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DUMAN, DENİZ

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DUMAN

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DENİZ

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2016 - 20202
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Subject: FINE-NEEDLE-ASPIRATION ×

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    PublicationOpen Access
    European Guideline on IgG4-related digestive disease - UEG and SGF evidence-based recommendations
    (SAGE PUBLICATIONS INC, 2020-07) DUMAN, DENİZ; Lohr, J-Matthias; Beuers, Ulrich; Vujasinovic, Miroslav; Alvaro, Domenico; Frokjaer, Jens Brondum; Buttgereit, Frank; Capurso, Gabriele; Culver, Emma L.; De-Madaria, Enrique; Della-Torre, Emanuel; Detlefsen, Sonke; Dominguez-Munoz, Enrique; Czubkowski, Piotr; Ewald, Nils; Frulloni, Luca; Gubergrits, Natalya; Duman, Deniz Guney; Hackert, Thilo; Iglesias-Garcia, Julio; Kartalis, Nikolaos; Laghi, Andrea; Lammert, Frank; Lindgren, Fredrik; Okhlobystin, Alexey; Oracz, Grzegorz; Parniczky, Andrea; Mucelli, Raffaella Maria Pozzi; Rebours, Vinciane; Rosendahl, Jonas; Schleinitz, Nicolas; Schneider, Alexander; van Bommel, Eric F. H.; Verbeke, Caroline Sophie; Vullierme, Marie Pierre; Witt, Heiko; Besselink, Marc G.; Bruno, Marco J.; Czako, Laszlo; del Chiaro, Marco; Filippova, Oleksandra; Fukuda, Akihisa; Gaujoux, Sebastien; Hart, Phil A.; Hegyi, Peter; Jonas, Eduard; Kahraman, Alisan; Kleger, Alexander; Kuryata, Olexander; Laukkarinen, Johanna; Lerch, Markus M.; Marchegiani, Giovanni; Marschal, Hanns-Ulrich; Matos, Celso; Molad, Yair; Oguz, Dilek; Pukitis, Aldis; Satoi, Sohei; Stone, John H.; Verheij, Joanne; de Vries, Niek
    The overall objective of these guidelines is to provide evidence-based recommendations for the diagnosis and management of immunoglobulin G4 (IgG4)-related digestive disease in adults and children. IgG4-related digestive disease can be diagnosed only with a comprehensive work-up that includes histology, organ morphology at imaging, serology, search for other organ involvement, and response to glucocorticoid treatment. Indications for treatment are symptomatic patients with obstructive jaundice, abdominal pain, posterior pancreatic pain, and involvement of extra-pancreatic digestive organs, including IgG4-related cholangitis. Treatment with glucocorticoids should be weight-based and initiated at a dose of 0.6-0.8 mg/kg body weight/day orally (typical starting dose 30-40 mg/day prednisone equivalent) for 1 month to induce remission and then be tapered within two additional months. Response to initial treatment should be assessed at week 2-4 with clinical, biochemical and morphological markers. Maintenance treatment with glucocorticoids should be considered in multi-organ disease or history of relapse. If there is no change in disease activity and burden within 3 months, the diagnosis should be reconsidered. If the disease relapsed during the 3 months of treatment, immunosuppressive drugs should be added.
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    PublicationOpen Access
    Small EUS-suspected gastrointestinal stromal tumors of the stomach: An overview for the current state of management
    (MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2016) DUMAN, DENİZ; Yegin, Ender Gunes; Duman, Deniz Guney
    Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors found in the gastrointestinal (GI) tract, with the stomach being the most common site. They represent a distinct group of GI tumors originating from the interstitial cells of Cajal and are characterized by gain-of-function mutations of KIT. KIT oncoprotein serves as both diagnostic and therapeutic targets. Prognosis is related to size, mitotic activity, and site of the tumor. Asymptomatic, small endoscopic ultrasonography (EUS)-suspected GISTs are increasingly encountered with the wide availability of endoscopic/endosonographic examination. The majority of small GISTs are biologically indolent, albeit possibly harboring c-KIT gene mutations. An ongoing controversy exists regarding the management and surveillance policy for small gastric GISTs. A number of reports on the management of GISTs have been published, not confidently addressing the issue of gastric GISTs of small size. This work provides an overview on the current state of management considerations, specifically focusing on small EUS-suspected gastric GISTs, which are increasingly encountered by clinicians.