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Dive into the research topics where Miray Karakoyun is active.

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Featured researches published by Miray Karakoyun.


Gene | 2015

Two novel UBR1 gene mutations ın a patient with Johanson Blizzard Syndrome: A mild phenotype without mental retardation.

Tahir Atik; Miray Karakoyun; Maja Sukalo; Martin Zenker; Ferda Ozkinay; Sema Aydogdu

Johanson-Blizzard Syndrome (JBS) (MIM #243800) is a rare autosomal recessive genetic disorder characterized by exocrine pancreatic insufficiency, abnormal facial appearance and varying degrees of mental retardation. Mutations in UBR1 gene (MIM *605981) are considered to be responsible for the syndrome. Here, we report a 3 year-old mentally normal JBS girl. The patient presented with exocrine pancreatic insufficiency as well as failure-to-thrive. On dysmorphological examination, she was noted to have an abnormal hair pattern with frontal upsweep and alae nasi hypoplasia. With these findings, JBS diagnosis was established clinically. Molecular analysis of the UBR1 gene revealed two inherited novel mutations; one coming from each parent. These novel mutations were c. 1280T>G and c. 2432+5G>C, and they were found to be disease causing via in-silico analysis. In conclusion, for patients with longstanding exocrine pancreatic insufficiency, it should be considered as being symptomatic of a far broader picture. To omit connection with rare genetic diseases, such as Johanson-Blizzard Syndrome, a detailed dysmorphological examination ought to be performed.


Pediatric Transplantation | 2013

An autoimmune disease refractory to immunosuppressive regimens: Celiac disease diagnosed long after liver transplantation

Cigdem Omur Ecevit; Miray Karakoyun; Fatih Unal; Hasan Ali Yuksekkaya; Basak Doganavsargil; Rasit Vural Yagci; Sema Aydogdu

CD is defined as T‐lymphocyte‐mediated gluten sensitivity. Although CD is known to affect the small intestine, it is nonetheless a multisystem disorder. Liver involvement in CD may vary from isolated hypertransaminasemia to cirrhosis. Because CD is an inappropriate immune response to gluten proteins, strict gluten‐free diet is the principal therapy, along with management of liver dysfunction. In patients who fail to respond to a gluten‐free diet, immunosuppressive drugs may improve intestinal inflammatory activity in untreated CD. The present case report is of a 25‐yr‐old woman with diarrhea lasting several weeks. The patient had received a liver transplant 13 yr earlier, and presented with cryptogenic cirrhosis diagnosed as CD. This appears to be the first case of its kind in which a pediatric long‐term liver transplant patient presents with diarrhea eventually diagnosed as CD whose diet included gluten, and who was treated by an immunosuppressive drug regimen. Because of the normalization of CD‐related antibodies in the post‐transplantation period without gluten restriction, CD should be part of a list of diagnostic possibilities in liver transplant patients presenting with diarrhea of unknown etiology.


European Journal of Gastroenterology & Hepatology | 2016

Autoimmune hepatitis and long-term disease course in children in Turkey, a single-center experience.

Miray Karakoyun; Cigdem Ecevit; Erhan Kilicoglu; Sema Aydogdu; Rasit Vural Yagci; Funda Ozgenc

Introduction The aim of this study is to determine clinic and laboratory features, treatment protocols, treatment responses, and long term follow-up of children with autoimmune hepatitis (AIH) in a region of Turkey followed at Ege University. Materials and methods The records of 47 children with AIH between 1998 and 2012 were retrospectively analyzed for clinical profiles, treatment response, relapse rate, and long-term side effects. Results The median age of the children was 10±4.1 years (55.3% females). A total of 29 patients presented with chronic hepatitis (61.7%). According to the autoantibody profiles, 40 (85.1%) and seven (14.9%) cases were classified as type 1 and type 2, respectively. Presentation with acute hepatitis and chronic hepatitis was significantly higher in type 1 disease. Laboratory findings at presentation was found similar among races as well as AIH types (P>0.05). The prednisolone was used for remission induction in 37 patients; 86.4% (n: 32) achieved a complete response, 2.7% (n: 1) achieved a partial response, and four patients (10.8%) showed no response. Maintenance was attained by low-dose steroid plus thiopurine and relapse in steroid responders (n: 32) was 9.4% (n: 3) at 8, 12, and 48 months. A total of 36% (n: 24) had neither acute nor chronic treatment side effects. Bone marrow suppression was observed in five patients and hyperglycemia was observed in one patient (10.6 and 2.1%), respectively. Conclusion AIH type 1 prevails in children in a region of Turkey during the second decade of life. Low-dose corticosteroids combined with azathioprine are found.


European Journal of Gastroenterology & Hepatology | 2017

The overlap of gastroesophageal reflux disease and functional constipation in children: the efficacy of constipation treatment

Masallah Baran; Yeliz Cagan Appak; Miray Karakoyun; Sevda Yalcinkaya; Kayi Eliacik; Bumin Dündar

Objectives This study was designed to investigate the frequency of gastroesophageal reflux disease (GERD) in children with functional constipation (FC). It was structured to assess the improvement level in reflux symptoms by measuring the acid reflux in these patients after they had received FC treatment. Methods Ninety-four children who suffered from constipation were evaluated prospectively. Data forms were completed to assess the GERD symptoms in all the cases. Twenty-four-hour pH meter monitoring was performed in 55 of the patients with GERD symptoms. The cases with abnormal acid reflux were treated by conventional therapy for FC. These cases were re-evaluated for GERD symptoms and weekly defecation frequency, and 24-h pH meter monitoring was performed at the end of a 3-month period. Results An abnormal level of acid reflux was determined in 23 of the 55 cases. After the constipation treatment, a significant improvement was achieved in the acid reflux index and GERD symptoms, whereas the weekly defecation frequency increased. Conclusion GERD is a frequent problem in children with FC. Treatment of the constipation can improve the reflux symptoms and abnormal acid reflux in these cases. Physicians should bear in mind the co-occurrence of these two prevalent problems for better disease management.


The Turkish journal of gastroenterology | 2018

Primary intestinal lymphangiectasia and a review of the current literature

Zeynep Altın; Yusuf Atabay; Serhat Özer; Miray Karakoyun; Sumeyye Ekmekci; Ezgi Yildiz Yurekli; Harun Akar

Zeynep Altın1* , Yusuf Atabay1 , Serhat Özer2 , Miray Karakoyun3 , Sümeyye Ekmekçi4 , Ezgi Yıldız Yürekli1* , Harun Akar1 1Department of Internal Medicine, Health Sciences University, İzmir Tepecik Health Practice and Research Center, İzmir, Turkey 2Department of Gastroenterology, Artvin State Hospital, Artvin, Turkey 3Department of Pediatric Gastroenterology, Health Sciences University, İzmir Tepecik Health Practice and Research Center, İzmir, Turkey 4Pathology Clinics, Health Sciences University, İzmir Tepecik Health Practice and Research Center, İzmir, Turkey


The Turkish journal of gastroenterology | 2018

Efficacy and safety of long-term thiopurine maintenance treatment for ulcerative colitis in Turkey: A single-center experience

Funda Ozgenc; Miray Karakoyun; Cigdem Ecevit; Hamiyet Hekimci; Ezgi Tasci; Gulin Erdemir; Tepecik Training Nutrition

BACKGROUND/AIMS Thiopurines are widely used in the treatment of inflammatory bowel disease, but data are limited. Or aim was to determine the outcome of thiopurine application in children diagnosed with ulcerative colitis (UC). MATERIALS AND METHODS Forty-eight patients with UC, diagnosed at our center between 2005 and 2016 and applied azathiopurine (AZA), were included in the study. Data were collected retrospectively. The diagnosis of UC was based on the conventional clinical, radiological, histological, and endoscopic assessment. All patients with UC at this intercept were analyzed at the 4- and 6-week and 3-month intervals after remission to determine patient characteristics, thiopurine properties, and its efficacy and toxicity. Determination of remission, relapse, and steroid refractoriness/dependency were guided according to the European Crohns and Colitis Organisation consensus. RESULTS Azathiopurine was started at the median 1 month (0-12 months), and it was applied thereafter for maintenance (n=43). Response to remission induction was obtained in 40 (93.7%) patients. The median duration of the AZA treatment was 24 months (5-63). In 34 (85%) of the 40 children, it was well tolerated until the last visit. During the follow-up, adverse events occurred in 6 patients. These are leucopenia, neutropenia, vomiting, diarrhea, and skin rush. CONCLUSION Thiopurine is an appropriate treatment option for remission in patients with UC. For a long-term follow-up, it is very important to identify patients with UC who have clinical remission with side effects and with thiopurine application.


The Turkish journal of gastroenterology | 2018

Post-transplant malignancies in pediatric liver transplant recipients: Experience of two centers in Turkey

Miray Karakoyun; Sebnem Onen; Masallah Baran; Murat Cakir; Cigdem Omur Ecevit; Murat Kilic; Mehmet Kantar; Serap Aksoylar; Funda Ogenc; Sema Aydogdu

BACKGROUND/AIMS A liver transplant is the preferred treatment for patients with end-stage liver disease, as it usually results in longterm survival. However, due to the use of chronic immunosuppressive therapy, which is necessary to prevent rejection, de novo cancer is a major risk after transplantation. The aim of this study was to assess the incidence of post-transplant malignancies in children after liver transplantations. MATERIALS AND METHODS The study group consisted of 206 liver transplant recipients, with no history of cancer, including hepatocellular carcinoma, in two liver transplantation centers in Turkey between 1997 and 2015. Data were obtained from patients data chart. RESULTS In the study group, de novo cancer was diagnosed in 13 of the 206 patients. Post-transplant lymphoproliferative disease (PTLD) occurred in seven (53.8%) patients and other malignancies in six of the 13 patients. The types of PTLD were as follows: B-cell origin (n=2), Epstein-Barr virus (EBV)-related (n=2), T-cell origin (n=1), and Hodgkins lymphoma (n=2). EBV DNA was isolated from seven patients, three of whom developed PTLD. The others developed Kaposis sarcomas, Burkitts lymphomas, cutaneous large-cell lymphomas, Hodgkins lymphomas, and liver sarcomas. CONCLUSION After transplantation, immunosuppressive treatment is unavoidable, increasing the risk of malignancies. However, a close follow-up and periodic screening can reduce cancer-related mortality and morbidity.


Sao Paulo Medical Journal | 2018

The cause of abdominal mass in a child with celiac disease: Rapunzel syndrome. A case report

Yeliz Çağan Appak; Duygu Ertan; Miray Karakoyun; Gonca Özyurt; Tunç Özdemir; Maşallah Baran

CONTEXT Rapunzel syndrome is a rare form of gastric trichobezoar that develops through outstretching of the bezoar from the stomach to the intestine. CASE REPORT A 12-year-old girl who had been diagnosed with celiac disease six years earlier was brought to the department of pediatric gastroenterology because of abdominal distension. A palpable mass was detected. A trichobezoar that stretched to the small intestine was removed surgically. The patient was diagnosed as having anxiety and depressive disorder, and treatment started. Following the treatment, her previous trichophagia completely disappeared. CONCLUSION Presence of trichobezoar should be kept in mind, especially when young girls who have psychiatric problems suffer from gastrointestinal symptoms.


Iranian Journal of Pediatrics | 2018

Diagnosis and Management of Pancreatitis in Childhood: A Single-Centre Experience

Yeliz Çağan Appak; Miray Karakoyun; Gulsah Cetin; Nursel Akmaz; Masallah Baran

Background: Pancreatitis can be seen at any age in childhood. Therefore, it is important for pediatricians to know the diagnosis and the management of pancreatitis. Objectives: The aim of this study was to evaluate the etiological factors, clinical features and management of pancreatitis in children. Methods: This study included hospitalized children who were diagnosed with pancreatitis. The clinical presentations, laboratory analyses, radiological features, etiologies and treatments were recorded. Results: A total of 59 pancreatic attacks were recorded in 41 patients. The most common symptoms were abdominal pain and vomiting, and the most common etiological cause was idiopathic. Approximately 22% of the patients had acute recurrent episodes. Somatostatin was used to treat 61% of the attacks; however, it did not reduce the time to recovery after an attack when compared to those patients who did not use somatostatin (P = 0.36). The white blood cell counts and urea and calcium levels were significantly different between those patients who did and did not use somatostatin. Seventeen (28.8%) of the pancreatitis attacks were determined to be severe. Moreover, a mutation in the cystic fibrosis transmembrane conductance regulator was detected in two patients with recurrent pancreatitis. Conclusions: Fever and irritability can be signs of pancreatitis in infants and toddlers. In our cases, the somatostatin treatment was not effective in terms of the time to recovery after an attack.


Indian Pediatrics | 2018

Etiology and Outcome of Cholelithiasis in Turkish Children

Maşallah Baran; Yeliz Çağan Appak; Gokhan Tumgor; Miray Karakoyun; Tunç Özdemir; Gökhan Köylüoğlu

ObjectiveThe aim of this study was to examine the etiology of gallstones in children and responses to ursodeoxycholic acid (UDCA) treatment.Methods74 children with cholelithiasis were recruited, and underwent ultrasonography to detect gallstones. All relevant clinical information was recorded in a structured proforma.ResultsThe commonest risk factor was a family history of gallstones. Most children responded to UDCA treatment in the first six months; children with hemolytic diseases showed no response to UDCA.ConclusionUDCA treatment may be useful before surgery in asymptomatic patients of cholelithiasis without hemolytic diseases.

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Cigdem Ecevit

Boston Children's Hospital

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