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  1. Home
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Browsing by Author "Karadag, M"

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    The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T)
    Ercan, ES; Polanczyk, G; Ardic, UA; Yuce, D; Karacetin, G; Tufan, AE; Tural, U; Aksu, H; Aktepei, E; Arman, AR; Basgülk, S; Bilac, O; CosKunm, M; Celik, GG; Demirkaya, SK; Dursun, BO; Durukan, I; Fidan, T; Fis, NP; Gençoglan, S; Gökçen, C; Görker, I; Görmez, V; Gündogdu, OY; Gurkan, CK; Hergüner, S; Hesapçioglu, ST; Kandemir, H; Kiliç, BG; Kilinçaslan, A; Mutluer, T; Nasiroglu, S; Özcan, ÖÖ; Öztürk, M; Öztop, D; Sapmad, SY; Süren, S; Sahin, N; Tahiroglu, AY; Toros, F; Ünal, F; Vural, P; Yazici, IP; Yazici, KU; Yildirim, V; Yulaf, Y; Yüce, M; Yüksel, T; Akdemir, D; Altun, H; Ayik, B; Bilgic, A; Bozkurt, ÖH; Çakir, ED; Çeri, V; Demir, NÜ; Dinç, G; Irmak, MY; Karaman, D; Kinik, MF; Mazlum, B; Memik, NÇ; Özdemir, DF; Sinir, H; Tasdelen, BI; Taskin, B; Ugur, Ç; Uran, P; Uysal, T; Üneri, Ö; Yilmaz, S; Yilmaz, SS; Açikel, B; Aktas, H; Alaca, R; Aliç, BG; Almaidan, M; Ari, FP; Aslan, C; Atabay, E; Ay, MG; Aydemir, H; Ayranci, G; Babadagi, Z; Bayar, H; Bayhan, PÇ; Bayram, Ö; Bektas, ND; Berberoglu, KK; Bostan, R; Canli, MA; Cansiz, MA; Ceylan, C; Coskun, N; Coskun, S; Çakan, Y; Demir, I; Demir, N; Demirdögen, EY; Dogan, B; Dönmez, YE; Dönder, F; Efe, A; Eray, S; Erbilgin, S; Erden, S; Ersoy, EG; Eseroglu, T; Firat, SK; Gök, EE; Güler, G; Güles, Z; Günes, S; Günes, A; Günay, G; Özgür, BG; Güven, G; Goksoy, SC; Horozcu, H; Irmak, A; Isik, U; Kahraman, Ö; Kalayci, BM; Karaaslan, U; Karadag, M; Kilic, HT; Kiliçaslan, F; Kinay, D; Kocael, O; Koç, EB; Mutlu, RK; Lushi-San, Z; Nalbant, K; Okumus, N; Özbek, F; Özdemir, FA; Özdemir, H; Özkan, S; Özyurt, EY; Polat, B; Polat, H; Sekmen, E; Sertçelik, M; Sevgen, FH; Sevince, O; Süleyman, F; Shamkhalova, Ü; Simsek, NE; Tanir, Y; Tekden, M; Temtek, S; Topal, M; Topal, Z; Türk, T; Uçar, HN; Uçar, F; Uygun, D; Uzun, N; Vatansever, Z; Yazgili, NG; Yildiz, DM; Yildiz, N
    Aim: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. Method: A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. Results: Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. Conclusion: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.
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    Prevalence of Childhood Affective disorders in Turkey: An epidemiological study
    Karacetin, G; Arman, AR; Fis, NP; Demirci, E; Ozmen, S; Hesapcioglu, ST; Oztop, D; Tufan, AE; Tural, U; Aktepe, E; Aksu, H; Ardic, UA; Basgul, S; Bilac, O; Coskun, M; Celik, GG; Demirkaya, SK; Dursun, OB; Durukan, I; Fidan, T; Gencoglan, S; Gokcen, C; Gokten, ES; Gorker, I; Gormez, V; Gundogdu, OY; Gurkan, CK; Herguner, S; Kandemir, H; Kilic, BG; Kilincaslan, A; Mutluer, T; Nasiroglu, S; Ozcan, OO; Ozturk, M; Sapmaz, SY; Suren, S; Sahin, N; Tahiroglu, AY; Toros, F; Unal, F; Vural, P; Yazici, IP; Yazici, KU; Yildirim, V; Yulaf, Y; Yuce, M; Yuksel, T; Akdemir, D; Altun, H; Ayik, B; Bilgic, A; Bozkurt, OH; Cakir, ED; Ceri, V; Demir, NU; Dinc, G; Irmak, MY; Karaman, D; Kinik, MF; Mazlum, B; Memik, NC; Ozdemir, DF; Sinir, H; Tasdelen, BI; Taskin, B; Ugur, C; Uran, P; Uysal, T; Uneri, OS; Yilmaz, S; Yilmaz, SS; Acikel, B; Aktas, H; Alaca, R; Alic, BG; Almbaidheen, M; Ari, FP; Aslan, C; Atabay, E; Ay, MG; Aydemir, H; Ayranci, G; Babadagi, Z; Bayar, H; Bayhan, PC; Bayram, O; Bektas, ND; Berberoglu, KK; Bostan, R; Cakan, Y; Canli, MA; Cansiz, MA; Ceylan, C; Coskun, N; Coskun, S; Demir, I; Demir, N; Demirdogen, EY; Dogan, B; Donmez, YE; Donder, F; Efe, A; Eray, S; Erbilgin, S; Erden, S; Ersoy, EG; Eseroglu, T; Firat, SK; Gok, EE; Goksoy, SC; Guler, G; Gules, Z; Gunay, G; Gunes, S; Gunes, A; Guven, G; Horozcu, H; Irmak, A; Isik, U; Kahraman, O; Kalayci, BM; Karaaslan, U; Karadag, M; Kilic, HT; Kilicaslan, F; Kinay, D; Koc, EB; Kocael, O; Mutlu, RK; San, Z; Nalbant, K; Okumus, N; Ozbek, F; Ozdemir, FA; Ozdemir, H; Ozgur, BG; Ozkan, S; Ozyurt, EY; Polat, B; Polat, H; Sekmen, E; Sertcelik, M; Sevgen, FH; Sevince, O; Shamkhalova, U; Suleyman, F; Simsek, NE; Tanir, Y; Tekden, M; Temtek, S; Topal, M; Topal, Z; Turk, T; Ucar, HN; Ucar, F; Uygun, D; Uzun, N; Vatansever, Z; Yazgili, NG; Yildiz, DM; Yildiz, N; Ercan, ES
    Aim: To determine the prevalence of affective disorders in Turkey among a representative sample of Turkish population. Methods: This study was conducted as a part of the The Epidemiology of Childhood Psychopathology in Turkey (EPICPAT-T) Study, which was designed by the Turkish Association of Child and Adolescent Mental Health. The inclusion criterion was being a student between the second and fourth grades in the schools assigned as study centers. The assessment tools used were the K-SADS-PL, and a sociodemographic form that was designed by the authors. Impairment was assessed via a 3 point-Likert type scale independently rated by a parent and a teacher. Results: A total of 5842 participants were included in the analyses. The prevalence of affective disorders was 2.5 % without considering impairment and 1.6 % when impairment was taken into account. In our sample, the diagnosis of bipolar disorder was lacking, thus depressive disorders constituted all the cases. Among depressive disorders with impairment, major depressive disorder (MDD) (prevalence of 1.06%) was the most common, followed by dysthymia (prevalence of 0.2%), adjustment disorder with depressive features (prevalence of 0.17%), and depressive disorder-NOS (prevalence of 0.14%). There were no statistically significant gender differences for depression. Maternal psychopathology and paternal physical illness were predictors of affective disorders with pervasive impairment. Conclusion: MDD was the most common depressive disorder among Turkish children in this nationwide epidemiological study. This highlights the severe nature of depression and the importance of early interventions. Populations with maternal psychopathology and paternal physical illness may be the most appropriate targets for interventions to prevent and treat depression in children and adolescents.
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    Cytokine expression profiles in children and adolescents with tic disorders
    Kutuk, MO; Tufan, AE; Kilicaslan, F; Gokcen, C; Aksu, GG; Yektas, C; Kandemir, H; Celik, F; Mutluer, T; Buber, A; Karadag, M; Coban, N; Coskun, S; Hangul, Z; Altintas, E; Acikbas, U; Giray, A; Aka, Y; Basturk, B; Kutuk, O
    The etiology of tic disorders (TDs) is not precisely known, although several lines of evidence suggest involvement of the immune system in pathogenesis. Here, we aimed to determine the expression levels of pro-inflammatory and anti-inflammatory cytokines in children with TD and compare them with those of healthy controls. Furthermore, we also evaluated their association with clinical variables in the TD group. Within the study period, 88 children with tic disorders and 111 healthy control children were enrolled. Most children with tic disorders were diagnosed with Tourette's disorder (n = 47, 53.4%) or persistent motor tic disorder (n = 39, 44.3%), while the remainder (n = 2, 2.3%) were diagnosed with persistent vocal tic disorder. We found that children with tic disorders had significantly elevated levels of IL-1 beta, TNF-alpha, IL-6 and IL-4 expression, while we detected lower expression levels of IL-17 in children with tic disorders. Our findings provide a molecular landscape of cytokine expression in children with TD, which may suggest a proinflammatory state not affected by the presence of comorbidity and symptom severity. Delineating the contribution of alterations in the immune system to the pathogenesis of tic disorders may pave the way for better therapeutic interventions.
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    Cytokine expression profiles in Autism spectrum disorder: A multi-center study from Turkey
    Kutuk, MO; Tufan, E; Gokcen, C; Kilicaslan, F; Karadag, M; Mutluer, T; Yektas, C; Coban, N; Kandemir, H; Buber, A; Coskun, S; Acikbas, U; Guler, G; Topal, Z; Celik, F; Altintas, E; Giray, A; Aka, Y; Kutuk, O
    Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by impairments in communication and social interaction as well as restricted interests and repetitive behaviors. The pathogenesis of ASD is not completely understood, but a growing body of research has demonstrated that the immune response may be a contributing factor in the etiology and/or ontogeny of ASD. The aim of this study was to determine the expression levels of IL-1 beta, IL-1 alpha, IL-4, IL-6, IL-17, TNF-alpha and TGF-beta in peripheral blood mononuclear cells of children with ASD and healthy controls in order to determine the contributions of cytokines to ASD. Within the study timeframe, 195 children with ASDs (80.5% male) and 162 controls (73.6% male) were enrolled. Most children with ASD had a comorbid disorder (n = 114, 58.5%), with the most common diagnoses as Intellectual Developmental Disorder (IDD, n = 64, 32.8%) and ADHD (n = 64, 32.8%). The majority of children with ASD had severe autistic symptoms as evaluated via Childhood Autism Rating Scale (CARS, n = 130, 64.6%). The mean CARS score in the ASD sample was 40.8 (S.D. = 7.6). The patients with ASD were found to have significantly higher levels of IL-6 (p < 0.001) and significantly lower levels of IL-17 (p < 0.05, all Bonferroni corrected). Treatment tended to affect IL-4 levels. Lastly, discriminant function analysis (DFA) revealed that a combination of IL-6, IL-17 and IL-1 alpha correctly classified 56.6% of cases. Despite extensive immunological evidence suggesting immune system aberrations, further research is required to clarify the relationship between immune profiles and ASD symptoms.
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    Effect of Asbestos Exposure on the Frequency of EGFR Mutations and ALK/ROS1 Rearrangements in Patients With Lung Adenocarcinoma A Multicentric Study
    Yilmaz, S; Demirci, NY; Metintas, S; Zamani, A; Karadag, M; Guçlu, OA; Kabalak, PA; Yilmaz, U; Ak, G; Kizilgoz, D; Ozturk, A; Yilmaz, U; Batum, O; Kavas, M; Serifoglu, I; Unsal, M; Komurcuoglu, BE; Cengiz, TI; Ulubay, G; Ozdemirel, TS; Ozyurek, BA; Kavurgaci, S; Alizoroglu, D; Celik, P; Erdogan, Y; In, E; Aksoy, A; Altin, S; Gunluoglu, G; Metintas, M
    Objective: The aim of this study is to investigate the effect of asbestos exposure on cancer-driver mutations. Methods: Between January 2014 and September 2018, epidermal growth factor receptor (EGFR), anaplastic lymphoma receptor tyrosine kinase (ALK), and c-ros oncogene 1 receptor tyrosine kinase gene (ROS1) alterations, demographic characteristics, asbestos exposure, and asbestos-related radiological findings of 1904 patients with lung adenocarcinoma were recorded. Results: The frequencies of EGFR mutations, ALK, and ROS1 rearrangements were 14.5%, 3.7%, and 0.9%, respectively. The rates of EGFR mutations and ALK rearrangements were more frequent in asbestos exposed non-smokers (48.7% and 9%, respectively). EGFR mutation rate was correlated to female gender and not-smoking, ALK rearrangement rate was correlated to younger age, not-smoking, and a history of asbestos exposure. Conclusions: The higher rate of ALK rearrangements in asbestos-exposed lung adenocarcinoma cases shows that asbestos exposure may most likely cause genetic alterations that drive pulmonary adenocarcinogenesis.
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    High Depression Symptoms and Burnout Levels Among Parents of Children with Autism Spectrum Disorders: A Multi-Center, Cross-Sectional, Case-Control Study (Jan, 10.1007/s10803-021-04874-4, 2021)
    Kütük, MÖ; Tufan, AE; Kiliçaslan, F; Güler, G; Çelik, F; Altintas, E; Gökçen, C; Karadag, M; Yektas, Ç; Mutluer, T; Kandemir, H; Büber, A; Topal, Z; Acikbas, U; Giray, A; Kütük, Ö
    The original version of the article has unfortunately missed the revised affiliations for the following authors.
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    Novel inflammatory targets for immunotherapies in pediatric patients with trichotillomania
    Kutuk, MO; Tufan, AE; Kilicaslan, F; Mutluer, T; Gokcen, C; Karadag, M; Yektas, C; Kandemir, H; Buber, A; Aksu, GG; Topal, Z; Giray, A; Celik, F; Acikbas, U; Kutuk, O
    Immune dysregulation may be important in the etiology of obsessive-compulsive and related disordersandbody-focusedrepetitivebehaviors, such as Trichotillomania (TTM). The role of inflammation and inflammatory markers in TTM has received relatively little attention. This study was aimed to determine the expression levels of inflammatory markers (i.e. IL-1 beta, IL-1 alpha, IL-4, IL-6, IL-17, TNF-alpha and TGF-5) in peripheral blood mononuclear cells of children with TTM and healthy controls and to evaluate their association with clinical variables. Seventy-seven patients with TTM and 107 healthy controls were enrolled in the study. Peripheral blood was collected in standardized conditions. The mean age of patients and controls did not differ significantly (10.8 +/- 4.4 and 12.0 +/- 3.2 years; respectively). The majority of patients with TTM and controls were females (n = 55, 71.4 % and n = 55, 51.4 %; respectively); with a greater preponderance of females among TTM. Patients with TTM had significantly elevated expression levels of TNF-alpha, IL-6 and IL-17 compared to controls. However, the expression level of IL-4 was significantly reduced in TTM patients compared to controls. Accordingly, we found a proinflammatory state in TTM and those findings may suggest novel treatment options for TTM and further, crossdisciplinary studies focusing on neuro- inflammation in TTM conducted on larger samples are needed.
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    Frequency of Mutations and Related Factors in Lung Adenocarcinoma Cases in Turkey
    Yilmaz, S; Karadag, M; Demirci, N; Kizilgöz, D; Kabalak, PA; Metintas, M; Ak, G; Yilmaz, U; Komurcuoglu, B; Guclu, O; Ozturk, A; Ozdemirel, T; Cengiz, TI; Ozyurek, B; Erdogan, Y; Altin, S; Celik, P; Gunluoglu, G; Ulubay, G; Zamani, A; Kavas, M; Tatar, D; Metintas, S
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    High Depression Symptoms and Burnout Levels Among Parents of Children with Autism Spectrum Disorders: A Multi-Center, Cross-Sectional, Case-Control Study
    Kütük, MÖ; Tufan, AE; Kiliçaslan, F; Güler, G; Çelik, F; Altintas, E; Gökçen, C; Karadag, M; Yektas, Ç; Mutluer, T; Kandemir, H; Büber, A; Topal, Z; Acikbas, U; Giray, A; Kütük, Ö
    The diagnosis of autism spectrum disorder (ASD) in a child affects family processes, increases parenting stress and marital conflicts, and may lead to parental psychopathology. It may also affect the prognosis for their children. The aim of this study is to determine depression and burnout levels as well as their predictors among parents of children with ASD compared with those of healthy children. We also sought to evaluate rate of complementary and alternative medicine (CAM) interventions among parents and explore the associations of this phenomenon in an exploratory fashion. 145 children with ASD and 127 control children were enrolled along with their mothers and fathers. Beck Depression Inventory and Maslach Burnout Inventory were used to evaluate parents' depression symptoms and burnout levels. Symptoms of children with ASDs were evaluated according to the Childhood Autism Rating Scale by the clinicians. Family, child and CAM variables were screened by means of a sociodemographic data form. Descriptive, bivariate and correlation analyses were used in statistical evaluations. Predictors of burnout were evaluated with multiple regression analysis. Burnout and depression levels among parents of children with ASD were significantly elevated compared to controls. Burnout levels of mothers were significantly elevated compared to fathers while depression scores of fathers were significantly elevated compared to mothers. Maternal burnout was significantly predicted by presence of functional speech in child while paternal burnout was significantly predicted by paternal vocation. Maternal depression was associated with paternal depression, lack of speech in child and attendance of child to special education services. Paternal depression was associated with autistic symptom severity and maternal depression. More than half the parents sought CAM interventions. Education level did not affect search for CAM interventions while both maternal and paternal psychopathology and presence of epilepsy among children increased use of CAM methods. Psychological support should be provided to both mothers and fathers of a child receiving a diagnosis of ASD. Addressing parents' burnout and stress levels and facilitating their negotiation of knowledge on etiology and treatments for ASD may be beneficial for the family unit as a whole.
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    Shared Biological Pathways and Processes in Patients with Intellectual Disability: A Multicenter Study
    Günay, C; Aykol, D; Özsoy, O; Sönmezler, E; Hanci, YS; Kara, B; Sünnetçi, DA; Cine, N; Deniz, A; Özer, T; Ölçülü, CB; Yilmaz, O; Kanmaz, S; Yilmaz, S; Tekgül, H; Yildiz, N; Arslan, EA; Cansu, A; Dündar, NO; Kusgoz, F; Didinmez, E; Gençpinar, P; Uzunhan, TA; Ertürk, B; Gezdirici, A; Ayaz, A; Ölmez, A; Ayanoglu, M; Tosun, A; Topçu, Y; Kiliç, B; Aydin, K; Çaglar, E; Kosvali, OE; Okuyaz, C; Besen, S; Orgun, LT; Erol, I; Yüksel, D; Sezer, A; Atasoy, E; Toprak, U; Güngör, S; Ozgor, B; Karadag, M; Dilber, C; Sahinoglu, B; Yalçin, EU; Hacifazlioglu, NE; Yaramis, A; Edem, P; Tekin, HG; Yilmaz, U; Ünalp, A; Turay, S; Biçer, D; Mert, GG; Çetin, ID; Kirik, S; Öztürk, G; Karal, Y; Sanri, A; Aksoy, A; Polat, M; Özgün, N; Soydemir, D; Uzan, GS; Üstebay, D; Gök, A; Yesilmen, MC; Yis, U; Karakülah, G; Bursali, A; Oktay, Y; Kurul, SH
    Background Although the underlying genetic causes of intellectual disability (ID) continue to be rapidly identified, the biological pathways and processes that could be targets for a potential molecular therapy are not yet known. This study aimed to identify ID-related shared pathways and processes utilizing enrichment analyses. Method In this multicenter study, causative genes of patients with ID were used as input for Disease Ontology (DO), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes enrichment analysis. Results Genetic test results of 720 patients from 27 centers were obtained. Patients with chromosomal deletion/duplication, non-ID genes, novel genes, and results with changes in more than one gene were excluded. A total of 558 patients with 341 different causative genes were included in the study. Pathway-based enrichment analysis of the ID-related genes via ClusterProfiler revealed 18 shared pathways, with lysine degradation and nicotine addiction being the most common. The most common of the 25 overrepresented DO terms was ID. The most frequently overrepresented GO biological process, cellular component, and molecular function terms were regulation of membrane potential, ion channel complex, and voltage- gated ion channel activity/voltage-gated channel activity, respectively. Conclusion Lysine degradation, nicotine addiction, and thyroid hormone signaling pathways are well-suited to be research areas for the discovery of new targeted therapies in ID patients.
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    Functional outcome in late adolescence/early adulthood of patients with autism spectrum disorderresand its relationships with parental burnout and depression: A preliminary multi-center, cross-sectional study
    Kutuk, MO; Tufan, AE; Kilicaslan, F; Vural, P; Gokcen, C; Guney, SA; Kutuk, B; Ozyurt, G; Inal, N; Multer, T; Acikalin, EY; Ozer, FH; Pamuk, EN; Yesilmese, SC; Karadag, M; Hangul, Z; Bilginer, C; Sahin, N; Bilac, O; Kandemir, H; Ercan, ES; Soylemez, TE; Acikel, SB; Aksu, GG; Dag, P; Toros, F; Mutlu, C; Kardas, O; Kardas, B; Kizildag, S; Demirci, E; Ozmen, S; Sevicin, L; Karagoz, YS; Isik, U; Aktepe, E; Altun, H; Yektas, Ç; Tuysuz, BP; Buber, A; Cansiz, MA; Ogutlu, H; Eray, S; Taner, HA; Altintas, E; Kutuk, O
    The aim of this study is to determine the functioning of adults with autism spectrum disorders (ASDs) diagnosed in childhood and depression and burnout levels among their parents. A total of 261 adults with ASDs and their parents were recruited for the study. Both parents completed the Beck Depression and Maslach Burnout Inventories and reported the functioning of their adult offspring with ASDs. Only 5.4 % of our sample reported good or very good outcomes. The most common psychiatric comorbidities were intellectual disabilities and attention-deficit/ hyperactivity disorder. Maternal burnout and depression scores were significantly elevated compared to those of fathers. There is an undeniable urgent need for more research to identify the needs of adults and families suffering from ASD. Modifications for those with ASD may have to be made for support in workplaces, achieving driving licenses, using public transportation and attendance at tertiary education.
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    Optic neuritis in Turkish children and adolescents: A multicenter retrospective study
    Direk, MÇ; Besen, S; Öncel, I; Günbey, C; Özdogan, O; Orgun, LT; Sahin, S; Cansu, A; Yildiz, N; Kanmaz, S; Yilmaz, S; Tekgül, H; Türkdogan, D; Ünver, O; Thomas, GO; Basibüyük, S; Yilmaz, D; Kurt, AN; Gültutan, P; Özsoy, Ö; Yis, U; Kurul, SH; Güngör, S; Özgör, B; Karadag, M; Dündar, NO; Gençpinar, P; Bildik, O; Orak, SA; Kabur, ÇÇ; Kara, B; Karaca, Ö; Canpolat, M; Gümüs, H; Per, H; Yilmaz, Ü; Karaoglu, P; Ersoy, Ö; Tosun, A; Öztürk, SB; Yüksel, D; Atasoy, E; Gücüyener, K; Yildirim, M; Bektas, Ö; Çavusoglu, D; Yarar, Ç; Güngör, O; Mert, GG; Sarigeçili, E; Edizer, S; Çetin, ID; Aydin, S; Diler, B; Özdemir, AA; Erol, I; Okuyaz, Ç; Anlar, B
    Background: Various etiologies may underlie optic neuritis, including autoantibody-mediated disorders described in the last decade. We re-examined demographic, clinical, laboratory features and prognostic factors in pediatric patients with autoimmune optic neuritis according to current knowledge.Methods: Cases of pediatric ON from 27 centers in Turkiye diagnosed between 2009 and 2022 were included for retrospective evaluation.Results: The study included 279 patients, 174 females and 105 males, with a female-to-male ratio of 1.65. The average age at onset was 12.8 +/- 3.4 years, and mean follow-up, 2.1 years (range: 1-12.1 years). Patients <10 years old were grouped as prepubertal and those >= 10 years old as others. The diagnoses made at the end of follow-up were multiple sclerosis associated optic neuritis (n = 90, 32.3 %), single isolated optic neuritis (n = 86, 31 %), clinically isolated syndrome (n = 41, 14.7 %), myelin oligodendrocyte glycoprotein antibody associated optic neuritis (n = 22, 7.9 %), and relapsing isolated optic neuritis (n = 18, 6.5 %). Predominant diagnoses were myelin oligodendrocyte glycoprotein antibody associated optic neuritis and acute disseminated encephalomyelitis associated optic neuritis in the prepubertal group and multiple sclerosis associated optic neuritis in the older group. Recurrences were observed in 67 (24 %) patients, including 28 with multiple sclerosis associated optic neuritis, 18 with relapsing isolated optic neuritis, 11 with myelin oligodendrocyte glycoprotein antibody associated optic neuritis, 8 with aquaporin-4 antibody related optic neuritis, and 2 with chronic relapsing inflammatory optic neuropathy. Recurrences were more common among female patients. Findings supporting the diagnosis of multiple sclerosis included age of onset >= 10 years (OR=1.24, p = 0.027), the presence of cranial MRI lesions (OR=26.92, p<0.001), and oligoclonal bands (OR=9.7, p = 0.001). Treatment in the acute phase consisted of intravenous pulse methylprednisolone (n = 46, 16.5 %), pulse methylprednisolone with an oral taper (n = 212, 76 %), and combinations of pulse methylprednisolone, plasmapheresis, or intravenous immunoglobulin (n = 21, 7.5 %). Outcome at 12 months was satisfactory, with 247 out of 279 patients (88.5 %) demonstrating complete recovery. Thirty-two patients exhibited incomplete recovery and further combination treatments were applied. Specifically, patients with relapsing isolated optic neuritis and aquaporin-4 antibody related optic neuritis displayed a less favorable prognosis.Conclusion: Our results suggest optic neuritis is frequently bilateral in prepubertal and unilateral in peri- or postpubertal patients. Age of onset 10 or older, presence of oligoclonal bands, and brain MRI findings reliably predict the development of multiple sclerosis. The risk of developing multiple sclerosis increases mostly during the second and third years of follow-up. Relapsing isolated optic neuritis remains a separate group where the pathogenesis and outcome remain unclear. Investigation of predisposing and diagnostic biomarkers and long follow-up could help to define this group.

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