Non-Steroid Anti-İnflamatuvar İlaç Kullanımına Bağlı Multiorgan Yetmezliği: Olgu Sunumu

Year 2023, Volume: 15 Issue: 2, 63 - 66, 31.08.2023

Mehmet Selim Mamiş , Ahmet Uyanıkoğlu

Abstract

Bu olgu sunumunda acil servise bilinç bulanıklığı ile başvuran, non-steroid anti-inflamatuar ilaç kullanımına bağlı multiorgan yetmezliği gelişen hastayı sunmayı amaçladık. Acil servise 32 yaşında erkek hasta uykuya meyil ve bilinç bulanıklığı şikayeti ile getirildi. Bilinen kronik herhangi bir hastalığının olmadığı, alkol kullanım ve madde bağımlılığı hikayesinin olmadığı söylendi. Hasta yakınlarından alınan anamnezde son 1 yıldır diş ağrıları için aralıklarla naproksen + kodein içeren tablet ilaç kullandığı öğrenildi. Yapılan fizik muayenesinde genel durumu orta, bilinci açık, uykuya meyilli ve letarjik, konuşma bozukluğu, terleme, pupillerinde bilateral miyozis saptandı. Oda havasında oksijen saturasyonu (SaO2) 89’lara kadar düşüp nazal oksijen desteği ile SaO2 >96 olması dışındaki vitalleri stabildi. Bakılan laboratuvar sonuçlarında 10 katı geçen transaminaz yüksekliği ve protrombin zamanında uzama saptanan hasta akut karaciğer yetmezliği ön tanısı ile hastanenin yoğun bakım ünitesinde tedavi ve takibine devam edildi. Acil servise bilinç bulanıklığı ile hastaneye başvuran, herhangi bir komorbid hastalığı olmayan ve özellikle genç hastalarda ilaç kullanımının sorgulanması unutulmamalıdır. Karaciğer yetmezliği tespit edilen bu hastalarda, nakil yapılabilecek durumların gözden kaçmaması gerekir. Transplantasyon endikasyonu olması durumunda, organ nakillerinin yapıldığı merkezlerde tedavi ve takipleri yapılmalıdır.

Keywords

Naproksen ve kodein, hepatotoksisite, multiorgan yetmezliği, karaciğer nakli

Supporting Institution

Harran Üniversitesi Tıp Fakültesi

Thanks

Makalemizi dikkate aldığınız için teşekkür ederiz.

Multiorgan Failure Due To Non-Steroid Anti-Inflammatory Drug Use: A Case Report

Abstract

In this case report, we aimed to present a patient who presented to the emergency department with confusion and developed multiorgan failure due to the use of non-steroidal anti-inflammatory drugs. A 32-year-old male patient was brought to the emergency department with complaints of drowsiness and confusion. It was said that she did not have any known chronic disease and had no history of alcohol use or substance abuse. In the anamnesis taken from the relatives of the patient, it was learned that she had been using tablets containing naproxen + codeine intermittently for the last 1 year for toothache. On physical examination, her general condition was moderate, she was conscious, sleepy and lethargic, speech disorder, sweating, and bilateral miosis in her pupils were found. Her vitals were stable, except that the oxygen saturation (SaO2) in room air decreased to 89 and SaO2 was> 96 with nasal oxygen support. In the laboratory results, the transaminase elevation exceeding 10 times and prothrombin time prolongation were detected. The patient was treated and followed up in the intensive care unit of the hospital with a preliminary diagnosis of acute liver failure. It should not be forgotten that the use of drugs should be questioned in patients who apply to the emergency department with clouding of consciousness, do not have any comorbid diseases, and especially in young patients. In these patients with hepatic insufficiency, the situations in which transplantation can be performed should not be overlooked. In case of transplantation indication, treatment and follow-up should be done in centers where organ transplantation is performed.

Keywords

Naproxen and codeine, hepatotoxicity, multiorgan failure, liver transplantation

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