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  • Küçük Resim
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    Long-term monitoring of graves’ disease in children and adolescents: A single-center experience
    (Turkiye Klinikleri, 2019) Tunç, Selma; Köprülü, Özge; Ortaç, Hatice; Nalbantoğlu, Özlem; Dizdarer, Ceyhun; Demir, Korcan; Özkan, Behzat
    Background/aim: Graves’ disease (GD) is more severe, requires a more complex treatment, and has a lower probability of achieving remission in children than in adults. There is no consensus on the appropriate duration of antithyroid drug (ATD) treatment. Surgical or radioactive iodine (RAI) treatments are not definitive and generally result in permanent hypothyroidism. This study’s goal was examining the effectiveness of ATD treatment in children and adolescents with GD and determining the risk factors of remission and relapse. Materials and methods: This retrospective study included 45 patients (36 females and 9 males, median age 12.5 years) aged 4–18 who were diagnosed with GD between 2003 and 2017. All patients initially were treated with an ATD. ATD treatment was discontinued at a mean of 23.2 ± 13.2 months (10–37 months). Results: Patients were classified into remission (n = 24) and relapse groups (n = 21). The duration of initial ATD treatment in the remission group was longer (26.91 ± 5.17 months) than in the relapse group (19.09 ± 7.14 months) (P = 0.01). The total ATD treatment duration was statistically longer in the remission group (42.14 ± 14.35 months) than in the relapse group (26.95 ± 16.13 months) (P = 0.03). Conclusion: Long-term initial ATD treatment and long-term total ATD treatment were evaluated as positive parameters for the remission of Graves’ disease in children and adolescents. Our findings showed that the chance of long-term remission increases in direct proportion to the initial ATD treatment duration and the total ATD treatment duration.
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    Revisiting the annual incidence of type 1 diabetes mellitus in children from the Southeastern Anatolian Region of Turkey: A regional report
    (Galenos Yayınevi, 2022) Özalkak, Şervan; Yıldırım, Ruken; Tunç, Selma; Ünal, Edip; Taş, Funda Feryal; Demirbilek, Hüseyin; Özbek, Mehmet Nuri
    Objective: The incidence of type 1 diabetes mellitus (T1D) in children has an increasing trend globally, with a variable rate depending on region and ethnicity. Our group first reported T1D incidence in Diyarbakır in 2011. The aim of this study was to evaluate the current incidence rate of pediatric T1D in Diyarbakır, and compare the incidence, and clinical and presenting characteristics of more recent cases with those reported in our first report. Methods: Hospital records of patients diagnosed with T1D in Diyarbakır city between 1st January 2020 and 31st December 2020 and aged under 18 years old were retrieved, and their medical data was extracted. Demographic population data were obtained from address-based census records of the Turkish Statistical Institution (TSI). Results: Fifty-seven children and adolescents were diagnosed with T1D. Of those, 34 were female (59.6%), indicating a male/female ratio of 1.47. The mean age at diagnosis was 9.5±3.9 years (0.8-17.9). TSI data indicated a population count of 709,803 for the 0-18 years age group. Thus the T1D incidence was 8.03/105 in the 0-18 age group and was higher in the 0-14 age group at 9.14/105. The cumulative increase in the incidence of T1D in the 0-14 age group was 26.9% suggesting an increasing rate of 2.7% per year. The frequency of presentation with diabetic ketoacidosis was 64.9%. Conclusion: The annual incidence of pediatric T1D in Diyarbakır city increased from 7.2/105 to 9.14/105 within the last decade. The rate of annual increase was 2.7% in the 0-14 age group comparing this study with our earlier report, with a predominance in male subjects and a shift of peak incidence from the 5-9 year age group in the first study to the 10-14 year age group in this one.