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Mikobakteriyel Hastalıklara Mendelyen Duyarlılık

Year 2020, Volume: 12 Issue: 3, 147 - 153, 01.06.2020

Abstract

Mikobakteriyel hastalıklara Mendelyen duyarlılık (MSMD, OMIM 209950), zayıf
virulanslı non-tüberküloz mikobakterilere (NTM) ve atenüe Mycobacterium bovis
içeren Bacillus Calmette-Guérin (BCG) aşısına duyarlılık gösteren ancak diğer
mikroorganizmalara normal immün yanıt veren, rutin immün yetersizlik taramasında
hematolojik ve immünolojik incelemeleri normal bulunan ‘immün sistemin doğuştan
kusuru’dur. Hastaların klinik belirtileri NTM enfeksiyonu veya BCG aşısı yayılımı
veya her ikisinin birlikteliğine göre değişir. Lokal veya yaygın lenfadenopatiler, deri
belirtileri, akciğer tutulumu, osteomiyelit, hepatosplenomegali sık görülen klinik bulgulardır.
MSMD hastalarında 15 farklı gende (IFNGR1, IFNGR2, STAT1 LOF, JAK1,
IRF8, SPPL2A, IL12B, IL12RB1, IL12RB2, IL23R, ISG15, TYK2, RORC, CYBB
ve NEMO) mutasyon tanımlanmıştır. Kalıtım şekline, mutant proteinin üretim düzeyine
ve yol açtığı biyokimyasal anormalliğe bağlı olarak 30 farklı genetik hastalık
tanımlanmıştır. Genetik mutasyonların bir kısmında konak IFN-γ üretemez iken, diğer
bir kısmında sitokine immün yanıt bozulmaktadır. Bu hastalar Salmonella gibi makrofaj
içine giren birkaçbakteriye ve bazı virüslere de duyarlıdırlar. Dünya üzerinde
yaklaşık 1/50 000 kişide MSMD olduğu tahmin edilmektedir.

References

  • 1. Casanova JL, Abel L. Lethal infectious diseases as Inborn errors of immunity: Toward a synthesis of the germ end genetic theories. Annu Rev Pathol Mech Dis 2021; 16: X–X https://doi.org/10.1146/annurev-pathol-031920-101429.
  • 2. Bustamante J Mendelian susceptibility to mycobacterial disease: recent discoveries. Hum Genet. 2020 Feb 5. doi: 10.1007/s00439-020-02120-y. [Epub ahead of print]
  • 3. Casanova JL. Severe infectious diseases of childhood as monogenic inborn errors of immunity. Proc Natl Acad Sci USA, 2015: 112 (51): E7128–37. doi:10.1073/pnas.1521651112
  • 4. Casanova JL, Jouanguy E, Lamhamedi S, Blanche S, Fischer A. Immunological conditions of children with BCG disseminated infection. Lancet 1995; 346 (8974): 581.
  • 5. Mimouni J. Our experiences in three years of BCG vaccination at the center of the O.P.H.S. at Constantine; study of observed cases (25 cases of complications from BCG vaccination). Alger Medicale 1951; 55 (8): 1138–1147.
  • 6. Ülgenalp I, Yalçın M, Çetiner M, Özgen M, Köseli I. Ölümle sonuçlanan jeneralize BCG enfeksiyonu. Tüberküloz ve Toraks 1973; 21:11–19.
  • 7. Jouanguy E, Altare F, Lamhamedi S, et al. Interferon-gammareceptor deficiency in an infant with fatal bacille Calmette Guerin infection. N Engl J Med 1996; 335 (26): 1956–1961.
  • 8. Newport MJ, Huxley CM, Huston S, et al. A mutation in the interferon-gamma-receptor gene and susceptibility to mycobacterial infection. N Engl J Med 1996; 335 (26): 1941–1949.
  • 9. Casanova JL, Ochs H. Interferon-gamma receptor deficiency: An expanding clinical phenotype? J Pediatr 1999; 135 (5): 543-545.
  • 10. Casanova JL, Abel L. Genetic dissection of immunity to mycobacteria: the human model. Annu Rev Immunol 2002; 20: 581–620.
  • 11. Dorman SE, Picard C, Lammas D, et al. Clinical features of dominant and recessive interferon gamma receptor 1 deficiencies. Lancet 2004; 364: 2113-2121.
  • 12. Filipe-Santos O, Bustamante J, Chapgier A, et al. Inborn errors of IL-12/23- and IFN-gamma-mediated immunity: molecular, cellular, and clinical features. Semin Immunol 2006; 18: 347-361.
  • 13. Sologuren I, Boisson-Dupuis S, Pestano J, et al. Partial recessive IFN-γR1 deficiency: genetic, immunological and clinical features of 14 patients from 11 kindreds. Hum Mol Genet 2011; 20: 1509-1523.
  • 14. Rosain J, Kong XF, Martinez-Barricarte R, et al. Mendelian susceptibility to mycobacterial disease: 2014-2018 update. Immunol Cell Biol 2019; 97: 360-367.
  • 15. Altare F, Jouanguy E, Lamhamedi-Cherradi S, et al. A causative relationship between mutant IFNgR1 alleles and impaired
  • cellular response to IFNgamma in a compound heterozygous child. Am J Hum Genet 1998; 62: 723-726.
  • 16.MacLennan C, Fieschi C, Lammas DA, et al. Interleukin (IL)- 12 and IL-23 are key cytokines for immunity against Salmonella in humans. J Infect Dis 2004: 190 (10): 1755–1757.
  • 17. Sanal O, Turkkani G, Gumruk F, et al. A case of interleukin- 12 receptor beta-1 deficiency with recurrent leishmaniasis. Pediatr Infect Dis J 2007; 26: 366-368.
  • 18. Dorman SE, Uzel G, Roesler J, et al. Viral infections in interferon- gamma receptor deficiency. J Pediatr 1999; 135: 640- 643.
  • 19. Camcioglu Y, Picard C, Lacoste V, et al. HHV-8-associated Kaposi sarcoma in a child with IFNgammaR1 deficiency. J Pediatr 2004; 144: 519-523.
  • 20. Boisson-Dupuis S, Bustamante J, El-Baghdadi J, et al. Inherited and acquired immunodeficiencies underlying tuberculosis in childhood. Immunol Rev 2015; 264: 103-120.
  • 21. Bousfiha A, Jeddane L, Picard C, et al. Human Inborn Errors of Immunity: 2019 Update of the IUIS Phenotypical Classification.
  • J Clin Immunol 2020; 40 (1): 66-81. doi: 10.1007/s10875-020-00758-x. Epub 2020 Feb 11.
  • 22. Bax HI, Freeman AF, Ding L, et al. Interferon alpha treatment of patients with impaired interferon gamma signaling. J Clin Immunol 2013; 33: 991-1001.
  • 23. Döffinger R. Jouanguy E, Dupuis S, et al. Partial interferongamma receptor signaling chain deficiency in a patient with
  • bacille Calmette-Guérin and Mycobacterium abscessus infection. J Infect Dis 2000; 181: 379-384.
  • 24.Picard C, Fieschi C, Altare F, et al. Inherited interleukin-12 deficiency: IL12B genotype and clinical phenotype of 13 patients from six kindreds. Am J Hum Genet 2002; 70: 336-348.
  • 25. Prando C, Samarina A, Bustamante J, et al. Inherited IL-12p40 deficiency: genetic, immunologic, and clinical features of 49 patients from 30 kindreds. Medicine (Baltimore) 2013; 92: 109- 122.
  • 26. Rosain J, Oleaga-Quintas C, Deswarte C, et al. A variety of Alu-mediated copy number variations can underlie IL-12Rbeta1 deficiency. J Clin Immunol 2018; 38: 617–627.
  • 27. de Jong R, Altare F, Haagen IA, et al. Severe mycobacterial and Salmonella infections in interleukin-12 receptor-deficient patients. Science 1998; 280: 1435-1438.
  • 28. Pedraza S, Lezana JL, Samarina A, et al. Clinical disease caused by Klebsiella in 2 unrelated patients with interleukin 12 receptor beta1 deficiency. Pediatrics 2010; 126 (4): e971-976.
  • 29. de Beaucoudrey L, Samarina A, Bustamante J, et al. Revisiting human IL-12Rβ1 deficiency: a survey of 141 patients from 30 countries. Medicine (Baltimore) 2010; 89: 381-402.
  • 30. Averbuch D, Chapgier A, Boisson-Dupuis S, Casanova JL, Engelhard D. The clinical spectrum of patients with deficiency of Signal Transducer and Activator of Transcription-1. atr Infect Dis J 2011; 30: 352-355.
  • 31. Bigley V, Maisuria S, Cytlak U, et al. Biallelic interferon regulatory factor 8 mutation: A complex immunodeficiency syndrome with dendritic cell deficiency, monocytopenia, and immune dysregulation. J Allergy Clin Immunol 2018; 141: 2234-2248.
  • 32. Salem S, Langlais D, Lefebvre F, et al. Functional characterization of the human dendritic cell immunodeficiency associated with the IRF8(K108E) mutation. Blood 2014; 124: 1894- 1904.
  • 33. Bogunovic D, Byun M, Durfee LA, et al. Mycobacterial disease and impaired IFN-γ immunity in humans with inherited ISG15 deficiency. Science 2012; 337: 1684-1688.
  • 34. Zhang X, Bogunovic D, Payelle-Brogard B, et al. Human intracellular ISG15 prevents interferon-α/β over-amplification and auto-inflammation. Nature 2015; 517 (7532): 89-93.
  • 35. Conti F, Lugo-Reyes SO, Blancas Galicia L, et al. Mycobacterial disease in patients with chronic granulomatous disease:
  • a retrospective analysis of 71 cases. J Allergy Clin Immunol 2016: 138 (1): 241–248.e3. doi:10.1016/j.jaci.2015.11.041.
  • 36. Köker MY, Camcıoğlu Y, van Leeuwen K, et al. Clinical, functional, and genetic characterization of chronic granulomatous
  • disease in 89 Turkish patients. J Allergy Clin Immunol 2013; 132 (5): 1156-1163.e5. doi: 10.1016/j.jaci.2013.05.039. Epub 2013 Jul 31.
  • 37. Kerner G, Ramirez-Alejo N, Seeleuthner Y, et al. Homozygosity for TYK2 P1104A underlies tuberculosis in about 1% of patients in a cohort of European ancestry. Proc Natl Acad Sci USA 2019: 116 (21): 10430–10434.
  • 38. Kilic SS, Hacimustafaoglu M, Boisson-Dupuis S, et al. A patient with tyrosine kinase 2 deficiency without hyper-IgE syndrome. J Pediatr 2012: 160 (6): 1055–1057.
  • 39. Boisson-Dupuis S. The monogenic basis of human tuberculosis. Human Genet 2020 Feb 13. doi: 10.1007/s00439-020- 02126-6. [Epub ahead of print].
  • 40. Okada S, Markle JG, Deenick EK, et al. Impairment of immunity to Candida and Mycobacterium in humans with bi-allelic RORC mutations. Science 2015; 349 (6248): 606–613. doi:10.1126/science.aaa4282.
  • 41. Çavuşoğlu C, Edeeer Karaca N, Azarsız E, Ulusoy E, Kütükçüler N. Rifampicin-resistant Mycobacterium bovis BCG strain isolated from an infant with NEMO mutation. Mikrobial Bul 2015; 49 (2): 272-277.
  • 42.Witalisz-Siepracka A, Klein K, Prinz D, et al. Loss of JAK1 drives innate immune deficiency. Front Immunol 2019; 9: 3108. doi: 10.3389/fimmu.2018.03108. eCollection 2018.
  • 43. Gursel M, Gursel I. Is global BCG vaccination-induced trained immunity relevant to the progression of SARS-CoV-2 pandemic? Allergy 2020 Apr 27. doi: 10.1111/all.14345. [Epub ahead of print].
  • 44. Aaby P, Roth A, Ravn H, et al. Randomized trial of BCG vaccination at birth to low-birth-weight children: beneficial nonspecific effects in the neonatal period? J Infect Dis 2011:204(2):245–52. doi:10.1093/infdis/jir240.
  • 45. Nunes-Santos CJ, Rosenzweig SD. Bacille Calmette–Guerin complications in newly described primary immunodeficiency
  • diseases: 2010–2017. Front Immunol 2018: 9: 1423. doi: 10.3389/fimmu.2018.01423.
  • 46. Marciano BE, Huang CY, Joshi G, et al. BCG vaccination in patients with severe combined immunodeficiency: complications,
  • risks, and vaccination policies. J Allergy Clin Immunol 2014: 133 (4): 1134–1141. doi:10.1016/j.jaci.2014.02.028.
  • 47. Reed B, Dolen WK. The child with recurrent Mycobacterial disease. Curr Allergy Asthma Rep 2018; 18 (8): 44. doi: 10.1007/s11882-018-0797-3.
  • 48. Medical Advisory Committee of the Immune Deficiency Foundation, Shearer WT, Fleisher TA, Buckley RH, Ballas Z, Ballow M, et al. Recommendations for live viral and bacterial
  • vaccines in immunodeficient patients and their close contacts. J Allergy Clin Immunol 2014: 133 (4): 961–966. doi: 10.1016/ j.jaci.2013.11.043.
  • 49. Bonilla FA. Update: vaccines in primary immunodeficiency. J Allergy Clin Immunol
Year 2020, Volume: 12 Issue: 3, 147 - 153, 01.06.2020

Abstract

References

  • 1. Casanova JL, Abel L. Lethal infectious diseases as Inborn errors of immunity: Toward a synthesis of the germ end genetic theories. Annu Rev Pathol Mech Dis 2021; 16: X–X https://doi.org/10.1146/annurev-pathol-031920-101429.
  • 2. Bustamante J Mendelian susceptibility to mycobacterial disease: recent discoveries. Hum Genet. 2020 Feb 5. doi: 10.1007/s00439-020-02120-y. [Epub ahead of print]
  • 3. Casanova JL. Severe infectious diseases of childhood as monogenic inborn errors of immunity. Proc Natl Acad Sci USA, 2015: 112 (51): E7128–37. doi:10.1073/pnas.1521651112
  • 4. Casanova JL, Jouanguy E, Lamhamedi S, Blanche S, Fischer A. Immunological conditions of children with BCG disseminated infection. Lancet 1995; 346 (8974): 581.
  • 5. Mimouni J. Our experiences in three years of BCG vaccination at the center of the O.P.H.S. at Constantine; study of observed cases (25 cases of complications from BCG vaccination). Alger Medicale 1951; 55 (8): 1138–1147.
  • 6. Ülgenalp I, Yalçın M, Çetiner M, Özgen M, Köseli I. Ölümle sonuçlanan jeneralize BCG enfeksiyonu. Tüberküloz ve Toraks 1973; 21:11–19.
  • 7. Jouanguy E, Altare F, Lamhamedi S, et al. Interferon-gammareceptor deficiency in an infant with fatal bacille Calmette Guerin infection. N Engl J Med 1996; 335 (26): 1956–1961.
  • 8. Newport MJ, Huxley CM, Huston S, et al. A mutation in the interferon-gamma-receptor gene and susceptibility to mycobacterial infection. N Engl J Med 1996; 335 (26): 1941–1949.
  • 9. Casanova JL, Ochs H. Interferon-gamma receptor deficiency: An expanding clinical phenotype? J Pediatr 1999; 135 (5): 543-545.
  • 10. Casanova JL, Abel L. Genetic dissection of immunity to mycobacteria: the human model. Annu Rev Immunol 2002; 20: 581–620.
  • 11. Dorman SE, Picard C, Lammas D, et al. Clinical features of dominant and recessive interferon gamma receptor 1 deficiencies. Lancet 2004; 364: 2113-2121.
  • 12. Filipe-Santos O, Bustamante J, Chapgier A, et al. Inborn errors of IL-12/23- and IFN-gamma-mediated immunity: molecular, cellular, and clinical features. Semin Immunol 2006; 18: 347-361.
  • 13. Sologuren I, Boisson-Dupuis S, Pestano J, et al. Partial recessive IFN-γR1 deficiency: genetic, immunological and clinical features of 14 patients from 11 kindreds. Hum Mol Genet 2011; 20: 1509-1523.
  • 14. Rosain J, Kong XF, Martinez-Barricarte R, et al. Mendelian susceptibility to mycobacterial disease: 2014-2018 update. Immunol Cell Biol 2019; 97: 360-367.
  • 15. Altare F, Jouanguy E, Lamhamedi-Cherradi S, et al. A causative relationship between mutant IFNgR1 alleles and impaired
  • cellular response to IFNgamma in a compound heterozygous child. Am J Hum Genet 1998; 62: 723-726.
  • 16.MacLennan C, Fieschi C, Lammas DA, et al. Interleukin (IL)- 12 and IL-23 are key cytokines for immunity against Salmonella in humans. J Infect Dis 2004: 190 (10): 1755–1757.
  • 17. Sanal O, Turkkani G, Gumruk F, et al. A case of interleukin- 12 receptor beta-1 deficiency with recurrent leishmaniasis. Pediatr Infect Dis J 2007; 26: 366-368.
  • 18. Dorman SE, Uzel G, Roesler J, et al. Viral infections in interferon- gamma receptor deficiency. J Pediatr 1999; 135: 640- 643.
  • 19. Camcioglu Y, Picard C, Lacoste V, et al. HHV-8-associated Kaposi sarcoma in a child with IFNgammaR1 deficiency. J Pediatr 2004; 144: 519-523.
  • 20. Boisson-Dupuis S, Bustamante J, El-Baghdadi J, et al. Inherited and acquired immunodeficiencies underlying tuberculosis in childhood. Immunol Rev 2015; 264: 103-120.
  • 21. Bousfiha A, Jeddane L, Picard C, et al. Human Inborn Errors of Immunity: 2019 Update of the IUIS Phenotypical Classification.
  • J Clin Immunol 2020; 40 (1): 66-81. doi: 10.1007/s10875-020-00758-x. Epub 2020 Feb 11.
  • 22. Bax HI, Freeman AF, Ding L, et al. Interferon alpha treatment of patients with impaired interferon gamma signaling. J Clin Immunol 2013; 33: 991-1001.
  • 23. Döffinger R. Jouanguy E, Dupuis S, et al. Partial interferongamma receptor signaling chain deficiency in a patient with
  • bacille Calmette-Guérin and Mycobacterium abscessus infection. J Infect Dis 2000; 181: 379-384.
  • 24.Picard C, Fieschi C, Altare F, et al. Inherited interleukin-12 deficiency: IL12B genotype and clinical phenotype of 13 patients from six kindreds. Am J Hum Genet 2002; 70: 336-348.
  • 25. Prando C, Samarina A, Bustamante J, et al. Inherited IL-12p40 deficiency: genetic, immunologic, and clinical features of 49 patients from 30 kindreds. Medicine (Baltimore) 2013; 92: 109- 122.
  • 26. Rosain J, Oleaga-Quintas C, Deswarte C, et al. A variety of Alu-mediated copy number variations can underlie IL-12Rbeta1 deficiency. J Clin Immunol 2018; 38: 617–627.
  • 27. de Jong R, Altare F, Haagen IA, et al. Severe mycobacterial and Salmonella infections in interleukin-12 receptor-deficient patients. Science 1998; 280: 1435-1438.
  • 28. Pedraza S, Lezana JL, Samarina A, et al. Clinical disease caused by Klebsiella in 2 unrelated patients with interleukin 12 receptor beta1 deficiency. Pediatrics 2010; 126 (4): e971-976.
  • 29. de Beaucoudrey L, Samarina A, Bustamante J, et al. Revisiting human IL-12Rβ1 deficiency: a survey of 141 patients from 30 countries. Medicine (Baltimore) 2010; 89: 381-402.
  • 30. Averbuch D, Chapgier A, Boisson-Dupuis S, Casanova JL, Engelhard D. The clinical spectrum of patients with deficiency of Signal Transducer and Activator of Transcription-1. atr Infect Dis J 2011; 30: 352-355.
  • 31. Bigley V, Maisuria S, Cytlak U, et al. Biallelic interferon regulatory factor 8 mutation: A complex immunodeficiency syndrome with dendritic cell deficiency, monocytopenia, and immune dysregulation. J Allergy Clin Immunol 2018; 141: 2234-2248.
  • 32. Salem S, Langlais D, Lefebvre F, et al. Functional characterization of the human dendritic cell immunodeficiency associated with the IRF8(K108E) mutation. Blood 2014; 124: 1894- 1904.
  • 33. Bogunovic D, Byun M, Durfee LA, et al. Mycobacterial disease and impaired IFN-γ immunity in humans with inherited ISG15 deficiency. Science 2012; 337: 1684-1688.
  • 34. Zhang X, Bogunovic D, Payelle-Brogard B, et al. Human intracellular ISG15 prevents interferon-α/β over-amplification and auto-inflammation. Nature 2015; 517 (7532): 89-93.
  • 35. Conti F, Lugo-Reyes SO, Blancas Galicia L, et al. Mycobacterial disease in patients with chronic granulomatous disease:
  • a retrospective analysis of 71 cases. J Allergy Clin Immunol 2016: 138 (1): 241–248.e3. doi:10.1016/j.jaci.2015.11.041.
  • 36. Köker MY, Camcıoğlu Y, van Leeuwen K, et al. Clinical, functional, and genetic characterization of chronic granulomatous
  • disease in 89 Turkish patients. J Allergy Clin Immunol 2013; 132 (5): 1156-1163.e5. doi: 10.1016/j.jaci.2013.05.039. Epub 2013 Jul 31.
  • 37. Kerner G, Ramirez-Alejo N, Seeleuthner Y, et al. Homozygosity for TYK2 P1104A underlies tuberculosis in about 1% of patients in a cohort of European ancestry. Proc Natl Acad Sci USA 2019: 116 (21): 10430–10434.
  • 38. Kilic SS, Hacimustafaoglu M, Boisson-Dupuis S, et al. A patient with tyrosine kinase 2 deficiency without hyper-IgE syndrome. J Pediatr 2012: 160 (6): 1055–1057.
  • 39. Boisson-Dupuis S. The monogenic basis of human tuberculosis. Human Genet 2020 Feb 13. doi: 10.1007/s00439-020- 02126-6. [Epub ahead of print].
  • 40. Okada S, Markle JG, Deenick EK, et al. Impairment of immunity to Candida and Mycobacterium in humans with bi-allelic RORC mutations. Science 2015; 349 (6248): 606–613. doi:10.1126/science.aaa4282.
  • 41. Çavuşoğlu C, Edeeer Karaca N, Azarsız E, Ulusoy E, Kütükçüler N. Rifampicin-resistant Mycobacterium bovis BCG strain isolated from an infant with NEMO mutation. Mikrobial Bul 2015; 49 (2): 272-277.
  • 42.Witalisz-Siepracka A, Klein K, Prinz D, et al. Loss of JAK1 drives innate immune deficiency. Front Immunol 2019; 9: 3108. doi: 10.3389/fimmu.2018.03108. eCollection 2018.
  • 43. Gursel M, Gursel I. Is global BCG vaccination-induced trained immunity relevant to the progression of SARS-CoV-2 pandemic? Allergy 2020 Apr 27. doi: 10.1111/all.14345. [Epub ahead of print].
  • 44. Aaby P, Roth A, Ravn H, et al. Randomized trial of BCG vaccination at birth to low-birth-weight children: beneficial nonspecific effects in the neonatal period? J Infect Dis 2011:204(2):245–52. doi:10.1093/infdis/jir240.
  • 45. Nunes-Santos CJ, Rosenzweig SD. Bacille Calmette–Guerin complications in newly described primary immunodeficiency
  • diseases: 2010–2017. Front Immunol 2018: 9: 1423. doi: 10.3389/fimmu.2018.01423.
  • 46. Marciano BE, Huang CY, Joshi G, et al. BCG vaccination in patients with severe combined immunodeficiency: complications,
  • risks, and vaccination policies. J Allergy Clin Immunol 2014: 133 (4): 1134–1141. doi:10.1016/j.jaci.2014.02.028.
  • 47. Reed B, Dolen WK. The child with recurrent Mycobacterial disease. Curr Allergy Asthma Rep 2018; 18 (8): 44. doi: 10.1007/s11882-018-0797-3.
  • 48. Medical Advisory Committee of the Immune Deficiency Foundation, Shearer WT, Fleisher TA, Buckley RH, Ballas Z, Ballow M, et al. Recommendations for live viral and bacterial
  • vaccines in immunodeficient patients and their close contacts. J Allergy Clin Immunol 2014: 133 (4): 961–966. doi: 10.1016/ j.jaci.2013.11.043.
  • 49. Bonilla FA. Update: vaccines in primary immunodeficiency. J Allergy Clin Immunol
There are 57 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section makale
Authors

Serdar Nepesov This is me

Yıldız Camcıoğlu This is me

Publication Date June 1, 2020
Published in Issue Year 2020 Volume: 12 Issue: 3

Cite

APA Nepesov, S., & Camcıoğlu, Y. (2020). Mikobakteriyel Hastalıklara Mendelyen Duyarlılık. Klinik Tıp Pediatri Dergisi, 12(3), 147-153.
AMA Nepesov S, Camcıoğlu Y. Mikobakteriyel Hastalıklara Mendelyen Duyarlılık. Pediatri. June 2020;12(3):147-153.
Chicago Nepesov, Serdar, and Yıldız Camcıoğlu. “Mikobakteriyel Hastalıklara Mendelyen Duyarlılık”. Klinik Tıp Pediatri Dergisi 12, no. 3 (June 2020): 147-53.
EndNote Nepesov S, Camcıoğlu Y (June 1, 2020) Mikobakteriyel Hastalıklara Mendelyen Duyarlılık. Klinik Tıp Pediatri Dergisi 12 3 147–153.
IEEE S. Nepesov and Y. Camcıoğlu, “Mikobakteriyel Hastalıklara Mendelyen Duyarlılık”, Pediatri, vol. 12, no. 3, pp. 147–153, 2020.
ISNAD Nepesov, Serdar - Camcıoğlu, Yıldız. “Mikobakteriyel Hastalıklara Mendelyen Duyarlılık”. Klinik Tıp Pediatri Dergisi 12/3 (June 2020), 147-153.
JAMA Nepesov S, Camcıoğlu Y. Mikobakteriyel Hastalıklara Mendelyen Duyarlılık. Pediatri. 2020;12:147–153.
MLA Nepesov, Serdar and Yıldız Camcıoğlu. “Mikobakteriyel Hastalıklara Mendelyen Duyarlılık”. Klinik Tıp Pediatri Dergisi, vol. 12, no. 3, 2020, pp. 147-53.
Vancouver Nepesov S, Camcıoğlu Y. Mikobakteriyel Hastalıklara Mendelyen Duyarlılık. Pediatri. 2020;12(3):147-53.