Müfide OKAY ÖZGEYİK, Ozge AYBI, Hakan GOKER

Lösemi hastasında Sefepim Kullanımına Bağlı Görülen Stevens-Johnson Sendromu: Olgu Sunumu

Giriş: Stevens-Johnson sendromu (SJS) ve toksik epidermal nekrolizis (TEN) ilaçlarla tetiklenen ciddi mukokütanöz reaksiyonlardır. Burada, ilk kez sefepim kullanımına bağlı SJS/TEN sendromu geliştiren relaps akut myeloid lösemi (AML) hastasını sunduk. Olgu sunumu: 59 yaşında AML tanılı erkek hasta, kök hücre transplantasyonundan 12 ay sonraki kemik iliğinde %25 blast görüldü. Nötropenik ateş tablosu geliştiren hastaya sefepim tedavisi başlandı. Tedaviden 1 gün sonra, bazıları ürtikeryal lezyonlar geliştiği için seftazidime geçildi. Seftazidinden 2 gün sonra vücutta dökülme şeklinde lezyonlar görüldü. Büllöz eritema multiforme/SJS/TEN ayırıcı tanıda düşünüldü. Siklosporin 4 mg/kg/gün başlandı. Lezyonlar gerileme gösterdi. Sonuç: Hematolojik kanserlerde SJS/TEN’e yatkınlık artmış durumdadır. Klinisyenler bu hastalarda herhangi bir ilaç verilmesinden sonra vücutta gelişen döküntülerde uyanık olmalıdırlar.

Anahtar Kelimeler:

Stevens-Johnson Sendromu, Lösemi, Sefepim

Stevens-Johnson Syndrome Due to Cefepime Usage in A Leukemia Patient: A Case Report

Introduction: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe mucocutaneous reactions, triggered by medications. Herein, we first reported a relapse acute myeloid leukemia (AML) patient who developed SJS/TEN syndrome after cefepime (β-lactam antibiotic) use for neutropenic fever. Case report: A 50-year-old male patient with AML had 25% blast rate at bone marrow biopsy in the twelve months after stem cell transplantation. Due to neutropenic fever, cefepime was started. After one day, ceftazidime was started because of some urticaria like lesions. Desquamation of the body was seen 2 days after ceftazidime. Bullous erythema multiforme/SJS/TEN was considered in the differential diagnosis. Cyclosporine 4 mg/kg per day was started. There was an alleviation in the lesions. Conclusion: Susceptibility to SJS/TEN has somewhat increased hematological malignancies. Clinicians should be aware of any rashes occurring in the body after any medication, in these patients.

Keywords:

Stevens-Johnson Syndrome, Leukemia, Cefepime,

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