Ferit TANERİ, Baloş Füsun TÖRÜNER, Nuri ÇAKIR, Esen AKBAY, Gülyüz ÖZTÜRK, Ünlü Reyhan ERSOY, Göksan AYVAZ, İlhan YETKİN, Metin ARSLAN

Apheresis in the treatment of hyperthyroidism

Toksik noduler guatr olgularda hastalar ötiroid hale geldikten sonra cerrahi tedavi uygulanabilir. Bunun için kullanılan antitiroid ilaçların yan etkileri nedeniyle bu olguların preoperatif hazırlığı bazen çok zor olabilir. En ciddi yan etkilerden olan agranulositoz geliştiğinde ilacın kesilmesi gerekir. Bu durumda seçenekler son derece sınırlıdır. Aferez, antitiroid ilaçlara intolerans durumunda tirotoksik hastaların cerrahiye hazırlığı için kullanılabilecek bir yöntemdir. Antitiroid ilaçlara bağlı granulositopeni gelişen 56 yaşında hipertiroidili kadın hastada cerrahi öncesi uygulanan aferez vaka olarak sunulmaktadır.

Hipertiroidi tedavisinde aferez

In toxic nodular goiter, surgery is possible after the patient becomes euthyroid. Antithyroid drugs are used to achieve this state. Preoperative management of hyperthyroidism is sometimes very troublesome as some complications may be observed with the use of antithyroid drugs. One of the most dangerous adverse effects is agranulocytosis. When it occurs, ^cessation of the drug is necessary; and use of granulocyte colony-stimulating factor (G-CSF) may be effective. There are not many alternatives to antithyroid drugs for achieving euthyroidism. Apheresis may be a useful method in preoperative management ofthyrotoxic patients in intolerance to antithyroid drugs. We report a 56 year-old woman with hyperthyroidism and antithyroid drug-induced granulocytopenia, in whom apheresis was performed before surgery.

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