Anti-D Uygulamasına Cevap Veren Refrakter İmmün Trombositopenik Purpura Olgusu
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Tarih
2003
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info:eu-repo/semantics/openAccess
Özet
Amaç: Immün trombositopenik purpura (İTP), trombositlerin yüzeyinde yer alan proteinlerin henüz tam olarak bilinmeyen nedenlerden dolayı antijenik bir özellik kazanması ile karakterizedir. Bu durum otoantikor oluşumuna yol açarak trombositopeni ve kanamaya eğilim ile sonuçlanır. Trombosit sayısı çok düşük olan hastalarda seyrek de olsa ciddi kanamalar görülebilir. Bu nedenle hastaların trombosit sayısının en kısa zamanda yükseltilmesi şarttır. Tedavi amacıyla hastalara glukokortikoid, intravenöz immünglobulin, anti-D ve splenektomi uygulamaları gündeme gelebilir. Bu tedaviler içinde, yalnızca Rh () hastalara uygulanabilen anti-D çok geniş bir kullanım alanı bulamamıştır. Olgu sunumu: Trombositopeni ile başvuran 24 yaşındaki bayan hastanın 8 yıldır kesin tanısının konulamadığı anlaşıldı. Hastaya ITP tanısı konularak intravenöz metilprednizolon, oral deksametazon ve intravenöz immünglobulin gibi etkinliği kanıtlanmış tedaviler uygulandı. Ancak yanıt alınamadı. Bunun üzerine standart tedavilere yanıt vermeyen olgularda kullanılabilen anti-D ile hastanın trombosit sayısı normale döndürüldü- Sonuç: Olgumuz uzun süre ITP tanısı kesinliğe kavuşturulamayan, ITP tanısı konulduktan sonra standart tedavilere cevap vermeyen, bu nedenle sık kullanım alanı bulamamış olan anti-D'ye verdiği olumlu cevap nedeni ile sunulmuştur.
Immune thrombocytopenic purpura (ITP) is characterized by autoantibodies directed to the proteins on the surface of thrombocytes due to an unknown reason. This results in autoantibody generation and thrombocytopenia leading to bleeding diathesis. Severe bleeding can be encountered in patients with very low platelet counts. So number of thrombocytes should be increased as soon as possible. Glucocorticoids, intravenous immunpglobUlins, anti-D and splenectomy may be the choices. Anti-D that is only applied to Rh () ones has extremely low chance of application. Case report: It was realized that although 24 years old female patient had been suffering thrombocytopenia for 8 year correct diagnosis had not been revealed. The patients was diagnosed as ITP and previously established treatment methods such as intravenous methylprednisolon, oral dexamethasone and intravenous immunoglobulins were tried but result was disappointing. So anti-D, a treatment method only used to resistant cases, was tried with success and thrombocyte count normalized. Conclusion: We present this case since its diagnosis of ITP was not proved for years and disease did not respond to standard measures of treatment and responded to anti-D.
Immune thrombocytopenic purpura (ITP) is characterized by autoantibodies directed to the proteins on the surface of thrombocytes due to an unknown reason. This results in autoantibody generation and thrombocytopenia leading to bleeding diathesis. Severe bleeding can be encountered in patients with very low platelet counts. So number of thrombocytes should be increased as soon as possible. Glucocorticoids, intravenous immunpglobUlins, anti-D and splenectomy may be the choices. Anti-D that is only applied to Rh () ones has extremely low chance of application. Case report: It was realized that although 24 years old female patient had been suffering thrombocytopenia for 8 year correct diagnosis had not been revealed. The patients was diagnosed as ITP and previously established treatment methods such as intravenous methylprednisolon, oral dexamethasone and intravenous immunoglobulins were tried but result was disappointing. So anti-D, a treatment method only used to resistant cases, was tried with success and thrombocyte count normalized. Conclusion: We present this case since its diagnosis of ITP was not proved for years and disease did not respond to standard measures of treatment and responded to anti-D.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp
Kaynak
Genel Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
13
Sayı
2
Künye
Kurtoğlu, E., Hidayetoğlu, T., (2003). Anti-D Uygulamasına Cevap Veren Refrakter İmmün Trombositopenik Purpura Olgusu. Genel Tıp Dergisi, 13(2), 73-75.
