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Biomedical subjects

Bülent Ataş

Publications and source records attributed to Bülent Ataş.

At least 19 recordsLinked to original sources

Bilateral brachial plexopathy complicating Henoch-Schönlein purpura.

An 11-year-old boy presented with convulsion, fever, rash, abdominal pain, swelling on the eyelids, elbow and wrists, oliguria and hematuria. Based on the abnormal findings the patient was diagnosed with Henoch-Schönlein purpura. On the 3rd day of admission, neurological examination showed ataxic gait, loss of deep tendon reflexes, and decreased (4/5) of muscle strength on all extremities. Additionally, bilateral loss of touch, pain and temperature sensation in a glove, from the elbows to distal region (on C5-T1 level) was diagnosed. Cerebrospinal fluid examination and cranial magnetic resonance imaging (MRI) were normal. The patient was discharged with oral prednisolone on the 7th day of admission. One week after discharging from the hospital, he was re-admitted with vertigo and seizures. He was in coma. MRI of cranial, cervical and cervical plexus were normal. Electromyography showed severe bilateral brachial plexopathy. Prednisolone and intravenous immunglobulin (IVIG) therapy were given without significant improvement. He was discharged from the hospital on the 17th day of admission. On the second month of follow-up, a second cure of IVIG was given because of no clinical improvement. Now, he is on the 4th month of follow-up, unfortunately, no improvement was noted on his muscle strength and sensorial abnormalities on the upper extremities.

Brachial Plexus Neuropathies↗

Cranial MRI findings in children with protein energy malnutrition.

In this study, cranial magnetic resonance imaging (MRI) findings were investigated in children with moderate and severe protein energy malnutrition (PEM) to determine cerebral abnormalities in malnutrition in childhood. A total of 20 children aged 3 months to 36 months were included in the study. Thirteen (65%) children had severe malnutrition and seven (35%) children had moderate malnutrition. Fifteen (75%) children had abnormal MRI findings: all of them had cerebral atrophy, and 10 (75%) children had cerebral atrophy plus ventricular dilatation. None of the children had abnormality in the brain stem or cerebellum. The authors did not find statistically significant differences between the groups when comparing the MRI findings for degree of malnutrition, head circumference, iron deficiency anemia, and serum albumin levels. In conclusion, the findings showed that most (75%) children with moderate/severe PEM had abnormal MRI findings. Therefore, it is suggested that children with PEM should be evaluated for cerebral atrophy.

Adolescent↗

Four children with colchicine poisoning.

Colchicine poisoning is a rare event. It is characterized by multiorgan involvement and by poor prognosis associated with overdose. In this article we present four children with colchicine poisoning to emphasize that colchicine poisoning has a large spectrum in childhood. The children's ages ranged between 1 year and 3.5 years. The ingested dosage of colchicine was between 0.37 and 1.72 mg/kg. Most of the findings of colchicine poisoning such as gastrointestinal symptoms, hepatotoxicity, cardiotoxicity, bone marrow suppression, hypocalcaemia and hair loss were diagnosed in our patients. Two children receiving 0.37 mg/kg and 1 mg/kg colchicine and admitted 13 and 19 hours after poisoning, respectively, died. Our findings suggest that in addition to amounts of the drug, mortality was also related to the duration between drug ingestion and admission to hospital.

Child, Preschool↗

Measles is still a severe problem in Eastern Turkey.

In this study, we reviewed the demographic and clinical findings of 143 children with measles to draw attention the importance of measles and its complications in Eastern Turkey. Of 143 patients, 75 (52.5%) were boys, 68 (47.5%) were girls. The patients' age ranged from 5 months to 13 years (3.97 +/- 3.11 years). The peak of admissions (37%) occurred in the age range five to 24 months. The majority of the cases (84.7%) were not immunized against measles. Of 143 cases, 104 (72.7%) cases were malnourished. Of 143 children, 57 (40%) children had one or more complication of measles and the most common complication was pneumonia. Two (1.3%) children died. In conclusion, our findings showed that measles and its complications were severe problem in our country. We think that it is primarily related to very low socioeconomic status of our region.

Adolescent↗

Hyperkalemia most likely associated with massive cephalhematoma in a newborn infant who was treated with urgent peritoneal dialysis: case report.

Cephalhematomas rarely lead to serious complications such as infection, osteomyelitis and skull fractures. However, we present a newborn infant with hyperkalemia in the context of a serious complication believed to be caused by hemolysis of a large cephalhematoma. The patient was treated with urgent peritoneal dialysis and discharged with a successful outcome. In conclusion, neonates with massive cephalhematoma should be closely examined in terms of bilirubin counts as well as electrolyte counts.

Cerebral Hemorrhage↗

PFAPA syndrome mimicking familial Mediterranean fever: report of a Turkish child.

The PFAPA (Periodic Fever, Aphthous stomatitis, Pharyngitis, Adenitidis) syndrome is characterized by periodic fever, adenitis, pharyngitis, and aphthous stomatitis. Herein, we present a Turkish child with PFAPA syndrome mimicking familial Mediterranean fever because of a rare presentation. A 9-year-old boy was admitted with recurrent fever, aphthous stomatitis, sore throat, headache, and general body pains, lasting 2 to 3 days since 3.5 years of age. He was completely symptom-free between the attacks. He was diagnosed as having familial Mediterranean fever according to the clinical findings when he was 6 years of age and Colchicum tablet was administrated. Despite colchicines therapy for 8 months, his attacks did not subside; therefore, the drug was discontinued. He had high fever, a painful cervical lymphadenopathy, aphthous stomatitis, and tonsillo-pharyngitis. The patient was then diagnosed as having PFAPA syndrome. He was given a single dose of prednisolone (0.35 mg/kg/dose). His complaints dramatically and completely disappeared 3 h after administration of the drug. During the 8th month of follow-up, a similar febrile attack lasting only 1 day was noted and it was controlled with a single dose of prednisolone (0.5 mg/kg/day). At this writing the patient is in the 12th month of follow-up, and there have been no symptoms after the second attack. In conclusion, our patient shows that PFAPA syndrome can be confused with familial Mediterranean fever. We also would like to emphasize that the typical PFAPA syndrome can be easily diagnosed by detailed history-taking and physical findings.

Child↗

Onset of generalized seizures after intrathecal interferon therapy of SSPE.

An 11-year-old male was admitted with inability to walk and speech abnormality. He was diagnosed with subacute sclerosing panencephalitis on the basis of clinical and laboratory findings. Therapy with inosiplex (100 mg/kg/day orally) plus intrathecal interferon-alpha (3 million units/dose twice per week) and ribavirin (15 mg/kg/day orally) was initiated. Ribavirin was given orally because of a lack of parenteral form in our country. During follow-up, he complained about fever and widespread body pains after intrathecal therapy. On the sixth month of follow-up, generalized tonic-clonic seizures, associated with high fever, and lasting approximately 1-2 minutes occurred about 6 hours after giving interferon-alpha. Four days after the first seizures, a similar seizure attack reoccurred after intrathecal IFN-alpha. An antiepileptic agent was not administered because electroencephalogram results did not indicate epileptic discharges. At the current time, he is in the ninth month of follow-up and remains seizure-free. In conclusion, our case demonstrated that standard dose intrathecal interferon-alpha might cause seizures in children. We think that this unfortunate condition was more common in subacute sclerosing panencephalitis children treated with intrathecal interferon-alpha.

Child↗

Report of eight children with amitraz intoxication.

Many pesticides are formulated in organic solvents. An example is amitraz, one of the formamidine groups of pesticidal chemicals. It is commonly used for the treatment of generalized demodicosis in dogs and for the control of ticks and mites in cattle and sheep. In this article, the clinical and laboratory findings of eight children with amitraz intoxication are reviewed. The purpose was to enlighten the findings of amitraz intoxication in children. Of the eight patients, five (62.5%) were boys, three (37.5%) were girls, and the ages ranged from 1 to 4 years. All children accidentally ingested amitraz orally, with no dermal exposure. The most common observed signs were decreased consciousness and bradycardia. Leukocytosis, hyperglycemia, hypernatremia, increased serum aspartate transaminase level, and prolonged partial prothrombin time were diagnosed in children. None of the children had hypothermia, hypotension, or convulsion and none of the patients died. The findings show that the initial signs and symptoms of acute amitraz intoxication appeared severe but they disappeared, with only supportive care needed in most cases within a few days.

Aspartate Aminotransferases↗

Prognostic factors in children with purulent meningitis in Turkey.

In this study the clinical and laboratory findings of 48 children with purulent meningitis were examined, prospectively, to determine the prognostic factors in childhood meningitis in a developing country. Patients were examined for the following variables: history of antibiotic use; period between onset of symptoms and hospital admission; age at presentation; sex; fever; convulsion; level of consciousness; malnutrition; anemia; leukocyte and thrombocyte counts; erythrocyte sedimentation rate; serum C-reactive protein (CRP) level; and cerebrospinal fluid (CSF) including white blood cell count; glucose, protein, and CRP concentrations; antibiotic treatment; neurological sequelae; and fatality rate during the hospital stay. Most of these parameters were re-evaluated in all patients 36-48 h after admission. Patients were divided into 3 groups: surviving without sequelae, surviving with sequelae, and not surviving (deceased). A total of 48 children, 19 girls (39.5%) and 29 boys (60.5%), aged 2 months to 13 years, were included in the study. Of the 48 patients, 29 (60.5 %) survived without sequelae, 13 (27%) survived with sequelae and 6 (12.5%) died. In a comparison among groups, we found that absence of anemia, low (< 1,000) CSF white blood cell (WBC) count, and high CRP level at admission were the indicative of poor prognosis. Thirty-six to 48 h after admission, the presence of fever, depressed level of consciousness, high (> 1,000) CSF WBC count, and low CRP level were also poor prognostic factors. In addition, we observed that mortality rate was lower in the penicillin G + chloramphenicol group than in the ampicillin-sulbactam + cefotaxime group (P < 0.05). The mean period between onset of symptoms and hospital admission was longer in the surviving with sequelae and in the not surviving groups than in the surviving without sequelae group (P < 0.05).

Adolescent↗

Seizures in a boy with subacute sclerosing panencephalitis during high-dose intrathecal interferon-alpha therapy.

A 27-month-old boy was admitted with speech abnormality, inability to walk, and involuntary movements. He was diagnosed with subacute sclerosing panencephalitis based on clinical and laboratory findings. Inosiplex (100 mg/kg/day orally) plus intrathecal interferon-alpha (3 million units/dose twice per week) in a standard regime were given. After four doses of interferon it was prescribed as 6 million units/dose/week because he had been admitted from a remote district. One day after giving the second dose of 6 million units of interferon, two generalized tonic-clonic seizures that occurred within an hour, associated with high fever, which lasted approximately 5 minutes were observed. An antiepileptic agent was not administered because electroencephalogram results did not indicate epileptic discharges. After this condition we returned to the first treatment protocol of interferon (3 million units/dose twice per week). At the current time, he is in the fifth month of follow-up and remains convulsion-free. To the best of our knowledge, seizures as a result of high-dose intrathecal interferon in subacute sclerosing panencephalitis has not been reported in the literature. Our patient demonstrated that it is reasonable to avoid the use of high-dose intrathecal interferon-alpha in childhood.

Antineoplastic Agents↗

No effect of long-term valproate therapy on thyroid and parathyroid functions in children.

In this study, we studied serum calcium, phosphorus, alkaline phosphatase, thyroid hormones (total thyroxine, free thyroxine, thyroid-stimulating hormone), parathyroid hormone, and osteocalcine levels in children with epilepsy who had been receiving long-term valproate (VPA) therapy in order to determine whether there was any effect of VPA therapy on these hormones. The study included 31 patients with epilepsy receiving VPA and 22 healthy age-matched controls. The age ranged from 15 months to 16 years and 18 months to 17 years in the study and control group, respectively. The duration of VPA use was between 12 months and 5 years (1.93 +/- 1.90 years). When comparing the results, we did not find any significant difference in any of the parameters, including serum calcium, phosphorus, alkaline phosphatase, osteocalcine, and thyroid and parathyroid hormone levels, between the study and control group. We suggest that VPA can safely be used with regard to thyroid and parathyroid dysfunction in childhood epilepsy.

Adolescent↗

Report of eight infants with acute infantile hemorrhagic edema and review of the literature.

Acute infantile hemorrhagic edema (AIHE) is a cutaneous leukocytoclastic vasculitis, clinically characterized by the symptom triad of fever, large purpuric skin lesions, and edema. The clinical picture has a violent onset, a short benign course, and spontaneous complete recovery. In this article, we present eight patients who were admitted with rashes on the skin and edema on the eyelids and extremities, and were diagnosed with AIHE according to their clinical and histopathological features (immunohistological study was also performed in three of them). Our purpose was to emphasize that, aside from Henoch-Schönlein purpura, meningococcemia, septicemia, and purpura fulminans, AIHE benign disorder should also be considered in the differential diagnosis to determine the clinical course and treatment protocol in patients with purpuric rashes.

Acute Disease↗