Öz
Granülomatöz polianjiit birçok sistemi tutan, hayatı
tehdit eden bir hastalıktır. Tedavi stratejileri hastalığı iyileştirdiği gibi
enfeksiyonlara yatkınlığı da arttırmaktadır. Enfeksiyonlar tanının ilk
yılındaki en önemli ölüm nedenidir. Hastalığın seyrinde görülebilen
enfeksiyonlar hastalık aktivasyonu ile ayırıcı tanıda her zaman düşünülmelidir.
Ayırıcı tanıda klinik seyir, laboratuvar tetkikleri, patolojik incelemeler ve
radyolojik görüntülemeler yardımcı olmaktadır. Granülomatöz polianjiit tanısı
ile izlediğimiz olgumuzda hastalık aktivasyonu ile karışabilecek enfeksiyonlara
dikkat çekmeye çalıştık.
Anahtar Kelimeler
Polianjiitli granülomatozis enfeksiyon immünsupresif ajanlar.
Kaynakça
- Ntatsaki E, Watts RA, Scott DG. Epidemiology of ANCA-associated vasculitis. Rheum Dis Clin North Am 2010;36(3):447-61.
- Walton EW. Giant-cell granuloma of the respiratory tract (Wegener’s granulomatosis). Br Med J 1958;2(5091):265-70.
- Schonermarck U, Gross WL, de Groot K. Treatment of ANCAassociated vasculitis. Nat Rev Nephrol 2014;10(1):25-36.
- Holle JU, Gross WL, Latza U, Nolle B, et al. Improved outcome in 445 patients with Wegener’s granulomatosis in a German vasculitis center over four decades. Arthritis Rheum 2011;63(1):257-66.
- Cartin-Ceba R, Golbin JM, Keogh KA, et al. Rituximab for remission induction and maintenance in refractory granulomatosis with polyangiitis (Wegener’s): Ten-year experience at a single center. Arthritis Rheum 2012;64(11):3770-8.
- Flossmann O, Berden A, de Groot K, et al. Long-term patient survival in ANCA-associated vasculitis. Ann Rheum Dis 2011;70(3):488-94.
- Frary EC, Hess S, Gerke O, Laustrup H. 18F-fluoro-deoxy-glucose positron emission tomography combined with computed tomography can reliably rule-out infection and cancer in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis suspected of disease relapse. Medicine (Baltimore). 2017;96(30):e7613.
- Kronbichler A, Jayne DR, Mayer G. Frequency, risk factors and prophylaxis of infection in ANCA-associated vasculitis. Eur J Clin Invest 2015;45(3):346-68.
- Charlier C, Henegar C, Launay O, et al. Risk factors for major infections in Wegener granulomatosis: Analysis of 113 patients. Ann Rheum Dis 2009;68(5):658-63.
- Weidanz F, Day CJ, Hewins P, Savage CO, Harper L. Recurrences and infections during continuous immunosuppressive therapy after beginning dialysis in ANCA-associated vasculitis. Am J Kidney Dis 2007;50(1):36-46.
Öz
Granulomatosis with polyangiitis is a life-threatening
disease that affects many systems. Treatment strategies improve the disease but
also increase the susceptibility to infections. Infections are the most
important cause of death within the first year of diagnosis. The infections
that can be seen in the course of the disease should always be considered in
the differential diagnosis with disease activation. Clinical course, laboratory
examinations, pathological examinations and radiological imaging are helpful in
differential diagnosis. With the diagnosis of granulomatous polyangiitis in our
case, we tried to draw attention to infections that could be confused with
disease activation.
Anahtar Kelimeler
Granulomatosis with polyangiitis infection immunosuppressive agents.
Kaynakça
- Ntatsaki E, Watts RA, Scott DG. Epidemiology of ANCA-associated vasculitis. Rheum Dis Clin North Am 2010;36(3):447-61.
- Walton EW. Giant-cell granuloma of the respiratory tract (Wegener’s granulomatosis). Br Med J 1958;2(5091):265-70.
- Schonermarck U, Gross WL, de Groot K. Treatment of ANCAassociated vasculitis. Nat Rev Nephrol 2014;10(1):25-36.
- Holle JU, Gross WL, Latza U, Nolle B, et al. Improved outcome in 445 patients with Wegener’s granulomatosis in a German vasculitis center over four decades. Arthritis Rheum 2011;63(1):257-66.
- Cartin-Ceba R, Golbin JM, Keogh KA, et al. Rituximab for remission induction and maintenance in refractory granulomatosis with polyangiitis (Wegener’s): Ten-year experience at a single center. Arthritis Rheum 2012;64(11):3770-8.
- Flossmann O, Berden A, de Groot K, et al. Long-term patient survival in ANCA-associated vasculitis. Ann Rheum Dis 2011;70(3):488-94.
- Frary EC, Hess S, Gerke O, Laustrup H. 18F-fluoro-deoxy-glucose positron emission tomography combined with computed tomography can reliably rule-out infection and cancer in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis suspected of disease relapse. Medicine (Baltimore). 2017;96(30):e7613.
- Kronbichler A, Jayne DR, Mayer G. Frequency, risk factors and prophylaxis of infection in ANCA-associated vasculitis. Eur J Clin Invest 2015;45(3):346-68.
- Charlier C, Henegar C, Launay O, et al. Risk factors for major infections in Wegener granulomatosis: Analysis of 113 patients. Ann Rheum Dis 2009;68(5):658-63.
- Weidanz F, Day CJ, Hewins P, Savage CO, Harper L. Recurrences and infections during continuous immunosuppressive therapy after beginning dialysis in ANCA-associated vasculitis. Am J Kidney Dis 2007;50(1):36-46.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 14 Eylül 2018 |
| Gönderilme Tarihi | 16 Mayıs 2017 |
| Yayımlandığı Sayı | Yıl 2018 |