Ferda BİLGİR

5074

STANDART DOZ STEROİDE DİRENÇLİ KRONİK İMMÜN TROMBOSİTOPENİDE SPLENEKTOMİYE HAZIRLAYICI REJİM OLARAK YÜKSEK DOZ METİL PREDNİZOLON’UN ETKİNLİĞİ

Amaç: İmmüntrombositopeni (ITP), immün yıkım nedeniyle trombosit sayısının azalması ve yaşam süresinin kısalması sonucu gelişen edinsel bir hastalıktır. 1. Basamak tedavide standart doz steroid kullanılmaktadır. Bu tedaviye yanıtsız hastalarda birçok ajan kullanılmakla birlikte splenektomiye üstünlükleri bulunmamaktadır. Kliniğimizde splenektomi uygulanan hastalarımızda hazırlayıcı rejim olarak yüksek doz prednizolonun etkinliğini araştırdık. Gereç ve Yöntem: Bu çalışmada 1996 - 1999 yılları arasında tedavi ve takipleri merkezimizce yapılan standart doz steroide dirençli oldukları için splenektomi uygulanan kronik ITP’li35 hastanın sonuçları değerlendirilmiştir. Bulgular: 35 hastanın 25’i kadın (%71,4), 10’u erkek, ortanca yaş 39,91 (17 - 79 yıl), hastalığın süresi 3 (1-9)yıl idi. Tüm hastalar başlangıç tedavisi olarak 1 mg/kg metil prednizolon almıştı. Bu tedaviye yeterli yanıt vermeyen ya da yanıt sonrası nüks eden bu hastalara splenektomi uygulandı.Trombosit değerleri 3x109 /L ile 48x109 /L arasında değişmekteydi (ortalama 18,94 x109 /L). Splenektomiye hazırlayıcı rejim olarak yüksek doz metil prednizolon kulllanıldı. Hazırlık sürecinde ve splenektomi sonrasında hastalarda önemli bir yan etki olmadı ve tedaviye tam yanıt alındı. Sonuç: Standart doz prednizolon tedavisine dirençli ITP hastalarında splenektomiye hazırlık rejimi olarak yüksek doz metil prednizolon etkili ve güvenli bir tedavi seçeneğidir.

EFFECTIVENESS OF HIGH DOSE METHYL PREDNISOLON AS STANDART DOSE STEROID-RESISTANT CHRONIC IMMUNE THROMBOCYTOPENIA SPLENECTOMY PREPARING REGIME

Introduction: Immune thrombocytopenia (ITP) is an acquired disease that results in reduced platelet count and shortened life span due to immun destruction. Standard dose steroid is used in the 1st step treatment. There are no advantages of splenectomy with the use of many agents in this treatment-free patients. We investigated the efficacy of high dose prednisolone as a preparatory regimen in our patients who underwent splenectomy in our clinic. Material and Methods: This study evaluated the outcomes of 35 patients with chronic ITP who underwent splenectomy because of their standardized dose of steroids resistant to treatment and follow-up between 1996 and 1999. Results: Of the 35 patients, 25 were female (71.4%), 10 were male, median age was 39.91 (17-79 years), and duration of illness was 3 (1-9) years. All patients received 1 mg / kg methylprednisolone as initial therapy. Splenectomy was performed for this patient who did not respondad equately to this treatment or relapsed after the response. Platelet count ranged from 3x109 /L to 48x109 /L (mean 18.94x109 /L). High-dose methylprednisolone was used as the splenectomy preparation regimen. There was no significant side effect in the preparation process and after splenectomy and the treatment was complete response. Conclusion: High dose methylprednisolone is an effective and safe treatment option for splenectomy preparation in ITP patients resistant to standard dose prednisolone treatment.
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İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi-Cover
  • ISSN: 1305-5151
  • Başlangıç: 1995
  • Yayıncı: İzmir Bozyaka Eğitim ve Araştırma Hastanesi
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