Savaş SEREL, Murat EMİROĞLU, Sadık ERSÖZ

Ksantomlar: Eksizyon gerçekten gerekli mi?

Ksantomatozis lipit içeren hücrelerin cilt ve visseral organlarda lokalize infiltrasyonlarının görüldüğü geniş bir hastalık grubudur. Burada 19 yaşında Familial Hiperkolesterolemi'li bir hastaya T 998 eylül ayında ortotopik karaciğer tranplantasyonu yapılan, eş zamanlı olarak ksantomlardan bazıları eliptik olarak eksize edilerek primer onarılan bir olgu sunuldu. Bu hastada transplantasyondan yaklaşık 12 ay sonra eksize edilmeyen ksantomların serum kolesterol seviyesinin düşmesi sonucu ilerleyici olarak kaybolduğu görüldü. Bu nedenle Familial Kolesterolemi'li hastaların eğer transplantasyon şansı varsa transplantas-yon öncesi ksantomların eksizyonunun gereksiz olduğuna inanıyoruz.

Xanthomas: Is excision really necessary?

Xanthomatoses are widespread disorders in which localized infiltrates of lipid-containing cells appear in the skin and visceral organs. We preseni a 19 year old girl with Familial Hypercholosterolemia (FH) who was operated for orthotophic liver transplantation in September 1988. Simultaneously, some of the xanthomas were treated by simple eliptic excision and primary closure. in this patient approximately 12 months after the liver transplantation xanthomas that were not treated progressively disappeared as a result of the decrease in the serum cholesterol levels . We believe that it is not necessary to excise xanthomas in patients with Familial Hypercholosterolemia before transplantation if they have a chance of it.

PDF

___

1. Ruggero Caputo, Marcello Monti, Emilio Betti. Nor- molipemic Eruptive Cutaneous Xanthomatosis. Arch Dermatol 1986: 122: 1294-1297.
2. Kristi J. Robson, Warren W. Piette. Cutaneous Mani- festaions of Systemic Disorders. Medical Clinics of North America. Vol 82 No 6 1998: 1367-1368.
3. John K. Brooks. Gingival and Cutaneous Xanthoma- tosis Associated with Primary Biliary Cirrhosis. Oral Surg Oral Med Oral Pathol 1990;70(6):744-747.
4. M. G. Peters, J. H. Hoofagle, C. McGarvey. Primary Biliar Cirrhosis: Management of An Unusual Case With Severe Xanthomata by Hepatic Transplantati- on. J Clin Gastroenterol 1989 11 (6): 694-7. 5. Goldstein JL, Brown MS. Familial hypercholestero-lemia In: Stanburg JB, Wyngaarden JB, Fredrickson DS, Goldstein Jl, Brown Ms, eds. The Metabolic Basis of Inherited Disease. New York: McGraw Hill, 1983:672-712.
6. Hoeg JF, Starzl TE, Brewer HB. Liver Transplantation for Treatment of Cardiovascular Disease: Comparison With Medication and Plasma Excahnge in Homozygeus Familial Hypercholesterolemia. The American Journal of Cardiology. 1987: Volume 59; 705-707.