FELTY SENDROMU: GRANÜLOSİT MAKROFAJ KOLONİ UYARICI FAKTÖR TEDAVİSİYLE BAŞARILI REMİSYON İNDÜKSİYONU VE SÜRDÜRME TEDAVİSİ

2002
Volume: 
65
Number: 
4
Sayfa Aralığı:: 
279-282
Publication Language: 
Turkish
Abstract (Original Language): 
Felty sendromu (FS), romatoid artritli (RA) hastalarda görülebilen ve splenomegali, lökopeni ve tekrarlayan infeksiyon bulgularıyla seyreden bir klinik tablodur. Burada, kronik poliartrit ile birlikte, splenomegali, lökopeni ve sepsis tablosuyla başvuran FS'li bir hasta sunuldu. Hastalığın başlangıcında antibiyoterapi ve granülosit koloni uyarıcı faktör (G-CSF) tedavisi ile lökopeni ve sepsis tablosu kontrol altına alınabildi. Ancak, takibi süresince farklı zamanlarda uygulanan yüksek doz kortikosteroid, hidroksiklorokin, metotreksat ve siklosporin-A tedavileri ile eklem bulguları düzelirken lökopeni sebat etti. Haftada Uç gün olmak üzere 30 MÜ/gün dozunda "siklik" G-CSF tedavisi başlanan ve lökopenisi düzelen hastaya splenektomi uygulandı. Splenektomi sonrası ikinci ayda lökopeninin nüksetmesi üzerine, yeniden siklik G-CSF uygulamasına geçildi. Hasta halen takibinin 8. ayında remisyonda izlenmektedir. FS'de G-CSF tedavisi gerek remisyon indüksiyonu gerekse sürdürme tedavisinde etkili ve güvenilir bir tedavi seçeneği olarak görünmektedir.
Abstract (2. Language): 
Felty's syndrome: Sııcesfııl remission indıtction and maintenance therapy witlı grcmıdocyte macrophage colony stimulating factor. Felty's syndrome (FS) is a dinieal piclııre clnıractori-zed vvith splenomegaly, leucopenia and recurrent infections in patients with rheumatoid arthri-tis (RA). FS was accepted as a rare and potentially fatal extraaıticular manifestation of RA. Herein, we presented a patient with FS who was admitted with splenomegaly, leucopenia and septicemia in addition to chronic polyarthritis. Although the articular symptoms were control-led by antibiotherapy and high dose corticosteroid treatment, leucopenia sustained. High dose corticosteroids, hydroxychloroquin, methotrexate and cyclosporin-A were tried during the fol-low-up which were succesfull in treating articular symptoms, but not leucopenia. Cyclic G-CSF treatment was started as 30 MÜ/d at three times v/eekly and after the improvement of leu-cocyte count, splenectomy was performed. Leucocyte count was not returned to normal levels after splenectomy and cyclic G-CSF treatment was restarted. The patient has been stili in remission for 8 months with G-CSF treatment. G-CSF treatment seems to be an effective and safe option for both remission induction and maintenance therapy in FS.
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Sürdürme Tedavisi
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