Oloinata evi bestelep 1PBK "yo 5 calle de 5 Kolestar exsimbs Laboratuar put @ wpe 5 Aste AiTnomat-hofifyoksek =) 2ta4G altands 30° {00 oro" ‘D Sirsid yaprod po Sie Silk etayte bile arte « + Bilirubin lerihastalicta artar su animator amen 5 AMaM2 dato spesiphe ss Hee ; 5; Metaboli kemikhastaklan-> Pv'¥ ¢4> © ntbsorpson vag) De tbigicwsh scigele ouwocro.an) Et Breit He Genet * = Eater "A + ALE PBI = Sabi Te ce ioasaus ieee anal Gar tal ven Bei ste Saye boelt etrafind inflenen gon sine pliomedn ee ae FFE ECM pordasl HT Bagu- Tani Karaciger Bx — vat + Flori safra kanal Aw © ~rawovonihinahienn ANA MP daha spe é ALE gibsettigi cbstrakepahe abst stables! ies fain thefrokipabek —erkalatlor use ile dione tle. ebstral tk x USE ile etsteabe Ale AMALE) =) PBL ¥ Aedes talvesol. te by tons feyit edilnal! 1Bade sa}eo upto hiveler acter hesan vardie « iaflanobyar Doin'se bx aed TKitepte Bild Chios Srbomu Va Tedavi ier karaciger hastalilarindan korunmak Hepat ve 829s ~All bakaimas: =15:20—6/6 f Tech UDCA werlir. ODCA verdibae, asdishadat oil" yuine V0CA AS. sirbilan mers 0D Soe ead ak OE ES a Soke land oeTip 1& Tip 2 Tan» a es — aerate ston le : ae + Eslik eden otoimmun hastaliklar Talim | © PALP/ASToram << 1740 => ALE pek artmor ea ss sein TareaTia Ig dizeyi > 9G Antikonar > Abt) HOIU 2 hpi vort ' + Karacigerbivopsisi > 2x 1H abindiayere TIL: doho iter ypote asiaita keeper eee c-rere erg ecee er rece ree creer eer Fragners debe iy’ tele. ae Tan bayel + Dat | Tripd Le Tau Tues Del BE aa nt J pry AMA ] Sov Tad See 1 Mikotik te tas ve outro gee gunna s ” PRIMER BILIER KOLANJIT um sala axiki clde cater ve kent goper Maiesiora bee lah ik Be, Ld | i Wee eur sefre galletas bere blilee ve. cea ce! ycler re pal bak Laramie Chk Contes Thue delta dhe wok, Primer Bilier Kolanjit Klinik Rastlanhsal ya sirstdon + Eskitanumlama: primer bile siroz eager sonra fon Cee ‘ =) Kolestar on plends old, tein : io Ce bande oon ane yapar Seve tactes asitbe baguth _semptom ve bulgulan gels ve nihayetinde soe olusur. + Gittbulgular hiperpigmentasyon, ksantom,ksantalema, kuru + 40.50 yas, kadin + 20-400/milyon —4 Wadi @xu fp glock + Keak =) poe : CPT haf + al y poll Freda betes sironle pln p beanie Myofitle: + Aremptondit. heats a ‘ Hiatt. safre yellendadie 4 . ; (eee : fs ula plinds) Seca Safin plows AL iain Bn pled> aster ler. Kelestar- MERIT iyeck Sti cetOtoimmun hepatit Klinik + Karacigerin kroni, inflamatuar, otoimmun hasta + Tim yaslar ve etnik kkenlerde;Kadin sib. + Insidans 1-2/100000 ~% Nadie —Akut hepatit © Beeen Ai Ye gpleilir haste Genetik olarak yatknii olan bireyde blinmeyen Bir tetkeyict erate) Se ‘comeminaniaiomenay — t+ boron. eee : * eglikeden; TASN CAAT ole Mile prvette Viger deena | ~Otoimmun oie se . Weve sk) —Géllakehastaliy eit eer) - Tom Fi haste OK klinik-laboratuar AU pel gbsalner. dal hor hoafaiflede-/ Sa erat pearhonynd me plete ‘Grontotr —y Arada bolle jerler FAS eS Gaees gs iyeee arkar VE gliase qiatlawosyon, hale: ovis Leebe vo kollajelen Naraboar Rotel verde Auda, clza alleeh alamace NASH etarte eben ‘Tedavi ° far WL olee. besmalt Leoni hipabet ndicboin bale ; geairmdiye intedaviss >) Obsside, Iain farihorss OM cL NASH ‘kilo verre. ) Kile vprecel gqlornys orel- Pan sora bajle dagil de HU, SY slaye ~HohadsOS1iglayS TST Koken geet ae ar oe eta est ears “roll ait bk as kai) = Varin att ADM wares, ae gee etycr aw, Lalsterel yibel ans) ign yt, Blna tubing “qorulealdper. TT ctrgunge (PENonalkolik yagli karaciger hastaligi iikini varia yefloweda erty dic | WAKE hast problem ye ede auirs ye birbi Aiea eer iain Joule allel show dale eda anon altole, RCT gbereelG 1 ards ale ny lla “tat hl. oma degil wae ange FPR 1 Ke Doyen TH alle bade Sheeler Ly ravenin—y iaflarorgon > NASH Ggonma) Finplowelw dice Webditae Pens ei Sieve * Asemptomatik ) Re bqu yok ++ Halsizlik, yorgunluk, sag Uist kadranda dolgunluk + Hepatomegali rez bugulan ed ~HaffASTatraniss 2 kaka. qeeman « TASTIATC! =— mp Avot Ke hastda AST ALT —Hofifersn yokes NAY ALT AST = Ttonep. aod Uscde eteferit® erhsy ha Hee tee BU entrant hho atalie Patogenez — Barsak ve adipor dokudan fazla yay gelmesi ¥ ayy insonl Patgioeticaien yy tie ++ TNF-a, IL-6, rezistin, visfatin, PAi-1 artist Filevi gate intidler + Adiponektin azalmasi anemnlldir rfahyemede lp server Cdapoyenes bipelim ere al Te SL laced Mat New Boel Fy all, oF pewide . Epidemiyoloji + Bat toplumiarin en sik KC hastaligy + Als aktrler - ~ Sant obeske nom Dsdemt = Metabolic eandrom + wark9i20.35 + NASH IS Tan + Yaflanmanin gorantaleme veya biyops ile gésterimesi + Beligin allo fullaniminndislanmas * Diger karaciger yailanma nedenlerinin aislanmast «9 Uaalac, er giles - Hier yaslonma olan hasteda Ke by wilibosware ecog Beery Soe '—NAYK tanisi kesin degilse rane. vt na alemde. ~ Helena hs cenvein bate > SG foe ne ied Tan, juin USC We Kewwe var, Hasta altel = Mimeaoe, pase ae + Noploves yspeok oat deal Dige Denk ce hb ball a rome AYE aye ey, New)Alkolik hepatit Alkolik hepatit addr Sishtoinn Yer ogg Malic ' + Siddetbetteme "°°" ~Distriiran okt : y oe, BL actar Tainde PT osaven ei. at Qe ee beeed il, “DEREKOEnaemie rine? eae Arte sa looks oe our: Bart (ated tee) teeta ghee BF . Tharve nit geal 0) iste iene veide 2 ere a al i Laat htt adie Bape ‘Ao ek adhe re ic + Yterlbeslenmetedais (2500 kal) ve hidrasyon cvavoe) tel Se « gta homes erie lemekign) = bit all Sins aotaal eg 5 pr telltale berg glow ile 9 4 seple prckiyatie. Ww Albelie Re Masai og! ne athe Fi pailigs ahh Me adel abseee et oy problemles fale Aeat way paren oni batik, eek Bilirwbia gobsek. Snaanld bir proper Par He yt chr Ton Babter » astyse Pay ue ve AaTeALre was Ley Sete Chronik, Mat Alkolik karaciger hastaliklari/Siroz tedavi © aol kestmest > Ara td? * Bara, stomps, naieson sll bratins ign lanai Spamettomrargepln> + Gekme semptomlonna ditkat ant, ara ema debi wemers, net + Obesite tedavisi,sigarabiraklmast 9 pige Fe hesere nadunleiat + beslenme tedavis gates a Heisnn alter p + HeCtaramast + Alo eset le yoksek oranda bulgular ger dénebilir — Bu nedenie KC trans éncesi6 ay alkol kesilmesi Gnerilir in Ankiy edible Prognoz NON-ALKOLIK KARACIGER HASTALIKLAR: BEDE ssn, A onlona iat 90 ides degen * Wut Leake o'r yonae Alls Wrakrot sa i206: yode Uap ar Patio Vesince Aids Te Wataugve L gw ne ae,‘Patogenez_ Patogenez — + Asetaldeit real ve tok . ee | EEE ase - + Yog eksikligi- “pstlalicit ve Abel yopae + Aktive stellt hdcre (Myofibroblast)aktivasyonu (kallajen ee Seplnce Joe “sente) yorar (— TGF-B bunun i¢in énemli bir uyaran ) Oberite ve sigarakullarim risk artinn, A Alkelin Kerdisi ve yctrme the obras Asetaldehit Tek bagine niye alkel degil. Baler suuleur. ” geen ake reveatl Ke haelginn pateleint wage talon Nae Poet Alkolik karaciger hastaliklart Teonit hetikg Samanta sirsba eer, + Alkoik Yogi karaciger Altel Kede, parkle pretantasyorira + Alkolik hepatit LNA ‘cig. + Siroz + Seon fs ato preserbasyor altolik, Aitale begle abut Wepatitin ads altabe Ipatibticy kliniL irae dhe farkle- Horwal Ke By > wbraalicatces e Hematalegt Laguler leper et Genette, soriit Ne cine Ronco Ree ) Alkolik karaciger hastaliklari (Yagli KC) klinik + Hopatomegal 9, bintinin. bale We Meghe Sirords te 5 ae FN Ceda in don ~ Sentrilobuler ve perivenulr yal infitrasyon ~ Balon dejeneresyonu, ako hyaln (Mallory-Denk cismi) = PAN inftasyona . wy hepatte ALT VAST . Awa altolit. tupabtte ASP PRUE 7. a wi to eye: x Hosta leg! aids fuas sighed - Gort Ase ALC U8Gde 1c Bae “Tons erat ex vetoes . bxde Deak dein bint ger r gail oy aks eeetry (ATE) ? Al antitripsin de | AZ antitripsin defekti/Klinik ‘i i AH ‘ 7 Momruifseerosskon OAH. ayce on 3b a sorter = Spontan padmotoraks — esa Ac eletin — _ tata hy Wines ee Sale fede.“ ATT eb, e100 hasar fede olor or si ee “keden venterlenir, Lana geaip oraden Ace ce ler. bi ccleniendiginds.’ fasiyicl p= od se genet we Fed” tava ¢hlamen Ke eine Fede hover” yapor Vietbie. cede em oie t Ae FOS orate yuu yous ariiven ABT yepvel Ac bean Maer tome masai eks 4 Sadece Jere voveh sk - ms i Master yplint arthearal Ac UCL (EN aa ohne Al antitripsin defekti tant ” A1antitripsin defekti tedavi Ytande onde, AAT diseyne si SF oigite hose esse gt Sigarakesimest + serum asrasnen PEAS GEE 9 aan gota ret es + PCR ile genotipleme bata ‘ insanaa elasmag) Ree yds yo nin ? Ace abl: 4 + Gen sekanstama Tdvide he 1nd ernalliade ejer Acde Eee nee age he tes Kina ikisi de bak ge WA Ae hem Ke wohl oly. a biter Ns Unie Hae prydne gobs, Saute biden Kenge We reer ed IRs fags vad gr : t @ Alkolik karaciger hastaligi + Alkol alanis Hepolesifie, 9 sis 9 HEC ~ Karacigerde yaglenma- see Hee ALKOLIK KARACIGER HASTALIG: + Neden her allie KC hasan ola??? Aibel siren ex boa atbaleiadn bie Youn aol alanlannkigik bi smunda sor gels a '~ Kadinlar daha kisa stire ve daha az alim ile siroza yatkindir. Wer youn alkal elaads Ke. bor abner. Nedes FE Fee pulie oleSihes Ayer MASH = dejoSONH'S Wath ARSE: vCoembs GY HA wDAk aL v a00elan Ter v Re gant Asti ALT ye ail Seley ala dy Wilson Klinik“ Sas ; Wilson- Klinik + karacger TR ile etl. Aedes Boys AST: ALT mma * = iit ~Kisilike degisiklideri, depresyon, hiperaktivite i Proline ole op fete fancy Mateos fon Br B8C ihe, : ae edt detanve des ele. caren rc atut rwpatitle grt, Lenib obrak, * Amenore,spontan abortus + Néroloiie eee wll att fyattl elebiir*Koleltaas TY cme ET AUT 08072000 gon Mbrde’ - wet ‘mst areuher : ~ ion omnia ort re en meee 7 e * KaysersFletscher halls, Katarakt Kos ghaielgs beklewmer : Gerde binkiry Pande do a Chen. seunli : He ve, MSS le 2 og p fesiee we sibtorFitl alos de bal glen ene Bilerel fk, Son stage re pines, Bobo dak, deg hk Lend data’. boordto yep seg aL Sine PTegisLk els ober Wilson tani testleri inttzon tedevi- ; + biyet a Toinde batir olan Kesinbd aralh~ O2* eee (sp) Ka : ; Renisitamin- “Garseeomustoas ) Uke, Seat Opt igual eae aa ‘i cmamaaiiaaane cloner, seas LF — ghinbe ihe Co enade. gona : — wi etl aie! seer arg Tevatiomolbdat= pc lomis FTricthn bi ale ~Auasandare Minit ayn ane werirnek babice + ATPTA gent DNAtesti> fever ira. tye per, Hon + Karacigernakli. BA bualena etbisin’ ereltie ham de Dmnin ebbin aredir. Moboletede A Tarawa tes darak, | Sololatmig, fetirn Land “fearon age owas a Sealeylamine Gal ve Sp dysbe, We fie HEN. : Se eet pagal Plein Wllznve ake. Irise batie ‘abmasitic Farle olan Co je, Bae der beer (yinloyae akon sete tite teat r Te thde. bakin orthegiat gpeebilictt lplemin — ~Abutresentasyenda = i baton Sevag ihisini ayer ayes vormall’an. em ve ban Wilson takip + Tedavi mur boy. veite take GRA KU Febsitte mut var + Ginkoda beklenen yan etk! yok + Serum serbest air dey tap het «25 ug) Ste ein ) Se, eli gura ‘1 ANTITRIPSIN EKSIKLIGI Ge aati eT e 4) G5 pple : ‘ almaleHemakromatozis-tant_ = ‘ Eo «Fortin ylksekli (21000) forge feed Tek haves forikn gibt ae ‘ ek icwat gin yeloh Saget grrmerae irae se beta lore Peta genet bakemekite it Yee rons yen we ve 186-90 U) ‘ay oe nt ddan Arada, Falvesal Ke be ye do MR fuller + Tk bosomat te anvils Hemakromatozis/tedavi ctarama > Gewtit hath old te tertean nay ere agin one) Fe tz — WILSON HASTALIGI wilde babi bicikie = Haft? afta bir ~Fertin wepeasin: so Fars Eekstlarin Fosi 2 Fe™% 9 Fel? - giana Woe a PetaStar, ~ Saoaterl membrana demir telerik forma gee eosin vale, Frater profetin. Hosa, AKT. | sal Remini, dev, Payee Fi Fp angi Lonel th, a ry : Hecmoh gil girees alex" pedhendi J tka sttear er ft hligaden re F ie wen Fe alten Bane ee ence fee ve in imletban pra sic abpey ve. dean red. aad” Lontralndan FP sont sasphioal 47S tebe Hebi dani demic met Se gnteonih agaseats ve gic. i aban) eagle ‘ ‘a Bueeathen 0c Fe pidsindas ‘rol Boa Bib wude HEE, Sn Naan, ped Men beter pad: APE are Name wore Maite bet fa dumic eepete FP Bolave ek as Fem digs Pee ge Hemakromatozis mut olobilecest = (282Y mutasyonu (xes:a0) \) Nae forth lees Va tet do tna + HEE digs ~ Homojuvelin mutasyonu = Hepeisin mutasyonu = TFR2 mutasyone ~ Ferroportin gen mutasyonu Fon Fe a epi FPL he a ee A Fea Re dink. Ome Ne ie’ gird’ FP dole denis sergatler” bana Hepsdin, FPA ine. ede Wake Jaxle Fe oleae Ee vjerle, Hepitn Eninon er line Saw ctor Brg, Sante” der Feat poy be ober Hemakromatozis-klinik A lctening et dono de + Homozigot C282Y mutasyonu olaniar; —“s IRL Tet te meng “ep > poormalk yok # 29d ink Yuttarat = 135 —_—_ =e + -B Semptom fig ole “vel hestai. —_ 7 Bede Fe Jpn’ gine abenan 345 ; ene pa soe - 2 bebe Vt geen + artiepat Goradtopin san ‘Se letarl aril deri renginde koyulagma, ibis kayo, OM aia) = tnt prs ets ot rekomest - = Ameer lleri evre: siroz bulgulan, artropati aitmiler, kalp yetmeziigl, testktleratrofl y ios coveda. scgen ye oper c Dn altsta Fe byabinine iveKronik Karaciger Hastaliklart Dr Huseyin Koseoglu Abul te Yeh w Algattle Ke w ott # acs HEMAKROMATOZIS Hemakromatozis + %1-10 heterorigat; %0,3-0,5 homozigat mutasyon oem cfomta dee Postale” alee deni’ Undion iay «tomes BI Js iss Bh Be ainda sox tin atinde eco one Fader Seem el hgh ew Ye eae fone Klinik bulgu: 40-50 yas) KVvaik Wlgy verass rowan a Kronik Karaciger Hastaliklart + Kronk Viral hepatler + Hemoksemators + Wilson Hastali + Digerkaltsal wc hastalilan «+ All Karacer Hasta Csno2) Non akoik yah KC Hasta = + Otoimmin Hepati + Pimer Bier Kean By hoslaliL nin hoped Sicor yoror Hemakromatozis + Vacutta deiisik organlarda demir biikimi le seyreden genet bir hastalkt. + Demir birkimi organ yetmedigine neden olur, °) dul" + Heterojen bir grup genetk defekt. ‘Herediter hemokromatozls >) —HFE gen mutasjenu HEE di gen mutasyons SS Sekonder demir birt (8) Normal demir hemostazi * Insanda yaklagk 4 er demir bulunur =2,Sqr entrostte -Deoyin Sigil tam #8CAe buhaur =A ge4G dal kee = Digerorganarda + Demir duodenumdan emilir + Demir metabolizmasi duodenumdan olan absorbsiyonun, ‘dzenlenmesiile olmaktadir. ~ A eed. ol Demir tim dizenlenemer > tahuaten Fe ably gibl mel yeuhir