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Öğe Acute pancreatitis due to pancreatic involvement of Burkitt's lymphoma in a child(Aves, 2015) Erol, Cengiz; Kose, Dogan; Yuksekkaya, Hasan Ali; Koksal, Yavuz[Abstract Not Availabe]Öğe Budd-chiari syndrome and renal arterial neurysms due to behcet disease: a rare association(African Field Epidemiology Network-Afenet, 2015) Batur, Abdussamet; Dorum, Meltem; Yuksekkaya, Hasan Ali; Koc, OsmanBehcet's disease is a multisystemic vasculitis of unknown etiology with a chronic relapsing course. Vasculitis in Behcet's disease with predominant vascular involvement is the only vasculitis that affects both arteries and veins of any size. Involvement of the renal artery and inferior vena cava is rare among the arteries and veins, respectively. When disease affect the veins, it is in the form of thrombosis. Arterial complications include aneurysms, stenosis and occlusions. Both rupture of arterial aneurysm and occlusion of suprahepatic veins, causing Budd-Chiari syndrome, are associated with a high mortality rate. Vascular involvement is more common in male patients than in female patients. Men and patients with a younger age of onset present with a more severe prognosis. In this case report, we describe a very rare cause of intrarenal arterial aneurysm's rupture with previous Budd-Chiari syndrome due to Behcet's disease and successful angiographic embolization of actively bleeding aneurysm.Öğe Comparison of standard and standard plus vitamin E therapy for Helicobacter pylori eradications in children(Aves, 2014) Tumgor, Gokhan; Baran, Masallah; Cakir, Murat; Yuksekkaya, Hasan Ali; Aydogdu, SemaBackground/Aims: Although various drugs can be used in adults for Helicobacter pylori eradication in adults, treatment options are limited in children. The aim of this study was to compare the effects of the standard lansoprazole, amoxicillin, and clarithromycin (LAC) protocol to those of LAC + vitamin E (LACE) combination for H. pylori eradication. Materials and Methods: The study included 90 children (age range: 10-17 years) who were admitted to four pediatric gastroenterology centers between March 2011 and November 2012 with dyspeptic symptoms and who had tested positive for H. pylori by 14C-urea breath tests. The patients were randomized into two groups. The LAC group [45 patients (pts)] was treated with a standard regimen consisting of lansoprazole (1 mg/kg/day), amoxicillin (50 mg/kg/day), and clarithromycin (14 mg/kg/day), each of which was given in two equally divided doses every 12 h for 14 days; the LACE group (45 pts) was given the standard regimen and vitamin E at 200 IU/day for 14 days. H. pylori eradication was assessed using the 14C-UBT in the 6th week after the cessation of treatment. Results: H. pylori was eradicated in 21 (46.6%) pts in the LAC group, while it was eradicated in 29 (64.4%) pts in the LACE group. There was no statistical difference between the two groups (p=0.13). Conclusion: The eradication rate of H. pylori in children while using the LAC regimen has decreased in the last years. The LACE regimen has been associated with an increased eradication rate but can reach to statistically significance. Further studies with larger cohorts are needed to examine the success of the LACE regimen for H. pylori eradication.Öğe The Effect of Enteral Nutrition Support Rich in TGF-? in the Treatment of Inflammatory Bowel Disease in Childhood(Mdpi, 2019) Agin, Mehmet; Yucel, Aylin; Gumus, Meltem; Yuksekkaya, Hasan Ali; Tumgor, GokhanBackground and Objective: Malnutrition is a major complication of inflammatory bowel disease (IBD). Our aim of the study was to examine the effects of Modulen IBD supplementation, which was administered to IBD patients without limiting their daily diet in addition to medical treatment, on the clinical, laboratory, anthropometric values, and disease activities of these patients. Materials and Methods: Seventy three children with IBD were evaluated retrospectively. The cases were classified as those who had Crohn disease receiving (CD-M; n = 16) or not receiving Modulen IBD (CD; n = 19) and those who had ulcerative colitis receiving (UC-M; n = 13) or not receiving Modulen IBD (UC; n = 25). Disease activities, laboratory values, remission rates, and anthropometric measurements of the groups were compared. In addition to IBD treatment, Modulen IBD in which half of the daily calorie requirement was provided was given for eight weeks. Results: In the third month of treatment, 14 (88%) patients were in remission in CD-M group and eight (42%) patients were in remission in CD group. The height and weight z scores, which were low at the time of diagnosis, improved in the first week in CD-M group. Inflammatory parameters (UC) were significantly lower in the UC-M group compared to the UC group in first and third months. In the third month, eight (62%) patients in the UC-M group and four (16%) in the UC group were remitted clinically and in terms of laboratory values. Conclusions: TGF-beta-rich enteral nutrition support in children with IBD is an easy, effective, and reliable approach. It was shown that TGF-beta-rich enteral nutritional supplementation enabled the disease to enter the remission earlier, and contributed to the early recovery of weight and height scores.Öğe Essential thrombocythemia with Mpl W515 K mutation in a child presenting with Budd-Chiari syndrome(Taylor & Francis Inc, 2015) Tokgoz, Huseyin; Caliskan, Umran; Yuksekkaya, Hasan Ali; Kucukkaya, ReyhanEssential thrombocythemia (ET) is an extremely rare childhood disorder characterised by clonal expansion of megakaryocytic lineage in bone marrow, leading to a persistent increase in the number of circulating thrombocytes and thus increased risk for thrombotic and haemorrhagic events. The molecular mechanisms of ET are not fully understood. Most children with ET have the JAK2 V617F somatic mutation; however, another mutation, involving a W to L or K substitution at Mpl codon 515, was reported in a small proportion of adult ET patients that is extremely rare in children. Herein, we describe a Mpl W515K somatic mutation in a paediatric case of ET who presented with Budd-Chiari syndrome. No paediatric patient harbouring a Mpl W515K mutation has been previously reported.Öğe The Ineffectiveness of Tacrolimus in an Infant With a Mutation in the IL-10 Receptor(Lippincott Williams & Wilkins, 2016) Sayar, Ersin; Yucel, Aylin; Eisele, Bianca; Sayar, Esra Hazar; Glocker, Erik; Yuksekkaya, Hasan Ali[Abstract Not Availabe]Öğe Inflammatory bowel disease in Turkish children(Zhejiang Univ Sch Medicine, 2015) Cakir, Murat; Unal, Fatih; Dinler, Gonul; Baran, Masallah; Yuksekkaya, Hasan Ali; Tumgor, Gokhan; Kasirga, ErhunThis study was undertaken to evaluate demographics, clinical manifestations, laboratory findings and outcomes of children with inflammatory bowel disease (IBD) in Turkey. We analyzed the medical records of 127 children diagnosed with IBD (under 18 years old) between January 2004 and January 2012 in 8 pediatric gastroenterology centers. Of the 127 patients, 90 (70.9%) suffered from ulcerative colitis (UC), 29 (22.8%) from Crohn's disease (CD), and 8 (6.3%) from IBD unclassified. The mean age of the 127 patients was 11.6 +/- 4.1 years, and 11.8% of the patients were below 5 years old. Of the patients, 49.6% were male, and males were more predominant in patients with CD than in those with UC (72.4% vs. 42.2%, P=0.008; a male/female ratio of 2.62 in CD, P=0.0016). Approximately one fifth of the patients had extra-intestinal manifestations and 13.3% of the patients had associated diseases. Extraintestinal manifestations and associated diseases were more common in early onset disease [P=0.017, odds ratio (OR)=4.02; P=0.03, OR=4.1]. Of the patients, 15% had normal laboratory parameters including anemia, high platelet count, hypoalbuminemia, hypoferritinemia, and high sedimentation rate. Area under receiver operation characteristics was used to predict pancolitis in patients with UC. The values of C-reactive protein, sedimentation rate and pediatric ulcerative colitis activity were 0.61 (P=0.06), 0.66 (P=0.01) and 0.76 (P=0.0001), respectively. Four (4.4%) patients with UC underwent colectomy, and finally two (1.5%, 95% confidence interval: 0-3.7%) patients died from primary disease or complications. IBD is an increasing clinical entity in Turkey. Features of IBD are similar to those in other populations, but prospective multicenter studies are needed to analyze the true incidence of IBD in Turkish children.Öğe Liver involvement in children with Familial Mediterranean fever(Elsevier Science Inc, 2012) Unal, Fatih; Cakir, Murat; Baran, Masallah; Arikan, Cigdem; Yuksekkaya, Hasan Ali; Aydogdu, SemaAim: Familial Mediterranean fever is characterised by recurrent, febrile, inflammatory attacks of the serosal membranes. Prolonged inflammatory response is triggered secondary to cytokine stimulation due to reduced activity of pyrin. Inflammatory cytokines play major role in the pathogenesis of acute liver injury; and chronic, recurrent cytokine production may cause chronic hepatitis/cirrhosis. We aimed to analyse liver involvement in children with Familial Mediterranean fever. Patients: The study included 58 patients with Familial Mediterranean fever. Patients with liver involvement were examined in detail. Results: Liver involvement was seen in 11 of 58 patients (18.9%). Two patients (3.4%) had abnormal liver enzymes during the diagnostic evaluation, whilst 9 patients (15.5%) were admitted with the features of liver diseases, and had final diagnosis of Familial Mediterranean fever (2 had Budd-Chiari syndrome, Shad chronic hepatitis/cirrhosis, 2 had acute hepatitis). None of the demographic factors or laboratory findings was different between the patients with or without liver involvement M694V allele was more common in patients with liver involvement but did not reach significant difference (50% vs. 33.6%, p = 0.21). All the patients showed clinical and laboratory improvement after colchicine. Conclusion: Paediatric hepatologists must keep Familial Mediterranean fever in mind in the patients with cryptogenic hepatitis/cirrhosis especially in regions where hereditary inflammatory diseases are common. Crown Copyright (C) 2012 Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l. All rights reserved.Öğe Ursodeoxycholic acid treatment for duodenogastric reflux in childhood(Kuwait Medical Assoc, 2021) Agin, Mehmet; Gumus, Meltem; Yucel, Aylin; Yuksekkaya, Hasan Ali; Aydogdu, Sema; Tumgor, GokhanObjective: The purpose of this study was to determine the clinical and histopathological features of duodenogastric reflux (DGR) in children and the effectiveness of ursodeoxycholic acid (UDCA) therapy. Design: Prospective Setting: Cukurova University Medical Faculty Pediatric Gastroenterology Clinic and Necmettin Erbakan University Medical Faculty Pediatric Gastroenterology Clinic, Adana and Konya, Turkey Subjects: One hundred and four children Intervention: One hundred and four patients with DGR were assessed in terms of their history, physical examination, endoscopy, histopathology and response to UDCA therapy. Main outcome measure: Positive results were obtained by administering UDCA treatment in addition to stomach drugs. Results: Eighty-two (79%) patients had previously used various antacids and proton pump inhibitors for dyspeptic symptoms. Gastritis was detected with upper gastrointestinal system endoscopy in all patients. Symptoms decreased by more than half or resolved completely in 97 patients (93%) at the 3-month follow-up interval. Conclusion: DGR should be considered in the etiology of patients with dyspeptic symptoms who fail to respond to antacid and proton pump inhibitor therapy. The majority of patients with DGR responded well to three months of UDCA therapy.
