İlaç Tedavisine Yanıt vermeyen, Hızlı İlerleyen Ağır Ülseratif Kolit Olgusu
İki aydır kanlı ishali olan 15 yaşında kız hasta sunuldu. Olgu, klinik ve labaratuar bulgularla ülseratif kolit tanısı aldı. Yüksek doz kortikosteroid ve siklosporin tedavilerine cevap alınamadığı için kolektomi yapıldı. Bu olgu nedeniylefulminan kolitli ülseratifçocuklarda ilaç tedavisine cevap alınamıyorsa hızlı kolektomi yapılabileceği düşünüldü.
A CASE OF FULMINANT PROGRESSIVE SEVERE
ULCERATIVE COLITIS, REFRACTORYTO MEDICAL TREATMENT
A 15-year-old girl presented with bloody diarrhea for 2 months duration. Ulcerative colitis was diagnosed with clinical and laboratory findings. Because high dose intravenous corticosteroids and cyclosporin treatments were failed, she underwent coledomy. Therefore children with severe fulminant colitis who do not respond to medical therapy, colectomy should be considered immediately.
___
- 1. Leichtner AM,Higuchi L. Ulcetative Colitis. In: Wlker WA,Goulet OJ,
Kleinman RE,Sherman PM, Sanderson IR,eds. Pediatric Gastrointestina.I Disease: Pathopbysiology, Diagnosis,Manegement. 4th
cd.BC Dcclı:cr CO. 2004;825-849.
- 2. Kı.ıgathasan S, Dubinski MC, Kdjo D, Mayct MS, Rufa PA, Wyllic R,
Zachos M, Hyams J. Severe colitis in childrcn. J Pcdiatt Gcstrocnt.erol
Nutt. 2005; 41: 375-385.
- 3. Cuff:ari C, Prcsent DH, Baylcss TM, Lichtcruıtein GR. Opt:imizing
therapy in patiets with pancolitis. Inflaınm Bowd Dis. 2005;11:937-
946.
- 4. RowcAF, WalkcrJH,KatpLC, Vasiliauskas EA, Plcvy SE, Tatgan SR
Facınrs pı:cdictive of rcsponse to cyclosporin tcntment far seven;
st.eroid-rcsistantulcerative colitis.Am J Gasttoenterol. 2000;95:2000-
2008.
- 5. Gold DM,Levine JJ,Weinstein TA, Kesslet B, Pettei MJ. Ptolonged
medical therapy for severe pediatric ulcerative colitis. Am J Gastroentuol 1995;90:732-735.
- 6. Travis SP, Farıant JM,Ricketts C, Nalan DJ, Mortcruıcn NM, Kettlcwcll MG, Jcwcll DP. Prcdicting outcome in severc ulcerative colitis.
Gut 1996; 38: 905-910.
- 7. Durai D, Hawthome AB. Rev:iewarticle: how and when to use ciclosporin in ulcerative colitis.Aliment Plıarnıacol Thct 2005; 22: 907-
916.
- 8. HyamsJS,Davis P, Gtanchcr K,Le=TJustinich CJ,Marl