Childhood epilepsy is a common neurological disorder with a prevalence of 300–600 cases per 100,000 people. It is associated with refractory epilepsies, global developmental delay, and epileptic encephalopathies, causing epileptic syndromes characterized by cognitive and behavioral disorders.

Amaç: Yaygın görülen bir tek gen hastalığı olan Alfa talasemi, α-globin zincirinin kusurlu sentezi ile ortaya çıkar. Globin genlerindeki bozukluklara bağlı olarak çok geniş bir klinik spektruma yayılan bu hastalıkta çok sayıda belirlenmemiş taşıyıcı olduğu düşünülmektedir. Klinik semptomu olmayan sessiz taşıyıcılardan, rahim içinde ölüme yol açan şiddetli anemi ile kendini gösteren, çok değişken bulgulara sahip genetik bir hastalıktır. Bu çalışmada bu amaçla alfa globin gen mutasyonu sıklığının ve tiplerinin bulunması ve varyasyon saptanan bireylerdeki fenotipik etkiyi görmek amaçlandı. Gereç ve Yöntemler: HBA1 ve HBA2 genlerindeki intron bölgelerini çevreleyen tüm kodlama bölgesi sanger dizileme ile tespit edildi. Delesyonlar ve duplikasyonlar multipleks ligasyona bağımlı prob amplifikasyonu (MLPA) ile mutasyonlar tespit edildi. Bulgular: Bölgemizde en sık rastlanan mutasyon tipi olan -3,7 / (%23,18), 3.7 kb’lık delesyon çalışmamızda da en sık olarak görülürken, diğer mutasyonların dağılımı ise --3,7 (%6,82), -3,7/-- MED (%0,91), --MED (%6,82), --20,5 (3,15), --SEA (%1,36), -4,2 (%0,95), triplikasyon (%0,45) ve nükleotid değişimleri (%4,55) olarak tespit edilmiştir. Sonuç: Mevcut bilgiler ışığında genotipin fenotipe yansımasının da farklılıklar olması nedeniyle taşıyıcı bireylerin tesbit edilmesi ve genotip fenotip ilişkisinin netleştirilmesi açısından daha geniş popülasyon taramasına ihtiyaç duyulmaktadır. Toplumu alfa talasemi ve ağır klinik seyreden genetik hastalıklar hakkında bilinçlendirmek için taşıyıcı bireylere genetik danışmanlık verilmesi ve genetik çalışmalara ağırlık verilmesi bir gerekliliktir.

Objective: Poor adherence to medications is an important problem, especially in patients with chronic diseases such as familial Mediterranean fever (FMF). In this study, we aimed to evaluate medication adherence in pediatric FMF patients and investigate the relationship between disease perception and treatment compliance. Method: Pediatric patients (60), while 44% of the patients were non-adherent to the treatment. Patients aged under 12 years of age were more adherent to colchicine treatment than those over 12 years of age (68.2% vs. 25.0%, p= 0.002). The comparison of the illness perception and medication adherence revealed higher brief IPQ total scores in patients who adhered to the treatment (median 48.5 vs 52.5, p=0.037). We found significant differences in timeline scores between patients who were adherent and those who were non-adherent to the treatment (p=0.01). Conclusion: Non-adherence to medication is an important and widespread problem, particularly among adolescent patients. Perceptions of the illness and beliefs about the duration of the disease may affect adherence to treatment. Medication adherence should be routinely assessed at follow-up visits and educational interventions might improve adherence to the treatment.

Neurodevelopmental disorders (NDDs) with ataxia are genetically heterogeneous and remain a diagnostic challenge. Recent advances in genomic technologies have facilitated the identification of rare, potentially causative variants in genes not traditionally associated with classic NDD phenotypes. The DNAH14 gene, encoding a dynein axonemal heavy chain involved in ciliary motility, has recently emerged as a novel candidate in neurological syndromes. Here, we report two Turkish siblings presenting with late-onset balance disorder, progressive ataxia, and cognitive impairment. Initial genetic analysis revealed that both siblings also harbor FXN GAA repeat expansions consistent with pathogenic Friedreich’s ataxia (FRDA). To elucidate the molecular basis of the patients’ cognitive impairment, whole-exome sequencing was performed. This analysis identified a novel homozygous frameshift variant in the DNAH14 gene, located within the conserved linker domain upstream of the motor core, which is critical for ATP hydrolysis and microtubule interactions. The variant is absent from population databases, predicted to be deleterious by multiple in silico algorithms, and segregates in the family in a manner consistent with autosomal recessive inheritance. The coexistence of FRDA expansions and a truncating DNAH14 variant suggests a potential dual genetic contribution to the observed phenotype, in which FRDA-associated pathology likely underlies the ataxia, while DNAH14 disruption may contribute to additional neurodevelopmental features. This is the first report describing the co-occurrence of FRDA and a homozygous truncating DNAH14 variant in the same individuals, broadening our understanding of overlapping neurogenetic mechanisms. Our findings expand the phenotypic spectrum of DNAH14-related disorders and highlight the importance of considering multilocus pathogenic variants in patients with complex or atypical ataxia presentations.

Biallelic variants in NDUFS6, encoding an accessory subunit of mitochondrial complex I, were initially associated with lethal neonatal mitochondrial encephalopathy and Leigh syndrome. Recent studies have demonstrated that NDUFS6 variants can also cause childhood- or adolescent-onset axonal neuropathy and Charcot–Marie–Tooth (CMT)-like phenotypes, indicating marked clinical heterogeneity. Here, we report a patient with a novel homozygous truncating NDUFS6 variant presenting with a neuropathy-predominant phenotype accompanied by epilepsy, in the absence of neonatal metabolic decompensation. The patient presented with childhood-onset progressive gait abnormality, pes cavus deformity, distal weakness requiring Achilles tendon-release surgery, pyramidal signs, urinary incontinence, and focal epileptiform EEG findings. Brain MRI showed bilateral lenticular nucleus abnormalities. Whole-exome sequencing identified a novel homozygous NDUFS6 nonsense variant (c.130C>T, p.Gln44*). While neuropathy has previously been reported primarily in association with the recurrent splice-site variant c.309+5G>A, our findings demonstrate that truncating NDUFS6 mutations can also underlie a neuropathy-predominant phenotype. Together with previously published cases, our findings support a phenotypic heterogeneity ranging from lethal encephalopathy to neuropathy and reinforce the role of NDUFS6 as a disease-causing gene for inherited peripheral neuropathy. These data support inclusion of NDUFS6 among established neuropathy and Charcot–Marie–Tooth genes.

Background: Inherited kidney diseases represent a genetically and clinically heterogeneous group of disorders affecting both pediatric and adult populations. Advances in next-generation sequencing (NGS) have improved diagnostic precision; however, genotype–phenotype correlations and diagnostic yield vary substantially across disease entities. Methods:We retrospectively evaluated 165 patients referred for genetic testing due to suspected inherited kidney disease. Patients were classified into three clinical groups: polycystic kidney disease, Alport syndrome, and other syndromic patients with inherited kidney diseases. Genetic analysis was performed using NGS with Human Phenotype Ontology–based gene filtering and included evaluation of both single-nucleotide variants and copy number variations. Results: Overall diagnostic yield differed markedly between groups. A molecular diagnosis was achieved in 71.4% of Alport patients, 41.0% of PKD patients, and 70.2% of patients in the Other syndromic group. In the Alport group, variants were identified exclusively in COL4A3, COL4A4, and COL4A5, with pathogenicity and gene involvement correlating with disease severity and the presence of extrarenal manifestations. The PKD group showed predominant involvement of PKD1, followed by PKHD1 and PKD2, while a substantial proportion of patients remained genetically negative, reflecting technical and biological complexity. The Other group exhibited pronounced genetic heterogeneity, with variants distributed across multiple genes involved in tubular, glomerular, metabolic, and ciliopathy-related pathways. Computational assessments demonstrated that several variants of uncertain significance (VUS) were located in functionally critical domains and were predicted to disrupt protein stability, intermolecular interactions, or conserved structural motifs, thereby supporting the biological plausibility of their potential pathogenic impact. Conclusions: Phenotype-driven NGS enables effective molecular diagnosis across diverse inherited kidney diseases while revealing disease-specific differences in diagnostic yield and genotype–phenotype correlations. Systematic inclusion of variants of uncertain significance and careful integration of genetic and clinical data are essential for accurate interpretation and long-term patient management. Collectively, this study enhances understanding of inherited kidney diseases and underscores the value of integrating comprehensive genomic and computational approaches into routine nephrogenetic practice.