ml in the study and control group, respectively. Serum NGF concentrations were significantly higher (P<0.05) in the study group compared with the control group. Interpretation & conclusions: Our preliminary findings show that enhanced serum NGF concentration may be used as a potential diagnostic tool in autism, however, further studies including a large number of patients are required to confirm the findings.Öğe Subacute Sclerosing Panencephalitis Cases Diagnosed by Increased CSF/Serum Measles Antibody Indices(Ankara Microbiology Soc, 2012) Samlioglu, Pinar; Unalp, Aycan; Gokcay, Ahmet; Altuglu, Imre; Ozturk, Aysel; Zeytinoglu, AysinSubacute sclerosing panencephalitis (SSPE) caused by persistent defective measles virus strains, is a progressive neurological disorder of children and adolescents. The aim of this letter was to share the data from SSPE-suspected cases who were definitely diagnosed by the detection of increased antibody index in serum and cerebrospinal fluid (CSF) samples. A total of 11 patients (mean age: 14.3 years) with suspected SSPE between February 2006 to August 2008, were included in the study. Simultaneously obtained serum and CSF samples from patients were analyzed in terms of albumin, total IgG and measles-specific IgG levels (Measles Virus IgG ELISA for CSF Diagnostics, Euroimmun, Germany). The value of CSQ(rel) (relative CSF/serum quotient) >= 1.5 was accepted indicative for intrathecal measles antibody synthesis. Seven (63.6%) of the 11 patients' diagnosis were confirmed with the demonstration of elevated CSF/serum indices (CSQ(rel), range: 2.3-36.9; mean: 12.9). Mean age of those seven cases was 12.3 years (age range: 7-21) and four of them were male. The history of patients with high antibody indices indicated that three of four patients who had measles infection had not been vaccinated against measles. These three unvaccinated patients had measles infection at 3rd, 8th and 30th months of age, respectively, and the period of SSPE development were 15, 6 and 4.5 years, respectively. With this letter we would like to emphasize once more that effective measles vaccination is the only way for the prevention of measles and SSPE and the demonstration of increased measles antibody index in simultaneously obtained serum and CSF samples is crucial for the diagnosis of SSPE.Öğe SURF1 related Leigh syndrome: Clinical and molecular findings of 16 patients from Turkey(Elsevier, 2020) Kose, Melis; Canda, Ebru; Kagnici, Mehtap; Aykut, Ayca; Adebali, Ogun; Durmaz, Asude; Unalp, AycanIntroduction: Pathogenic variants in SURF1, a nuclear-encoded gene encoding a mitochondrial chaperone involved in COX assembly, are one of the most common causes of Leigh syndrome (LS). Material-methods: Sixteen patients diagnosed to have SURF1-related LS between 2012 and 2020 were included in the study. Their clinical, biochemical and molecular findings were recorded. 10/16 patients were diagnosed using whole-exome sequencing (WES), 4/16 by Sanger sequencing of SURF1, 1/16 via targeted exome sequencing and 1/16 patient with whole-genome sequencing (WGS). The pathogenicity of SURF1 variants was evaluated by phylogenetic studies and modelling on the 3D structure of the SURF1 protein. Results: We identified 16 patients from 14 unrelated families who were either homozygous or compound heterozygous for SURF1 pathogenic variants. Nine different SURF1 variants were detected The c.769G > A was the most common variant with an allelic frequency of 42.8% (12/28), c.870dupT [(p.Lys291*); (8/28 28.5%)], c.169deIG [(p.Glu57 Lysfs*15), (2/24; 7.1%)], c.532 T > A [(p.Tyr178Asn); (2/28, 7.1%)], c.653_654delCT [(p.Pro218Argfs*29); (4/28, 14.2%)] c.595_597de1GGA [(p.Gly199del); (1/28, 3.5%)], c.751 + 1G > A (2/28, 4.1%), c.356C > T [(p.Pro119Leu); (2/28, 3.5%)] were the other detected variants. Two pathogenic variants, C.595_597delGGA and c.356C > T, were detected for the first time. The c.769 G > A variant detected in 6 patients from 5 families was evaluated in terms of phenotype-genotype correlation. There was no definite genotype - phenotype correlation. Conclusions: To date, more than 120 patients of LS with SURF1 pathogenic variants have been reported. We shared the clinical, molecular data and natural course of 16 new SURF1 defect patients from our country. This study is the first comprehensive research from Turkey that provides information about disease-causing variants in the SURF1 gene. The identification of common variants and phenotype of the SURF1 gene is important for understanding SURF1 related LS. Synopsis: SURF1 gene defects are one of the most important causes of LS; patients have a homogeneous clinical and biochemical phenotype.Öğe Two Siblings with Beta-Ketothiolase Deficiency: One Genetic Defect Two Different Pictures(Galenos Yayincilik, 2016) Kose, Melis Demir; Canda, Ebru; Kagnici, Mehtap; Isguder, Rana; Unalp, Aycan; Ucar, Sema Kalkan; Bahr, Luzy; Britschgi, Corinne; Sass, Jorn Oliver; Coker, MahmutDeficiency of mitochondrial acetoacetyl-coenzyme A thiolase T2 (methylacetoacetyl-coenzyme A thiolase, MAT) or beta-ketothiolase is a rare autosomal recessive disorder that is characterized by ketoacidosis episodes. Outcomes vary from normal development to severe cognitive impairment or even death after an acute episode of ketoacidosis. The classical biochemical profile of T2 deficiency is a result of mutations in both alleles of the ACAT1 gene and comprises characteristic abnormalities in urinary organic acids and blood or plasma acylcarnitine profiles. In this study, we present two sibling cases with quite different clinical properties.
