Ayşegül Taylan Özkan, Gülsüm İclal Bayhan, Yunus Emre Beyhan

Çocukluk çağı fasioliyaz olgularımızın klinik özellikleri

Fasioliyaz Fasciola hepatica ve F. gigantica’nın neden olduğu bir trematod enfeksiyonudur. Fasciola hepatica Türkiye’de mezoendemiktir. Burada altı çocuk fasioliyaz hastası sunuldu. Dört olgu hepatik fazda, iki olgu biliyer fazdaydı. Tüm hastalarda çeşitli çiğ sebzelerin tüketimi öyküsü vardı. Bir hasta dışında tüm hastalarda eozinofili saptandı. Üç hastada total IgE düzeyi belirgin şekilde yüksek bulundu. Bu hastalarda total IgE düzeyi yüksekliğine eşlik eden eozinofilik lökomoid reaksiyon vardı. Bir hasta dışında tüm hastalarda indirekt hemagglütinasyon testi pozitifti, bu testin negatif bulunduğu hastaya fasioliyazis tanısı uyumlu klinik bulgular ile konuldu. Bir hasta dışında tüm hastalar tek kür triklabendazol tedavisi ile iyileşti. Bir hastada ikinci kür triklabendazol tedavisi gerekti. Triklabendazol tedavisini önerilenden uzun kullanan bir hastada karaciğer enzimlerinde yükselme gözlendi. Bu hasta dışında hiçbir hastada triklabendazole bağlı karaciğer enzimlerinde yükselme saptanmadı. Tüm hastalarımız triklabendazol tedavisi ile tam olarak iyileşti. Sonuç olarak hastaların beslenme alışkanlıkları, eozinofili ve belirgin olarak yükselmiş IgE düzeyleri fasioliyazdan şüphelendirici önemli belirteçlerdir.

The clinical characteristics of fascioliasis in pediatric patients

Fascioliasis is a trematode flatworm infection caused by Fasciola hepatica and F. gigantica. Fasciola hepatica is mesoendemic in Turkey. Sixcases of pediatric fascioliasis are presented here. All patients had histories of consumption of various raw vegetables. Four of our patients wereat the hepatic phase, and two were at the biliary phase. Except for onepatient, all patients had eosinophilia. In three patients, total IgE levelswere markedly increased. In these patients, there was an eosinophilicleukomoid reaction accompanied by a high total IgE level. Except forone of our patients, all patients had positive indirect hemagglutinationtests. This patient was diagnosed as having fascioliasis with a compatible clinical picture. Except one, all of our patients were completelytreated with a single-treatment regimen of triclabendazole; one patientneeded re-administration. Only in patient 1, liver enzymes increased after triclabendazole administration because he had taken the medicationfor longer than prescribed by mistake. The elevation of liver enzymeswas not observed in the other patients who received the correct dose.All patients recovered completely with triclabendazole treatment. Thepatients’ dietary habits, eosinophilia, and markedly elevated IgE levelsmay be significant predictors for physicians to suspect fascioliasis.

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