Person: KARADAĞ, BÜLENT TANER
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KARADAĞ
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BÜLENT TANER
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Publication Metadata only Early pulmonary involvement in Niemann-Pick type B disease: Lung lavage is not useful(WILEY, 2005) KARADAĞ, BÜLENT TANER; Uyan, ZS; Karadag, B; Ersu, R; Kiyan, G; Kotiloglu, E; Sirvanci, S; Ercan, F; Dagli, T; Karakoc, F; Dagli, ENiemann-Pick disease (NPD) is a rare, autosomal-recessively inherited lipid storage disease which is characterized by intracellular deposition of sphingomyelin in various body tissues. The disease is heterogeneous and classified into six groups. Pulmonary parenchymal involvement may be a feature of several subtypes of NPD, including type B. Progressive pulmonary involvement in NPD type B is a major cause of morbidity and mortality It is usually diagnosed at older ages. Only a few cases with early pulmonary involvement have been reported. In this report, a patient with NPD type B, hospitalized with the diagnosis of pneumonia at age 3 months, is presented. Following treatment for pneumonia, she continued to have persistent respiratory symptoms and became oxygen-dependent. High-resolution computed tomography of the chest revealed diffuse interstitial changes. During follow-up, the patient developed hepatosplenomegaly. Lung, liver, and bone marrow biopsies showed characteristic findings for NPD. Biochemical studies also confirmed the diagnosis, and the sphingomyelinase enzyme level of the patient was low. Unilateral lung lavage was performed in order to decrease lipid storage as a treatment modality However, there was no clinical or radiological improvement. The patient died at age 15 months due to progressive respiratory failure. Pulmonary involvement is a rare entity in early childhood in patients with NPD type B, but should be considered in the differential diagnosis of persistent interstitial lung disease. It may cause progressive respiratory failure, but the treatment options remain limited.Publication Metadata only Bronchoscopic evaluation of unexplained recurrent and persistent pneumonia in children(WILEY-BLACKWELL, 2013) KARADAĞ, BÜLENT TANER; Gokdemir, Yasemin; Cakir, Erkan; Kut, Arif; Erdem, Ela; Karadag, Bulent; Ersu, Refika; Karakoc, Faziletd Background: Persistent or recurrent pneumonia in children can pose a significant challenge to paediatricians and respiratory physicians. Aim: The aim of this study is to determine the role of flexible bronchoscopy (FB) in evaluation of recurrent or persistent pneumonia that remain otherwise unexplained by non-invasive diagnostic tests in children. Methods: Retrospective evaluation of patients who underwent FB with an indication of recurrent or persistent pneumonia from 1997 to 2011. Results: Among 2600 FB procedures, 434 (17%) were performed with the indication of recurrent or persistent pneumonia. There were 237 (54%) boys. Median age at presentation was 84 months, and median duration of symptoms was 9 months. FB led to specific diagnosis in 33% of the cases. The most common diseases diagnosed by FB were malacia disorders (n: 32, 7%), aspirated foreign body (n: 30, 7%), endobronchial tuberculosis (n: 20, 5%), congenital airway anomalies (n: 14, 3%), mucus plugs (n: 14, 3%), pulmonary haemosiderosis (n: 12, 3%) and middle lobe syndrome (n: 11, 3%). During FB, only 6% of the patients had minor complications such as transient hypoxia, stridor and tachycardia. Conclusions: In our study, FB proved to be a safe and effective tool in evaluation of children with persistent or recurrent pneumonia. FB is indicated for children with recurrent or persistent pneumonia where the underlying diagnosis remains unclear even after non-invasive diagnostic tests.Publication Metadata only An unusual case of chylothorax complicating childhood tuberculosis(WILEY, 2008) KARADAĞ, BÜLENT TANER; Cakir, Erkan; Gocmen, Basar; Uyan, Zeynep Seda; Oktem, Sedat; Kiyan, Gursu; Karakoc, Fazilet; Ersu, Refika; Karadag, Bulent; Dagli, Tolga; Dagli, ElifEndobronchial tuberculosis (EBTB) and chylothorax are rare clinical disorders. The concurrence of these two disorders as manifestations of childhood pulmonary tuberculosis has not been reported. We report a 4-month-old boy presenting with chylothorax as the initial presentation of tuberculosis that has been successfully treated with octreotide, antituberculosis drugs and steroid therapy.Publication Metadata only Late diagnosis of foreign body aspiration in children with chronic respiratory symptoms(ELSEVIER IRELAND LTD, 2007) KARADAĞ, BÜLENT TANER; Karakoc, F.; Cakir, E.; Ersu, R.; Uyan, Z. S.; Colak, B.; Karadag, B.; Kiyan, G.; Dagli, T.; Dagli, E.Background: Children with undiagnosed and retained foreign bodies (FBs) may present with persistent respiratory symptoms. Delayed diagnosis is an important problem in developing countries and several factors affect the delay. Objectives: To investigate, the incidence of clinically unsuspected foreign body aspiration (FBA) in our flexible bronchoscopy procedures, the causes resulting in late diagnosis of FBA, and the incidence of the complications of FBA according to elapsed time between aspiration and diagnosis. Methods: We reviewed the records of all the patients who underwent flexible bronchoscopy between 1997 and 2004 in our clinic. Patients with FBA were identified and their medical records were reviewed. Results: During the study period, 654 children underwent flexible bronchoscopy; 32 cases (4.8%) of FBA were identified. Median age of patients was 29.5 months at presentation with a median symptomatic period of 3 months. None of the patients had a history of FBA. The most common misdiagnosis was bronchitis. Flexible bronchoscopy was performed to these patients within 1 week following presentation. In 87% of the patients (n = 28), FBs were in organic nature. Patients were followed up for 21.0 months after removal of the FBs. Fifty-three percent (n = 17) of the patients had a complete remission after bronchoscopic removal of the FBs. However, nine (28.8%) patients had chronic respiratory problems and six patients (18.8%) developed bronchiectasis. Conclusions: Atypical or prolonged respiratory symptoms should alert the physician and clinical and radiological findings should be carefully evaluated for a possible FBA. Delay in diagnosis and treatment of FBA should be avoided to prevent complications. (C) 2006 Elsevier Ireland Ltd. All rights reserved.Publication Metadata only Factors that correlate with sleep oxygenation in children with cystic fibrosis(WILEY, 2007) KARADAĞ, BÜLENT TANER; Uyan, Z. S.; Oezdemir, N.; Ersu, R.; Akpinar, I.; Keskin, S.; Cakir, E.; Karadag, B.; Karakoc, F.; Dagli, E.Objective: Cystic fibrosis (CF) patients may develop hypoxemia during sleep. Limited information is available on nocturnal oxygen saturation in CF children with less severe lung disease. The aim of this study was to investigate the degree of nocturnal oxygen desaturation and factors that correlate with nocturnal oxygenation in CIF children with normal pulmonary function tests (PFTs) or mild to moderate lung disease. Method: Awake resting and post-exercise SPO2 were measured by pulse oximetry. Each patient had overnight oximetry monitorization at home. Six minutes walk test (6MWT), Shwachman-Kulczycki (S-K), Brasfield and computed tomography (CT) scores, blood gas analysis and nutritional status of patients were evaluated. Results: Twenty-four patients with a median age of 9.5 years were included. Nocturnal mean SPO2 did not differ according to the severity of lung disease based on PFT However, lowest SPO2 obtained was lower in children with both mild and moderate lung disease compared to normals (87.4% vs. 91.7%, respectively, p=0.009). 95.8% of CF children with normal PFT or mild to moderate lung disease had desaturation events during sleep. Nocturnal mean SPO2 correlated with S-K (Spearman's rho=0.64, p < 0.0001), Brasfield (Spearman's rho=0.31, p=0.007) and CT scores (Spearman's rho= -0.67, p < 0.0001) as well as PaO2 (Spearman's rho= 0.28, p = 0.021), SaO(2) (Spearman's rho=0.28, p= 0.023), z-score of weight (Spearman's rho= 0.23, p= 0.20) and height (Spearman's rho = 0.20, p = 0.30), there was no correlation with 6MWT Conclusions: In CF children with normal PFT or mild-to-moderate lung disease, nocturnal oxygenation may correlate with S-K, Brasfield and CT scores as well as PaO2, SaO(2), z-score of weight and height.Publication Metadata only Mucoid impaction: An unusual form of allergic bronchopulmonary aspergillosis in a patient with cystic fibrosis(WILEY-LISS, 2006) KARADAĞ, BÜLENT TANER; Cakir, E.; Uyan, Z. S.; Hamutcu Ersu, R.; Karadag, B.; Karakoc, F.; Dagli, E.We reported a child with cystic fibrosis (CF) who developed mucoid impaction related to allergic bronchopulmonary aspergillosis (ABPA). This is the first reported case of mucoid impaction related to ABPA in CF described to date in the literature. The case was successfully treated by corticosteroids and itraconazole therapy, but relapsed 6 months later. During exacerbation therapy, cataract formation complicated the corticosteroid treatment. We want to emphasize that 6-months therapy may be inadequate for the treatment of ABPA, and it is important to monitor for possible complications of corticosteroids therapy.