İki Haftada Yedi Pulmoner Renal Sendrom Olgusu. RPGN Mevsimi Mi?

Yıl 2014, Cilt: 3 Sayı: 3, 967 - 975, 01.07.2014

Ali Gürel Bilge Aygen Hüseyin Çeliker Ayhan Doğukan

Öz

Pulmoner renal sendrom genellikle diffüz alveoler hemoraji ve özellikle hızlı ilerleyen glomerulonefrit şeklindeki otoimmün glomerüler tutulumla ortaya çıkar. Hızlı ilerleyen glomerulonefrit ve/ veya pulmoner renal sendromun tedavisi zor olsa da, yüksek doz metilprednizolon, siklofosfamid gibi sitotoksik ajanlar ve plazmaferez hayat kurtarıcı olabilmektedir. Güçlü klinik kuşku varlığında, hastalığın erken dönemlerinde histopatolojik değerlendirme öncesi ve hatta yokluğunda erken tanı ve tedavi gereklidir. Lupus nefriti, Wegener granülomatozisi ve anti nötrofil sitoplasmik antikor ilişkili glomerülonefritlerin mevsimsel ortaya çıkma eğilimleri olduğu bilinmektedir. Farklı hastalıkların bu mevsimsel ortaya çıkma eğilimi, altta yatan patojenik tetikleyici faktörleri yansıtıyor olabilir.Yedi olgumuzun tümü ilkbahar döneminde ve iki haftalık süreç içinde kliniğimize başvurdu. Gözlemlerimiz, hızlı ilerleyen glomerulonefrit ve/ veya pulmoner renal sendromunun mevsimsel ortaya çıkma eğilimi olabileceği yönündedir.

Anahtar Kelimeler

Hızlı İlerleyen Glomerulonefrit, Pulmoner Renal Sendrom, Mevsim

SEVEN CASES OF PULMONARY- RENAL SYNDROME IN TWO WEEK. IS IT RPGN SEASON?

Öz

Pulmonary-renal syndrome (PRS) generally presents with diffuse alveolar haemmorhage (DAH) and autoimmune mediated glomerular involvement especially rapidly progressive glomerulonephritis (RPGN). Although treatment of RPGN and/or PRS is difficult, high dose methylprednisolone, cytotoxic agents such as cyclophosphamide and plasmapheresis can be life saving. Early diagnosis and treatment is necessary even in strong clinical suspicion at early stages of the diseases before or without histopathological evaluation. It is known that lupus nephritis, Wegener’s granulomatosis, anti neutrophil cytoplasmic antibody (ANCA) associated glomerulonephritis have seasonal occurance tendency. Seasonal distributions of various diseases may reflect different pathogenic triggers that underly. All seven of our patients were addmitted to our clinic in two week period in early spring season. According to our observations, RPGN and/or pulmonary-renal syndromes may have a seasonal occurance tendency.

Anahtar Kelimeler

Rapidly Progressive Glomerulonephritis, Pulmonary Renal Syndrome, Season

Kaynakça

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