Selçuk Üniversitesi Tıp fakültesi Hastanesi Çocuk Romatoloji kliniğinde serum benzeri reaksiyon tanısı ile takip edilen hastaların retrospektif olarak değerlendirilmesi
Yükleniyor...
Dosyalar
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çeşitli antijenik uyaranlar ve özellikle antibiyotik kullanımının artmasından sonra SSLR, giderek artan sıklıkta tanımlanmaktadır. Çalışma ile hastalığın etyolojisi, risk faktörleri, tedavisi ve prognozu hakkında anlamlı veriler ortaya koyma amaçlandı. Bununla birlikte, azımsanmayacak kadar sık görülen bu reaksiyon hakkında klinisyenler arasında farkındalık oluşturmak ve ortak bir tedavi modalitesi ortaya çıkarmaya katkı sağlamak amaçlandı. Gereç Ve Yöntem: Eylül 2016-Ocak 2022 yılları arasında Selçuk Üniversitesi Tıp Fakültesi Hastanesi Çocuk Sağlığı ve Hastalıkları kliniğinde SSLR tanısı ile takip edilen 122 hastanın dosyaları retrospektif olarak incelendi. Hastalardan tam kan sayımı, C- reaktif proteini, Eritrosit Sedimantasyon hızı, serum elektrolitleri, kan glukozu, üre, karaciğer fonksiyon testleri incelendi. Hastaların cinsiyet, yaş, hastanede yatış süresi, eşlik ettiği klinik bulgular, ailede atopi öyküsü, öncesinde geçirmiş olduğu enfeksiyon ve almış olduğu ilaç öyküsü, elektronik dosya bilgilerinden elde edildi. İstatistiksel analiz SPSS (IBM SPSS Statistics V22.0, SPSS Inc., USA) paket programı ile yapıldı. Bulgular: Çalışmaya alınan hastalarda Artralji sıklığı %90,20, artrit %64,8, döküntü %82,0, lenfadenopati %36,90, ateş %34,4, karın ağrısı ise %13,90 oranında bulundu. Hastaların %49 unda ilaç kullanımı, ilaç kullanım öyküsü bulunan hastaların da %80'inde antibiyotik kullanım öyküsü olduğu tespit edildi. Antibiyotik kullanım öyküsü olan hastaların %61,7'sinin de amoksisilin klavunat kullandığı görüldü. Hastaların %70,5'inde hastalık öncesi enfeksiyon geçirme öyküsü mevcuttu. Bunların %8'i akut gastroenterit, %1,6'sı yumuşak doku enfeksiyonu, %1,6'sı idrar yolu enfeksiyonu ve %59'u ise üst solunum yolu enfeksiyonu öyküsü olan hastalardı. Laboratuvar bulgulartı incelendiğinde 48 (%40) hastada artmış lökositoz sayısı tespit edildi. Eritrosit sedimentasyon hızı (ESR) hastane referans aralıklarına göre incelendiğinde 89 (%72) hastada yüksek bulundu. CRP değerleri hastanemiz referans aralıklarına göre incelendiğinde 66 hastada (%54) yüksek bulundu. Hastaların tedavisinde uygulanan steroid şeması ile hastaların %90'ının klinik bulgularının tamamen kaybolduğu, akut faz değerlerinin normal aralığa gerilediği görülmüştür. Sonuç: Çalışmaya alınan hastaların çoğunda antibiyotik kullanımı özellikle Amoksisilin-Klavunat kullanımı tespit edildi. Hastalar büyük oranda ateş, artralji, artrit, lenfadenopati klinik bulguları ile başvurdu. Laboratuvar bulgularında lökositoz, sedimetasyon ve crp yüksekliği tespit edildi. Tedavide büyük oranda steroidler tercih edildi ve %90 oranında iyileşme sağlandı.
Aim: After various antigenic stimuli and especially the increased use of antibiotics, serum sickness-like reaction (SSLR) is being described with increasing frequency. The study aimed to reveal important data about the etiology, risk factors, treatment and prognosis of the disease. At the same time, it was aimed to raise awareness among clinicians about this very common reaction and to contribute to the development of a common treatment modality. Materials and Methods: The files of 122 patients who were followed up with the diagnosis of SSLR at the Selçuk University Faculty of Medicine Hospital Child Health and Diseases Clinic between September 2016 and January 2022 were retrospectively examined. Complete blood count, C-reactive protein, erythrocyte sedimentation rate, serum electrolytes, blood glucose, urea and liver function tests of the patients were examined. The patients' gender, age, duration of hospitalization, accompanying clinical findings, family history of atopy, and previous infection and medication history were obtained from the electronic file information. Statistical analysis was performed with the SPSS (IBM SPSS Statistics V22.0, SPSS Inc., USA) package program. Results: In the patients included in the study, the frequency of arthralgia was found to be 90.20%, arthritis 64.8%, rash 82.0%, lymphadenopathy 36.90%, fever 34.4%, and abdominal pain 13.90%. It was determined that 49% of the patients had a history of drug use, and 80% of the patients with a history of drug use had a history of antibiotic use. It was observed that 61.7% of the patients with a history of antibiotic use also used amoxicillin clavunate. 70.5% of the patients had a history of infection before the disease. Of these, 8% were patients with a history of acute gastroenteritis, 1.6% with soft tissue infection, 1.6% with urinary tract infection, and 59% with a history of upper respiratory tract infection. When laboratory findings were examined, an increased number of leukocytosis was detected in 48 (40%) patients. When erythrocyte sedimentation rate (ESR) was analyzed according to hospital reference ranges, it was found to be high in 89 (72%) patients. When CRP values were examined according to our hospital's reference ranges, it was found to be high in 66 patients (54%). With the steroid scheme applied in the treatment of the patients, it was observed that the clinical findings of 90% of the patients disappeared completely and the acute phase values decreased to the normal range. Conclusion: Antibiotic use, especially amoxicillin-clavunate use, was detected in most of the patients included in the study. Patients mostly presented with clinical findings of fever, arthralgia, arthritis and lymphadenopathy. Laboratory findings revealed leukocytosis, sedimentation and elevated CRP. Steroids were largely preferred in treatment and a 90% recovery rate was achieved.
Aim: After various antigenic stimuli and especially the increased use of antibiotics, serum sickness-like reaction (SSLR) is being described with increasing frequency. The study aimed to reveal important data about the etiology, risk factors, treatment and prognosis of the disease. At the same time, it was aimed to raise awareness among clinicians about this very common reaction and to contribute to the development of a common treatment modality. Materials and Methods: The files of 122 patients who were followed up with the diagnosis of SSLR at the Selçuk University Faculty of Medicine Hospital Child Health and Diseases Clinic between September 2016 and January 2022 were retrospectively examined. Complete blood count, C-reactive protein, erythrocyte sedimentation rate, serum electrolytes, blood glucose, urea and liver function tests of the patients were examined. The patients' gender, age, duration of hospitalization, accompanying clinical findings, family history of atopy, and previous infection and medication history were obtained from the electronic file information. Statistical analysis was performed with the SPSS (IBM SPSS Statistics V22.0, SPSS Inc., USA) package program. Results: In the patients included in the study, the frequency of arthralgia was found to be 90.20%, arthritis 64.8%, rash 82.0%, lymphadenopathy 36.90%, fever 34.4%, and abdominal pain 13.90%. It was determined that 49% of the patients had a history of drug use, and 80% of the patients with a history of drug use had a history of antibiotic use. It was observed that 61.7% of the patients with a history of antibiotic use also used amoxicillin clavunate. 70.5% of the patients had a history of infection before the disease. Of these, 8% were patients with a history of acute gastroenteritis, 1.6% with soft tissue infection, 1.6% with urinary tract infection, and 59% with a history of upper respiratory tract infection. When laboratory findings were examined, an increased number of leukocytosis was detected in 48 (40%) patients. When erythrocyte sedimentation rate (ESR) was analyzed according to hospital reference ranges, it was found to be high in 89 (72%) patients. When CRP values were examined according to our hospital's reference ranges, it was found to be high in 66 patients (54%). With the steroid scheme applied in the treatment of the patients, it was observed that the clinical findings of 90% of the patients disappeared completely and the acute phase values decreased to the normal range. Conclusion: Antibiotic use, especially amoxicillin-clavunate use, was detected in most of the patients included in the study. Patients mostly presented with clinical findings of fever, arthralgia, arthritis and lymphadenopathy. Laboratory findings revealed leukocytosis, sedimentation and elevated CRP. Steroids were largely preferred in treatment and a 90% recovery rate was achieved.
Açıklama
Anahtar Kelimeler
SSLR, Artrit, Serum Hastalığı, Tip 3 Reaksiyon, Aşırı Duyarlılık, Arthritis, Serum Sickness, Type 3 Reaction, Hypersensitivity
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Salar, S. T. (2023). Selçuk Üniversitesi Tıp fakültesi Hastanesi Çocuk Romatoloji kliniğinde serum benzeri reaksiyon tanısı ile takip edilen hastaların retrospektif olarak değerlendirilmesi. (Uzmanlık Tezi). Selçuk Üniversitesi, Tıp Fakültesi, Konya.
