Browsing by Author "Demir, Serkan"

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Cerebral Venous Sinus Thrombosis as a Rare Complication of Systemic Lupus Erythematosus: Subgroup Analysis of the Venost Study
(Elsevier, 2019) Duman, Taskin; Demirci, Seden; Uluduz, Derya; Kozak, Hasan Huseyin; Demir, Serkan; Misirli, Cemile Handan; Goksan, Baki
Aim: Systemic lupus erythematosus (SLE) is an unusual risk factor for cerebral venous sinus thrombosis (CVST). As few CVST patients with SLE have been reported, little is known regarding its frequency as an underlying etiology, clinical characteristics, or long-term outcome. We evaluated a large cohort of CVST patients with SLE in a multicenter study of cerebral venous thrombosis, the VENOST study, and their clinical characteristics. Material and Method: Among the 1144 CVST patients in the VENOST cohort, patients diagnosed with SLE were studied. Their demographic and clinical characteristics, etiological risk factors, venous involvement status, and outcomes were recorded. Results: In total, 15 (1.31%) of 1144 CVST patients had SLE. The mean age of these patients was 39.9 +/- 12.1 years and 13 (86.7%) were female. Presenting symptoms included headache (73.3%), visual field defects (40.0%), and altered consciousness (26.7%). The main sinuses involved were the transverse (60.0%), sagittal (40.0%), and sigmoid (20.0%) sinuses. Parenchymal involvement was not seen in 73.3% of the patients. On the modified Rankin scale, 92.9% of the patients scored 0-1 at the 1-month follow-up and 90.9% scored 0-1 at the 1-year follow-up. Conclusions: SLE was found in 1.31% of the CVST patients, most frequently in young women. Headache was the most common symptom and the CVST onset was chronic in the majority of cases. The patient outcomes were favorable. CVST should be suspected in SLE patients, even in those with isolated chronic headache symptoms with or without other neurological findings.
Clinical, Demographic, and Radiological Characteristics of Patients Demonstrating Antibodies Against Myelin Oligodendrocyte Glycoprotein
(Galenos Publ House, 2024) Koc, Sumeyye; Sen, Sedat; Terzi, Yuksel; Kizilay, Ferah; Demir, Serkan; Aksoy, Durdane Bekar; Terzi, Murat
Background: Optic neuritis, myelitis, and neuromyelitis optica spectrum disorder (NMOSD) have been associated with antibodies against myelin oligodendrocyte glycoprotein-immunoglobulin G (anti-MOG-IgG). Furthermore, patients with radiological and demographic features atypical for multiple sclerosis (MS) with optic neuritis and myelitis also demonstrate antibodies against aquaporin-4 and anti-MOG-IgG. However, data on the diagnosis, treatment, follow-up, and prognosis in patients with anti-MOG-IgG are limited. Aims: To evaluate the clinical, radiological, and demographic characteristics of patients with anti-MOG-IgG. Study Design: Multicenter, retrospective, observational study. Methods: Patients with blood samples demonstrating anti-MOG-IgG that had been evaluated at the Neuroimmunology laboratory at Ondokuz May & imath;s University's Faculty of Medicine were included in the study. Results: Of the 104 patients with anti-MOG-IgG, 56.7% were women and43.3% were men. Approximately 2.4% of the patients were diagnosed with MS, 15.8% with acute disseminated encephalomyelitis (ADEM), 39.4% with NMOSD, 31.3% with isolated optic neuritis, and 11.1% with isolated myelitis. Approximately 53.1% of patients with spinal involvement at clinical onset demonstrated a clinical course of NMOSD. Thereafter, 8.8% of these patients demonstrated a clinical course similar to MS and ADEM, and 28.1% demonstrated a clinical course of isolated myelitis. The response to acute attack treatment was lower and the disability was higher in patients aged > 40 years than patients aged < 40 years at clinical onset. Oligoclonal band was detected in 15.5% of the patients. Conclusion: For patients with NMOSD and without anti-NMO antibodies, the diagnosis is supported by the presence of anti-MOG-IgG. Furthermore, advanced age at clinical onset, Expanded Disability Status Scale (EDSS) score at clinical onset, spinal cord involvement, and number of attacks may be negative prognostic factors in patients with anti-MOG-IgG.
Comparative Efficacy of Rituximab Versus Azathioprine in the Treatment of MOG Antibody-Associated Disease (MOGAD)
(Elsevier, 2025) Sen, Sedat; Kurtuncu, Murat; Demir, Serkan; Gunduz, Tuncay; Demirel, Ezgi; Tutuncu, Melih; Tuncer, Asli
Background: Azathioprine (AZA) and rituximab (RTX) are frequently used drugs in the treatment of Myelin Oligodendrocyte Glycoprotein Associated Disease (MOGAD). Objectives: The aim of this study was to evaluate the efficacy and safety data of AZA and RTX treatments in MOGAD. Methods: Patients diagnosed according to the 2023 MOGAD diagnostic criteria and receiving AZA or RTX treatment were included in the study. Results: In 142 patients included in the study, the female/male value was 1.2. The rate of OCB positivity in MOGAD patients was 22.6 %. Patients on RTX had higher EDSS values than patients on AZA. However, the RTX group demonstrated a more pronounced improvement in disability, reflected by a greater negative trend in the Delta EDSS values. The attack-free rate was 78 % in the RTX group and 68 % in the AZA group during their treatment period. Both groups had no difference in the time of the first attack. The main factor affecting the time to first attack was having a higher EDSS at the time of treatment initiation. The survival analysis found that EDSS scores improved significantly in patients treated with RTX. Conclusion: Although survival analyses for both treatments appear to be similar, using RTX provides better EDSS scores.
Headache as the Sole Presenting Symptom of Cerebral Venous Sinuses Thrombosis: Subgroup Analysis of Data From the Venost Study
(Kare Publ, 2021) Duman, Taskin; Cinar, Nilgun; Uluduz, Derya; Domac, Fusun Mayda; Ozturk, Serefnur; Yayla, Vildan; Demir, Serkan
Objectives: Headache is the most common complaint in cerebral venous sinus thrombosis (CVST) and it may sometimes be the only symptom in these patients. This retrospective and prospective study was an investigation of any differences in terms of clinical risk factors, radiological findings, or prognosis in patients with CVST who presented with isolated headache (IH) and cases with other concomitant findings (non-isolated headache [NIH]). Methods: A total of 1144 patients from a multicenter study of cerebral venous sinus thrombosis ( VENOST study) were enrolled in this research. The demographic, biochemical, clinical, and radiological aspects of 287 IH cases and 857 NIH cases were compared. Results: There were twice as many women as men in the study group. In the IH group, when gender distribution was evaluated by age group, no statistically significant difference was found. The onset of headache was frequently subacute and chronic in the IH group, but an acute onset was more common in the NIH group. Other neurological findings were observed in 29% of the IH group during follow-up. A previous history of deep, cerebral, or other venous thromboembolism was less common in the IH group than in the NIH group. Transverse sinus involvement was greater in the IH group, whereas sagittal sinus involvement was greater in the NIH group. The presence of a plasminogen activator inhibitor (PAI) mutation was significantly greater in the IH group. Conclusion: IH and CVST should be kept in mind if a patient has subacute or chronic headache. PAI, which has an important role in thrombolytic events, may be a risk factor in CVST. Detailed hematological investigations should be considered. Additional studies are needed.