Primer İ mmü n Yetmezlik Tanısıyla Sübkütan İ mmü nglobü lin Alan Hastalarımızın Klinik İ zlemi

Primer immün yetmezliklerde enfeksiyonların önlenmesinde immünglobülin tedavisi uygulanmaktadır. Son yıllarda intravenöz yerine subkutan tedavi tercih edilmektedir. Bu çalışmada merkezimizde primer immün yetmezlik nedeniyle subkutan immünglobülin tedavisine geçilen hastaların demografik ve klinik özellikleri verilmiştir. 2014-2017 yılları arasında Eskişehir Osmangazi Üniversitesi Tıp Fakültesi Çocuk Alerji ve İmmünoloji kliniğinde primer immün yetmezlik tanısı ile subkutan tedaviye geçilen hastaların dosyaları retrospektif olarak incelendi. Çalışmaya primer immün yetmezlik tanılı 15 hasta alındı. Hastaların 9 (%60)’u erkek idi, yaşları en düşük 10 ay - en yüksek 15 yıl olarak saptandı. Hastaların üç tanesinde ataksi telenjektazi (%20), üç tanesinde ortak değişken immün yetmezlik (%20), 3 tanesinde X’e bağlı agamaglobülinemi (%20), bir tanesinde otozomal resesif agamaglobülinemi (%6.6), iki tanesinde sınıflandırılamayan hipogamaglobülinemi (%13.2), bir tanesinde geçici hipogamaglobülinemi (%6.6), bir tanesinde hiperimmünglobülin E sendromu (%6.6) ve bir tanesinde hiperimmünglobülin M sendromu (%6.6) tanısı mevcuttu. Ataksi telenjektazi ile takip edilen 3 hastanın 2’si subkutan immünglobülin tedavisinin 1. yılında geçirdikleri enfeksiyon nedeniyle hastaneye yatırılarak tedavi edildiler. Diğer hastaların 2 yıllık izlem sürecinde hastane yatışı gerektirecek enfeksiyonu kaydedilmedi. Tüm hastalar sonraki takiplerinde subkutan yolu tercih edeceklerini belirttiler. Sonuç olarak; subkutan yolla immünglobülin tedavisi, etkin, kolay ve emniyetli bir seçenektir

Clinical Follow üp of the Patients who Received Sübcütaneoüs İmmünoglobülin Treatment Düe to Primary İmmüne Defıciency

In primary immunodeficiencies, immunoglobulin therapy is applied to prevent infections. In recent years, subcutaneous treatment is preferred instead of intravenously. In this study, demographic and clinical characteristics of patients who underwent subcutaneous immunoglobulin treatment due to primary immunodeficiency in our center were given. The records of patients who underwent subcutaneous treatment with the diagnosis of primary immunodeficiency between 2014-2017 in Eskişehir Osmangazi University Faculty of Medicine Pediatric Allergy and Immunology clinic were analyzed retrospectively. 15 patients with primary immunodeficiency were included in the study.9 (60%) of the patients were male, their ages were determined as the lowest 10 months - highest 15 years. Ataxia telangiectasia in three patients (20%), common variable immune deficiency in three (20%), Xlinked agamaglobulinemia in three (20%), autosomal recessive agamaglobulinemia in one (6.6%), unclassified hypogamaglobulinemia in two (13.2%), transient hypogamaglobulinemia in one (6.6%), hyper IgE syndrome in one (6.6%) ,and hyper IgM syndrome in one (6.6%) detected. Two of the three patients (66.6%) who were followed with ataxia telangiectasia were hospitalized due to the infection they had in the first year of subcutaneous immunoglobulin treatment. During the 2-year follow-up period of other patients, no infection requiring hospitalization was recorded. All patients stated that they would prefer subcutaneous treatment in their follow-up. Consequently, subcutaneous immunoglobulin therapy is an effective, easy and safe option.

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