Şakir KATI, Cahit ÜÇOK, Muhit ÖZCAN, Selami TOPRAK

Waldenström makroglobulinemili bir hastada mandibuler inatçı enfeksiyon olgusu

Waldenström Makroglobulinemisi WM , farklılaşmış terminal B lenfositlerin neoplastik klonal proliferasyonuyla, aşırı IgM üretimiyle karakterize nadir görülen bir hastalıktır. Bu hastalık, monoklonal IgM proteiniyle karakterize lenfoplasmositik lenfomadır. Osteomiyelit ise; bir mikroorganizmanın infeksiyöz ve inflamatuar süreçler ile kemik dokuda hasar yaratması sonucu ortaya çıkan ilerleyici karakterde bir hastalıktır. Kemiğin sadece bir bölümü tutulabildiği gibi, medüller kanal, periost, korteks, ve çevre yumuşak dokuların tümü bu tabloya katılabilir. WM’li hastalarda muskuloskeletal enfeksiyonlar nadir görülür. Literatürde septik artrit vaka raporları oldukça nadirdir ve yayınlarda sadece bir bölgede lumbar vertebral bölgede osteomiyelit görülmüştür. Biz de bu çalışmada; WM’li bir hastada mandibulada gelişen inatçı enfeksiyon tablosunu, alınan kültürden edinilen bilgilerin ışığında, enfeksiyon kaynağı olan dişlerin çekimi, antibiyoterapi, anti-inflamatuar ilaçların kullandırılması ve hiperbarik oksijen tedavisi uygulaması ile değerlendirdik. 7. Ay sonundaki panoromik filme göre kemik dokuda iyileşmenin olduğu görülmüştür. Hastanın şikayetleri sona ermiş ve olumlu sonuçlar alınmıştır

Anahtar Kelimeler:

Sözcükler: Waldenström Makroglobulinemisi, ønatçÕ Enfeksiyon.

A case of stubborness infection in mandibula, in a patient with Waldenström Macroglobulinemia

Waldenström Macroglobulinemia WM is a rare disorder characterized by excessive IgM production resulting from neoplastic clonal proliferation of differentiated terminal B lymphocytes. This disorder is a lymphoplasmocytic lymphoma characterized by monoclonal IgM protein. Osteomyelitis is a progressive disease characterized by destruction of bone tissue by a microorganism through infectious and inflammatory processes. It may involve only a part of the bone although medullary canal, periosteum, cortex, and adjacent soft tissues may all be involved by the disease process. Musculoskeletal infections are rare in patients with WM. The septic arthritis cases in the previous literature are quite sparse and in studies osteomyelitis was observed at only one area at lumbal vertabral area. In this study we assessed a stubborness infection process in a patient with WM by treating her by extraction of the infectious teeth, antibiotherapy, anti-inflammatory agents, and hyperbaric oxygen therapy in the light of culture results. An improvement in panoramic film was observed after 7 months. The patient was free of her complaints, and a favorable outcome was achieved

Keywords:

Waldenström Macroglobulinemia, Stubborness Infection.,

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