Review
BibTex RIS Cite

Çocukluk Çağında Mikroskopik Kolite Yaklaşım

Year 2018, Volume: 16 Issue: 2, 219 - 229, 01.08.2018

Abstract

Mikroskopik Kolit; kronik sulu ishal, normal endoskopik ve histopatolojik bulgular ile karakterize inflamatuvar değişiklikler gösteren nadir bir barsak hastalığıdır. Kronik diarenin sık görülen bir nedenidir. Kollajenöz kolit ve lenfositik kolit (LK) olmak üzere iki subtipi mevcuttur. Klinik ve histopatoloik özellikleri benzer olan bu tiplerinin biribirinden ayrı hastalık mı,yoksa aynı hastalığın farklı fenotipleri mi olduğu halen bilinmemektedir. Etyolojisi bilinmemekle birlikte; genetik, otoimmunite, luminal bir antijene karşı (gıda, mikroorgaanizma vs) immunolojik veya inflamatuvar reaksiyon, ilaçlar, bakteriyal infeksiyon ve toksinleri, safra asitleri ve safra asit malabsorbsiyon, bozulmuş sıvı ve elektrolit emilimi ve salınımı, kollajen sentez-degredasyon (parçalanma) dengesi ve nitrik oksit öne sürülen başlıca mekanizmalardır. Erişkin yaş grubunda sıklıkla altıncı ve yedinci dekatlarda daha fazla olmakla birlikte çocuk yaş grubu dahil her yaş grubunda giderek arttığı bildirilmektedir. Çocukluk çağında MK’in sıklığı bilinmemektedir. Klinik bulguları nonspesifik olup ikisinde de kronik veya tekrarlayan sulu, kansız, dehidratasyona neden olmayan şiddetli, gecede olabilen ishal, karın ağrısı, kramplar, kilo kaybı ve fekal inkontinans görülür. Rutin laboratuvar incelemeler genellikle yardımcı değildir Tanı çoğu zaman klinik belirtiler varlığında, alınan biyopsilerle histolojik olarak konulabilmektedir. Bu amaçla çıkan ve sigmoid kolondan biyopsi alınmalıdır. Ayırıcı tanıda, ilaca bağlı mikrosopik kolit ve çölyak hastalığı mutlaka ekarte edilmelidir. Tedavisinde fazla kontrollü çalışma yoktur. En fazla çalışılan ilaç budesoniddir. Hafif vakalarda anti-diareikler genellikle yeterli olmaktadır. Genel olarak MKin uzun süreli izlem sonucunda prognoz oldukça iyidir.

References

  • 1- Pardi DS, Kelly CP. Microscopic colitis. Gastroenterology. 2011;140: 1155–65.
  • 2- Münch A, Aust D, Bohr J, Bonderup O, Fernández Bañares F, Hjortswang H, et al. Microscopic colitis: current status, present and future challenges: statements of the European Microscopic Colitis Group. J Crohns Colitis. 2012;6:932–45.
  • 3- Read NW, Krejs GJ, Read MG, Santa Ana CA, Morawski SG, Fordtran JS. Chronic diarrhea of unknown origin. Gastroenterology 1980; 78: 264-71.
  • 4- Jackson BK: Are collagenous aolitis and lymphocytic colitis distinct syndromes? Dig Dis Sci 1995; 13: 301-11.
  • 5- Zeroogian JM, Chopra S: Collagenous colitis and lymphocytic colitis. Annu Rev Med 1994; 45: 105-18.
  • 6- Jessurun J, Yardley JH, Lee EL, Vendrell DD, Schiller LR, Fordtran JS. Microscopic and collagenous colitis: different names for the same condition? Gastroenterology. 1986;91:1583-4.
  • 7- Levison DA, Lazenby AJ, Yardley JH. Microscopic colitis cases revisited. Gastroenterology. 1993;105:1594-6.
  • 8- Lindstrom CG: "Collagenous colitis" with watery diarrhea: a new entity? Patbol Eur 1976; 11: 87-9.
  • 9- Fernandez-Banares F, Salas A, Esteve M, Espinos J, Forne M. Collagenous and lymphocytic colitis: Evaluation of Clinical and Histological Features, Response to Treatment, and Long-term Follow-Up. Am J Gastroenterol. 2003; 98: 340-7
  • 10- Lazenby A, Yardley J, Gairdiello, Jessurun J, Bayless TM.. Lymphocytic (microscopic) colitis: a comparative histopathologic study, with particular reference to collogenous colitis. Hum Pathol 1989; 20: 19-28.
  • 11- Pardi DS, Loftus EV Jr, Smyrk TC, Kammer PP, Tremaine WJ. The epidemiology of microscopic colitis: a population based study in Olmsted County, Minnesota. Gut 2007;56:504–8.
  • 12- Bohr J, Wickbom A, Hegedus A, Nyhlin N, Hultgren Hörnquist E, Tysk C. Diagnosis and management of microscopic colitis: current perspectives.Clin Exp Gastroenterol. 2014;21:273-84.
  • 13- Gentile NM, Khanna S, Loftus EV Jr, Smyrk TC, Tremaine WJ, Harmsen WS, et al. The epidemiology of microscopic colitis in Olmsted County from 2002 to 2010: a population- based study. Clin Gastroenterol Hepatol 2014;12;:838–42.
  • 14- Erdem L, Yildirim S, Akbayir N, Yilmaz B, Yenice N, Gultekin OS, Peker O. Prevalence of microscopic colitis in patients with diarrhea of unknown etiology in Turkey. World J Gastroenterol. 2008;21:4319-23
  • 15- Narla NP, Smyrk TC, Pardi DS, Tung J. Clinical features and treatment responses in pediatric lymphocytic and collagenous colitis. J Pediatr Gastroenterol Nutr. 2013;57:557-61.
  • 16- Yen EF, Pardi DS.Review article: Microscopic colitis--lymphocytic, collagenous and 'mast cell'colitis. Aliment Pharmacol Ther. 2011;34:21-32.
  • 17- Münch A, Aust D, Bohr J, Bonderup O, Fernández Bañares F, Hjortswang H,Madisch A, Munck LK, Ström M, Tysk C, Miehlke S; European Microscopic Colitis Group (EMCG). Microscopic colitis: Current status, present and future challenges: statements of the European Microscopic Colitis Group. J Crohns Colitis. 2012;6:932-45.
  • 18- Mahajan L, Wyllie R, Goldblum J. Lymphocytic colitis in a pediatric patient: a possible adverse reaction to carbamazepine. Am J Gastroenterol 1997;92:2126–7.
  • 19- O’Beirne JP, Ireland A. Progression of collagenous colitis to Crohn’s disease. Eur J Gastroenterol Hepatol 2005;17:573–5.
  • 20- Ozturk Y, Soylu OB, Ozer E. Lymphocytic colitis in a child with nonresponsive celiac disease. Acta Gastroenterol Belg 2008;71:393–5.
  • 21- Benchimol EI, Kirsch R, Viero S, Griffiths AM.Collagenous colitis and eosinophilic gastritis in a 4-year old girl: a case report and review of the literature. Acta Paediatr 2007;96:1365–7.
  • 22- Esselinckx W, Brenard R, Colin JF, Melange M. Juvenile scleroderma and collagenous colitis. The first case. J Rheumatol 1989;16:834–6.
  • 23- Kuhn BR, Mezoff AG. Pediatric lymphocytic colitis presenting with intractable diarrhea. J Pediatr Gastroenterol Nutr 2011;53:579–81.
  • 24- Liu X, Xiao SY, Plesec TP, Jiang W, Goldblum JR, Lazenby AJ. Collagenous colitis in children and adolescents: study of 7 cases and literature review. Mod Pathol 2013;26:881–7.
  • 25- Singh P, Das P, Jain AK, Mathan M, Mathur M, Bhat AS, Varma S, Chaturvedi MK,Gupta SD, Bhatnagar S. Microscopic colitis in children with chronic diarrhea. J Pediatr Gastroenterol Nutr. 2013;57:240-4.
  • 26- El-Matary W, Girgis S, Huynh H, Turner J, Diederichs B. Microscopic colitis in children. Dig Dis Sci. 2010;55:1996-2001.
  • 27- Vanderhoof JA, Goble K, Young RJ. Collagenous colitis in a 4-year-old child: response to budesonide J Pediatr Gastroenterol Nutr.2010: 50:688.
  • 28- Najarian RM, Hait EJ, Leichtner AM, Glickman JN, Antonioli DA, Goldsmith JD. Clinical significance of colonic intraepithelial lymphocytosis in a pediatric population. Mod Pathol. 2009;22:13-20.
  • 29- Löfberg R. Microscopic and Collagenous colitis. Evidence-based gastroenterology and Child healty. Ed: john WD McDonald, Andrew K Burroughs, Brian G Feagan, second ed, 2002;pp 221-9
  • 30- Järnerot G, Hertervig E, Grännö C, Thorhallsson E, Eriksson S, Tysk C et al. Familial occurrence of microscopic colitis: a report on five families. Scand J Gastroenterol. 2001;36:959–62.
  • 31- Fine KD, Do K, Schulte K, Ogunji F, Guerra R, Osowski L, et al. High prevalence of celiac sprue-like HLA-DQ genes and enteropathy in patients with the microscopic colitis syndrome. Am J Gastroenterol. 2000;95:1974–82.
  • 32- Koskela RM, Karttunen TJ, Niemelä SE, Lehtola JK, Ilonen J, Karttunen RA. Human leucocyte antigen and TNFα polymorphism association in microscopic colitis. Eur J Gastroenterol Hepatol. 2008;20:276–82.
  • 33- Madisch A, Hellmig S, Schreiber S, Bethke B, Stolte M, Miehlke S. Allelic variation of the matrix metalloproteinase-9 gene is associated with collagenous colitis. Inflamm Bowel Dis 2011;17: 2295–8.
  • 34- Madisch A, Hellmig S, Schreiber S, Bethke B, Stolte M, Miehlke S. NOD2/CARD15 gene polymorphisms are not associated with collagenous colitis. Int J Colorectal Dis 2007;22:425–8.
  • 35- Camarero Salces C, Enes Romero P, Redondo C, Rizo Pascual JM, Roy Ariño G. Collagenous colitis and collagenous gastritis in a 9 year old girl: a case report and review of the literature. Acta Gastroenterol Belg. 2011;74:468-74.
  • 36- Chen B, Girgis S, El-Matary W.Childhood autism and eosinophilic colitis. Digestion. 2010;81:127-9.
  • 37- Tysk C, Bohr J, Nyhlin N, Wickbom A, Eriksson S. Diagnosis and management of microscopic colitis. World J Gastroenterol. 2008 ;14:7280-8.
  • 38- Burgel N, Bojarski C, Mankertz J, Zeitz M, Fromm M, Schulzke JD. Mechanisms of diarrhea in collagenous colitis. Gastroenterology 2002;123:433–43.
  • 39- Gunther U, Schuppan D, Bauer M, Matthes H, Stallmach A, Schmitt-Gräff A, et al. Fibrogenesis and fibrolysis in collagenous colitis. Patterns of procollagen types I and IV, matrix-metalloproteinase- 1 and -13, and TIMP-1 gene expression. Am J Pathol 1999; 155: 493–503.
  • 40- Bonderup OK, Hansen JB, Madsen P, Vestergaard V, Fallingborg J, Teglbjaerg PS. Budesonide treatment and expression of inducible nitric oxide synthase mRNA in colonic mucosa in collagenous colitis. Eur J Gastroenterol Hepatol 2006;18:1095-9.
  • 41- Ozdil K, Sahin A, Calhan T, Kahraman R, Nigdelioglu A, Akyuz U, et al. The frequency of microscopic and focal active colitis in patients with irritable bowel syndrome. BMC Gastroenterol. 2011; 31;11:96.
  • 42- Allende DS, Taylor SL, Bronner MP. Colonic perforation as a complication of collagenous colitis in a series of 12 patients. Am J Gastroenterol 2008;103:2598-604.
  • 43- Baert F, Schmit A, D’Haens G, et al. Budesonide in collagenous colitis: a double-blind placebo-controlled trial with histologic follow-up. Gastroenterology. 2002;122:20–5.
  • 44- Gremse DA, Boudreaux CW, Manci EA. Collagenous colitis in children. Gastroenterology. 1993 ;104:906-9.
  • 45- Calabrese C, Fabbri A, Areni A, Zahlane D, Scialpi C, Di Febo G. Mesalazine with or without cholestyramine in the treatment of microscopic colitis: randomized controlled trial. J Gastroenterol Hepatol. 2007;22:809-14.
  • 46- Wildt S, Munck LK, Vinter-Jensen L, Hanse BF, Nordgaard-Lassen I, Christensen S et al. Probiotic treatment of collagenous colitis: a randomized, double-blind, placebo-controlled trial with Lactobacillus acidophilus and Bifidobacterium animalis subsp. lactis. Inflamm Bowel Dis. 2006;12:395–401.
  • 47- Pardi DS, Loftus EV Jr, Tremaine WJ, Sandborn WJ. Treatment of refractory microscopic colitis with azathioprine and 6-mercaptopurine. Gastroenterology. 2001;120:1483–4.
  • 48- Esteve M, Mahadevan U, Sainz E, Rodriguez E, Salas A, Fernández-Bañares F. Efficacy of anti-TNF therapies in refractory severe microscopic colitis. J Crohns Colitis. 2011;5:612–8.
  • 49- Münch A, Ignatova S, Ström M. Adalimumab in budesonide and methotrexate refractory collagenous colitis. Scand J Gastroenterol. 2012;47:59–63.
  • 50- Varghese L, Galandiuk S, Tremaine WJ, Burgart LJ. Lymphocytic colitis treated with proctocolectomy and ileal J-pouch-anal anastomosis: report of a case. Dis Colon Rectum. 2002;45:123–6.
Year 2018, Volume: 16 Issue: 2, 219 - 229, 01.08.2018

Abstract

References

  • 1- Pardi DS, Kelly CP. Microscopic colitis. Gastroenterology. 2011;140: 1155–65.
  • 2- Münch A, Aust D, Bohr J, Bonderup O, Fernández Bañares F, Hjortswang H, et al. Microscopic colitis: current status, present and future challenges: statements of the European Microscopic Colitis Group. J Crohns Colitis. 2012;6:932–45.
  • 3- Read NW, Krejs GJ, Read MG, Santa Ana CA, Morawski SG, Fordtran JS. Chronic diarrhea of unknown origin. Gastroenterology 1980; 78: 264-71.
  • 4- Jackson BK: Are collagenous aolitis and lymphocytic colitis distinct syndromes? Dig Dis Sci 1995; 13: 301-11.
  • 5- Zeroogian JM, Chopra S: Collagenous colitis and lymphocytic colitis. Annu Rev Med 1994; 45: 105-18.
  • 6- Jessurun J, Yardley JH, Lee EL, Vendrell DD, Schiller LR, Fordtran JS. Microscopic and collagenous colitis: different names for the same condition? Gastroenterology. 1986;91:1583-4.
  • 7- Levison DA, Lazenby AJ, Yardley JH. Microscopic colitis cases revisited. Gastroenterology. 1993;105:1594-6.
  • 8- Lindstrom CG: "Collagenous colitis" with watery diarrhea: a new entity? Patbol Eur 1976; 11: 87-9.
  • 9- Fernandez-Banares F, Salas A, Esteve M, Espinos J, Forne M. Collagenous and lymphocytic colitis: Evaluation of Clinical and Histological Features, Response to Treatment, and Long-term Follow-Up. Am J Gastroenterol. 2003; 98: 340-7
  • 10- Lazenby A, Yardley J, Gairdiello, Jessurun J, Bayless TM.. Lymphocytic (microscopic) colitis: a comparative histopathologic study, with particular reference to collogenous colitis. Hum Pathol 1989; 20: 19-28.
  • 11- Pardi DS, Loftus EV Jr, Smyrk TC, Kammer PP, Tremaine WJ. The epidemiology of microscopic colitis: a population based study in Olmsted County, Minnesota. Gut 2007;56:504–8.
  • 12- Bohr J, Wickbom A, Hegedus A, Nyhlin N, Hultgren Hörnquist E, Tysk C. Diagnosis and management of microscopic colitis: current perspectives.Clin Exp Gastroenterol. 2014;21:273-84.
  • 13- Gentile NM, Khanna S, Loftus EV Jr, Smyrk TC, Tremaine WJ, Harmsen WS, et al. The epidemiology of microscopic colitis in Olmsted County from 2002 to 2010: a population- based study. Clin Gastroenterol Hepatol 2014;12;:838–42.
  • 14- Erdem L, Yildirim S, Akbayir N, Yilmaz B, Yenice N, Gultekin OS, Peker O. Prevalence of microscopic colitis in patients with diarrhea of unknown etiology in Turkey. World J Gastroenterol. 2008;21:4319-23
  • 15- Narla NP, Smyrk TC, Pardi DS, Tung J. Clinical features and treatment responses in pediatric lymphocytic and collagenous colitis. J Pediatr Gastroenterol Nutr. 2013;57:557-61.
  • 16- Yen EF, Pardi DS.Review article: Microscopic colitis--lymphocytic, collagenous and 'mast cell'colitis. Aliment Pharmacol Ther. 2011;34:21-32.
  • 17- Münch A, Aust D, Bohr J, Bonderup O, Fernández Bañares F, Hjortswang H,Madisch A, Munck LK, Ström M, Tysk C, Miehlke S; European Microscopic Colitis Group (EMCG). Microscopic colitis: Current status, present and future challenges: statements of the European Microscopic Colitis Group. J Crohns Colitis. 2012;6:932-45.
  • 18- Mahajan L, Wyllie R, Goldblum J. Lymphocytic colitis in a pediatric patient: a possible adverse reaction to carbamazepine. Am J Gastroenterol 1997;92:2126–7.
  • 19- O’Beirne JP, Ireland A. Progression of collagenous colitis to Crohn’s disease. Eur J Gastroenterol Hepatol 2005;17:573–5.
  • 20- Ozturk Y, Soylu OB, Ozer E. Lymphocytic colitis in a child with nonresponsive celiac disease. Acta Gastroenterol Belg 2008;71:393–5.
  • 21- Benchimol EI, Kirsch R, Viero S, Griffiths AM.Collagenous colitis and eosinophilic gastritis in a 4-year old girl: a case report and review of the literature. Acta Paediatr 2007;96:1365–7.
  • 22- Esselinckx W, Brenard R, Colin JF, Melange M. Juvenile scleroderma and collagenous colitis. The first case. J Rheumatol 1989;16:834–6.
  • 23- Kuhn BR, Mezoff AG. Pediatric lymphocytic colitis presenting with intractable diarrhea. J Pediatr Gastroenterol Nutr 2011;53:579–81.
  • 24- Liu X, Xiao SY, Plesec TP, Jiang W, Goldblum JR, Lazenby AJ. Collagenous colitis in children and adolescents: study of 7 cases and literature review. Mod Pathol 2013;26:881–7.
  • 25- Singh P, Das P, Jain AK, Mathan M, Mathur M, Bhat AS, Varma S, Chaturvedi MK,Gupta SD, Bhatnagar S. Microscopic colitis in children with chronic diarrhea. J Pediatr Gastroenterol Nutr. 2013;57:240-4.
  • 26- El-Matary W, Girgis S, Huynh H, Turner J, Diederichs B. Microscopic colitis in children. Dig Dis Sci. 2010;55:1996-2001.
  • 27- Vanderhoof JA, Goble K, Young RJ. Collagenous colitis in a 4-year-old child: response to budesonide J Pediatr Gastroenterol Nutr.2010: 50:688.
  • 28- Najarian RM, Hait EJ, Leichtner AM, Glickman JN, Antonioli DA, Goldsmith JD. Clinical significance of colonic intraepithelial lymphocytosis in a pediatric population. Mod Pathol. 2009;22:13-20.
  • 29- Löfberg R. Microscopic and Collagenous colitis. Evidence-based gastroenterology and Child healty. Ed: john WD McDonald, Andrew K Burroughs, Brian G Feagan, second ed, 2002;pp 221-9
  • 30- Järnerot G, Hertervig E, Grännö C, Thorhallsson E, Eriksson S, Tysk C et al. Familial occurrence of microscopic colitis: a report on five families. Scand J Gastroenterol. 2001;36:959–62.
  • 31- Fine KD, Do K, Schulte K, Ogunji F, Guerra R, Osowski L, et al. High prevalence of celiac sprue-like HLA-DQ genes and enteropathy in patients with the microscopic colitis syndrome. Am J Gastroenterol. 2000;95:1974–82.
  • 32- Koskela RM, Karttunen TJ, Niemelä SE, Lehtola JK, Ilonen J, Karttunen RA. Human leucocyte antigen and TNFα polymorphism association in microscopic colitis. Eur J Gastroenterol Hepatol. 2008;20:276–82.
  • 33- Madisch A, Hellmig S, Schreiber S, Bethke B, Stolte M, Miehlke S. Allelic variation of the matrix metalloproteinase-9 gene is associated with collagenous colitis. Inflamm Bowel Dis 2011;17: 2295–8.
  • 34- Madisch A, Hellmig S, Schreiber S, Bethke B, Stolte M, Miehlke S. NOD2/CARD15 gene polymorphisms are not associated with collagenous colitis. Int J Colorectal Dis 2007;22:425–8.
  • 35- Camarero Salces C, Enes Romero P, Redondo C, Rizo Pascual JM, Roy Ariño G. Collagenous colitis and collagenous gastritis in a 9 year old girl: a case report and review of the literature. Acta Gastroenterol Belg. 2011;74:468-74.
  • 36- Chen B, Girgis S, El-Matary W.Childhood autism and eosinophilic colitis. Digestion. 2010;81:127-9.
  • 37- Tysk C, Bohr J, Nyhlin N, Wickbom A, Eriksson S. Diagnosis and management of microscopic colitis. World J Gastroenterol. 2008 ;14:7280-8.
  • 38- Burgel N, Bojarski C, Mankertz J, Zeitz M, Fromm M, Schulzke JD. Mechanisms of diarrhea in collagenous colitis. Gastroenterology 2002;123:433–43.
  • 39- Gunther U, Schuppan D, Bauer M, Matthes H, Stallmach A, Schmitt-Gräff A, et al. Fibrogenesis and fibrolysis in collagenous colitis. Patterns of procollagen types I and IV, matrix-metalloproteinase- 1 and -13, and TIMP-1 gene expression. Am J Pathol 1999; 155: 493–503.
  • 40- Bonderup OK, Hansen JB, Madsen P, Vestergaard V, Fallingborg J, Teglbjaerg PS. Budesonide treatment and expression of inducible nitric oxide synthase mRNA in colonic mucosa in collagenous colitis. Eur J Gastroenterol Hepatol 2006;18:1095-9.
  • 41- Ozdil K, Sahin A, Calhan T, Kahraman R, Nigdelioglu A, Akyuz U, et al. The frequency of microscopic and focal active colitis in patients with irritable bowel syndrome. BMC Gastroenterol. 2011; 31;11:96.
  • 42- Allende DS, Taylor SL, Bronner MP. Colonic perforation as a complication of collagenous colitis in a series of 12 patients. Am J Gastroenterol 2008;103:2598-604.
  • 43- Baert F, Schmit A, D’Haens G, et al. Budesonide in collagenous colitis: a double-blind placebo-controlled trial with histologic follow-up. Gastroenterology. 2002;122:20–5.
  • 44- Gremse DA, Boudreaux CW, Manci EA. Collagenous colitis in children. Gastroenterology. 1993 ;104:906-9.
  • 45- Calabrese C, Fabbri A, Areni A, Zahlane D, Scialpi C, Di Febo G. Mesalazine with or without cholestyramine in the treatment of microscopic colitis: randomized controlled trial. J Gastroenterol Hepatol. 2007;22:809-14.
  • 46- Wildt S, Munck LK, Vinter-Jensen L, Hanse BF, Nordgaard-Lassen I, Christensen S et al. Probiotic treatment of collagenous colitis: a randomized, double-blind, placebo-controlled trial with Lactobacillus acidophilus and Bifidobacterium animalis subsp. lactis. Inflamm Bowel Dis. 2006;12:395–401.
  • 47- Pardi DS, Loftus EV Jr, Tremaine WJ, Sandborn WJ. Treatment of refractory microscopic colitis with azathioprine and 6-mercaptopurine. Gastroenterology. 2001;120:1483–4.
  • 48- Esteve M, Mahadevan U, Sainz E, Rodriguez E, Salas A, Fernández-Bañares F. Efficacy of anti-TNF therapies in refractory severe microscopic colitis. J Crohns Colitis. 2011;5:612–8.
  • 49- Münch A, Ignatova S, Ström M. Adalimumab in budesonide and methotrexate refractory collagenous colitis. Scand J Gastroenterol. 2012;47:59–63.
  • 50- Varghese L, Galandiuk S, Tremaine WJ, Burgart LJ. Lymphocytic colitis treated with proctocolectomy and ileal J-pouch-anal anastomosis: report of a case. Dis Colon Rectum. 2002;45:123–6.
There are 50 citations in total.

Details

Primary Language Turkish
Journal Section Derleme
Authors

Nafiye Urgancı

Publication Date August 1, 2018
Published in Issue Year 2018 Volume: 16 Issue: 2

Cite

APA Urgancı, N. (2018). Çocukluk Çağında Mikroskopik Kolite Yaklaşım. Güncel Pediatri, 16(2), 219-229.
AMA Urgancı N. Çocukluk Çağında Mikroskopik Kolite Yaklaşım. Güncel Pediatri. August 2018;16(2):219-229.
Chicago Urgancı, Nafiye. “Çocukluk Çağında Mikroskopik Kolite Yaklaşım”. Güncel Pediatri 16, no. 2 (August 2018): 219-29.
EndNote Urgancı N (August 1, 2018) Çocukluk Çağında Mikroskopik Kolite Yaklaşım. Güncel Pediatri 16 2 219–229.
IEEE N. Urgancı, “Çocukluk Çağında Mikroskopik Kolite Yaklaşım”, Güncel Pediatri, vol. 16, no. 2, pp. 219–229, 2018.
ISNAD Urgancı, Nafiye. “Çocukluk Çağında Mikroskopik Kolite Yaklaşım”. Güncel Pediatri 16/2 (August 2018), 219-229.
JAMA Urgancı N. Çocukluk Çağında Mikroskopik Kolite Yaklaşım. Güncel Pediatri. 2018;16:219–229.
MLA Urgancı, Nafiye. “Çocukluk Çağında Mikroskopik Kolite Yaklaşım”. Güncel Pediatri, vol. 16, no. 2, 2018, pp. 219-2.
Vancouver Urgancı N. Çocukluk Çağında Mikroskopik Kolite Yaklaşım. Güncel Pediatri. 2018;16(2):219-2.