{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T12:04:33Z","timestamp":1766318673490,"version":"3.40.5"},"reference-count":49,"publisher":"Walter de Gruyter GmbH","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2022-0004_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Alkaptonuria is a rare autosomal recessive genetic disorder resulting from the deficiency of homogentisate 1,2 dioxygenase (HGD), the third enzyme in the tyrosine degradation pathway. Homogentisic acid produced in excess oxidizes into ochronotic pigment polymer. Accumulation of this pigment in various tissues leads to systemic disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2022-0004_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Clinical, laboratory, molecular findings and treatment characteristics of 35 patients followed up in Ege University Pediatric Nutrition, and Metabolism Department with the diagnosis of alkaptonuria were evaluated retrospectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2022-0004_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty-four males (68.57%) and 11 females (31.42%) with a confirmed diagnosis of alkaptonuria from 32 different families were included in the study. We identified 11 different genetic variants; six of these were novel. c.1033C&gt;T, c.676G&gt;A, c.664G&gt;A, c.731_734del, c.1009G&gt;T, c.859_862delins ATAC were not previously reported in the literature. 24 (68.57%) patients only adhered to a low-protein diet in our study group. Seven (20%) patients initiated a low protein diet and NTBC therapy. Mean urinary HGA decreased by 88.7% with nitisinone. No statistical changes were detected in urinary HGA excretion with the low protein diet group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2022-0004_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In our study, alkaptonuria patients were diagnosed at different ages, from infancy to adulthood, and progressed with other systemic involvement in the follow-up. Since the initial period is asymptomatic, giving potentially effective treatment from an early age is under discussion. Raising disease awareness is very important in reducing disease mortality and morbidity rates.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2022-0004","type":"journal-article","created":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T16:50:03Z","timestamp":1654620603000},"page":"913-923","source":"Crossref","is-referenced-by-count":3,"title":["Long-term follow-up of alkaptonuria patients: single center experience"],"prefix":"10.1515","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9783-1016","authenticated-orcid":false,"given":"Ayse Ergul","family":"Bozaci","sequence":"first","affiliation":[{"name":"Department of Pediatrics , Ege University Faculty of Medicine, Division of Pediatric Metabolism , Izmir , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2564-7420","authenticated-orcid":false,"given":"Havva","family":"Yazici","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Ege University Faculty of Medicine, Division of Pediatric Metabolism , Izmir , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebru","family":"Canda","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Ege University Faculty of Medicine, Division of Pediatric Metabolism , Izmir , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9574-7841","authenticated-orcid":false,"given":"Sema Kalkan","family":"U\u00e7ar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Ege University Faculty of Medicine, Division of Pediatric Metabolism , Izmir , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merve Saka","family":"Guvenc","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics , Tepecik Research and Training Hospital , Izmir , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afig","family":"Berdeli","sequence":"additional","affiliation":[{"name":"Department of Molculer Genetics , Ege University Faculty of Medicine , Izmir , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Habif","sequence":"additional","affiliation":[{"name":"Department of Biochemistry , Ege University Faculty of Medicine , Izmir , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmut","family":"Coker","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Ege University Faculty of Medicine, Division of Pediatric Metabolism , Izmir , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2022,6,6]]},"reference":[{"key":"2023033122065305220_j_jpem-2022-0004_ref_001","doi-asserted-by":"crossref","unstructured":"La Du, BN, Zannoni, VG, Laster, L, Seegmiller, JE. 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