Abstract
Amaç: Otoimmun Hemolitik Anemi (OİHA), hastanın kendi eritrositlerine karşı gelişen antikorlar nedeni ile anemi gelişen bir hastalıktır. İdiopatik olabileceği gibi altta yatan ikincil bir nedenle de gelişebilir. Bu çalışmada OİHA nedenleri, tedavi yaklaşımları ve prognozları tartışılmıştır.
Gereç ve yöntemler: Nisan 2014-Nisan 2019 yılları arasında Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi Hastanesi İç Hastalıkları servislerinde OİHA tanısı alan 9 hastanın tıbbi kayıtları retrospektif olarak değerlendirilmiştir. Hastaların demografik özellikleri, ek hastalıkları, kullandıkları ilaçlar, kan tetkikleri, radyolojik verileri ve uygulanan tedaviler incelenmiştir.
Bulgular: OİHA tanısı alan ortalama yaşı 65,8 yıl , 3’ü erkek 6’i kadın olan toplam 9 hasta değerlendirilmiştir. 2 hastada etyolojide ilaç, 2 hastada SLE(Sistemik Lupus Eritematosis), 1 hastada NHL(NonHodgkin Lenfoma), 1’inde meme kanseri, 1’inde mide kanseri, 1 hastada idiopatik, 1 hastada ise ileri tetkiğe izin verilemediği için etyolojisi saptanamamıştır.
Hastaların hepsinde intra venöz 6-8 haftalık prednizolon tedavisinin ardından hemoliz tablolarının düzeldiği görülmüştür. NHL olan hastanın nüks olduğu saptanmıştır ve hastaya primer hastalığına yönelik tedavi başlanmıştır. Hastaların hiçbirinde mortalite görülmemiştir.
Sonuç: OİHA tanısı klinik ve laboratuvar bulgularla konulur. OİHA, önemli morbidite ve mortalite nedeni olabilir. Uygun tanı ve tedavi yaklaşımıyla morbidite ve mortaliteyi azaltmak mümkündür.
References
- 1. Gehrs BC, Friedberg RC. Autoimmune hemolytic anemia. Am J Hematol 69:258-271, 2002. 2. Bas GF , Tuscano ET , Tuscano JM . Diagnosis and classification of autoimmune hemolytic anemia Autoimmun Rev. 2014 Apr-May; 13 (4-5): 560-4 3. Lechner K, Jager U. How I treat autoimmune hemolytic anemias in adults. Blood 2010;116:1831-1838. 4. Zulfiqar AA, Pennaforte JL, Andres E. Autoimmune Hemolytic Anemia in Individuals Aged 75 and Older: A Study of 10 Individuals. J Geriatr Soc . 2016 Jun; 64 (6): 1372-4 5. Váróczy L, Gergely L, Zeher M, Szegedi G, Illés A. Malignant lymphoma-associated autoimmune diseases--a descriptive epidemiological study. Rheumatol Int 2002; 22(6):233-237. 6. Mujahid A. Rizvi, Andrew M. Evens, Martin S. Tallman, Beverly P. Nelson and Steven T. Rosen. T-Cell Non-Hodgkin Lymphoma. Blood 2006; 107: 1255-1264. 7. Stockwell DC, Bell MJ, Wong EC, Luban NL. Ceftriaxone-induced hemolytic anemia and hepatitis in an adolescent with hemoglobin sc disease (hbsc): 640. Crit Care Med 2004; 32(12):A180. 8. Bertolaccini ML, Hughes GRV, Khamasta MA .Systemic lupus erythematosus. In Daignostic Criteria in Autoimmune Diseases, Shoenfeld Y, Cervera R, Gershwin ME (eds) Humana Press, NewJersey USA, 2008 pp:3-8. 9. Shah A. Acquired hemolyic anemia. Indian J Med Sci 2004;58:533-6. 10. Neff AT.Autoimmune hemolytic anemias.In:Wintrobes Clinical Hematology. Greer JP, Foerster J, Lukens JN, Rodgers GM, Paraskevas F, Glader B(eds).11th ed. Philadelphia, Lippincot Williams & Wilkins 2004:1157- 1182. 11. Cunningham MJ, Silberstein LE.Autoimmune Hemolytic Anemia.In:Hematology Basic Principle and Practice.Hoffman R, Benz EJ, Shattil S, Furie B, Cohen HJ, Silberstein LE, McGlave P (eds).4th ed.Philadelphia, Elsevier Churchill Livingstone 2005:693-707.
Abstract
Objective: Autoimmune Hemolytic Anemia (OHRA) is anemia that develops due to antibodies against the patient's own erythrocytes. It may be idiopathic or may develop for an underlying secondary cause. In this study, the reasons, treatment approaches and prognosis of OIBA are discussed.
Material and methods: Medical records of 9 patients diagnosed with OIH between April 2014 and April 2019 in Recep Tayyip Erdogan University Medical Faculty Hospital Internal Medicine Department were retrospectively evaluated. Patients' demographic characteristics, comorbidities, drugs used, blood tests, radiological data and treatments were examined.
Results: A total of 9 patients (3 male, 6 female) with a mean age of 65.8 years were evaluated. The etiology could not be determined because 2 patients had no etiology of drug, 2 had SLE (Systemic Lupus Erythematosis), 1 had NHL (NonHodgkin Lymphoma), 1 had breast cancer, 1 had stomach cancer, 1 had idiopathic and 1 had no further investigation.
In all patients, hemolysis improved after 6 to 8 weeks of prednisolone treatment. The patient with NHL had a relapse, and treatment for primary disease was initiated. None of the patients had mortality.
Conclusion: The diagnosis of OIDA is made by clinical and laboratory findings. OIBA can be a major cause of morbidity and mortality. It is possible to reduce morbidity and mortality with appropriate diagnosis and treatment approach.
Keywords
References
- 1. Gehrs BC, Friedberg RC. Autoimmune hemolytic anemia. Am J Hematol 69:258-271, 2002. 2. Bas GF , Tuscano ET , Tuscano JM . Diagnosis and classification of autoimmune hemolytic anemia Autoimmun Rev. 2014 Apr-May; 13 (4-5): 560-4 3. Lechner K, Jager U. How I treat autoimmune hemolytic anemias in adults. Blood 2010;116:1831-1838. 4. Zulfiqar AA, Pennaforte JL, Andres E. Autoimmune Hemolytic Anemia in Individuals Aged 75 and Older: A Study of 10 Individuals. J Geriatr Soc . 2016 Jun; 64 (6): 1372-4 5. Váróczy L, Gergely L, Zeher M, Szegedi G, Illés A. Malignant lymphoma-associated autoimmune diseases--a descriptive epidemiological study. Rheumatol Int 2002; 22(6):233-237. 6. Mujahid A. Rizvi, Andrew M. Evens, Martin S. Tallman, Beverly P. Nelson and Steven T. Rosen. T-Cell Non-Hodgkin Lymphoma. Blood 2006; 107: 1255-1264. 7. Stockwell DC, Bell MJ, Wong EC, Luban NL. Ceftriaxone-induced hemolytic anemia and hepatitis in an adolescent with hemoglobin sc disease (hbsc): 640. Crit Care Med 2004; 32(12):A180. 8. Bertolaccini ML, Hughes GRV, Khamasta MA .Systemic lupus erythematosus. In Daignostic Criteria in Autoimmune Diseases, Shoenfeld Y, Cervera R, Gershwin ME (eds) Humana Press, NewJersey USA, 2008 pp:3-8. 9. Shah A. Acquired hemolyic anemia. Indian J Med Sci 2004;58:533-6. 10. Neff AT.Autoimmune hemolytic anemias.In:Wintrobes Clinical Hematology. Greer JP, Foerster J, Lukens JN, Rodgers GM, Paraskevas F, Glader B(eds).11th ed. Philadelphia, Lippincot Williams & Wilkins 2004:1157- 1182. 11. Cunningham MJ, Silberstein LE.Autoimmune Hemolytic Anemia.In:Hematology Basic Principle and Practice.Hoffman R, Benz EJ, Shattil S, Furie B, Cohen HJ, Silberstein LE, McGlave P (eds).4th ed.Philadelphia, Elsevier Churchill Livingstone 2005:693-707.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | March 31, 2020 |
| Submission Date | December 3, 2019 |
| Acceptance Date | March 24, 2020 |
| Published in Issue | Year 2020 Volume: 6 Issue: 1 |
