Abstract
Amaç: Kalp kasının tutulumu ve inflamasyonu ile karekterize miyokardit, çoğunlukla viral bir enfeksiyon sonrası görülür. Perikard tutulumu da olursa miyoperikardit denilir. Miyokardit iyileştikten ve kardiyak enzimler normalleştikten sonra herhangi bir zaman aralığında tekrar miyokardit geçiren vakalara rekürren (tekrarlayan) miyokardit denilmektedir ve oldukça nadir görülen bir durumdur. Bu çalışmada kliniğimizde takip edilen rekürren miyokarditli olguları incelemeyi amaçladık. Yöntem: 1 Haziran 2020 – 1 Ocak 2022 tarihleri arasında, hastanemizde çocuk kardiyoloji tarafından yatırılarak takip edilen rekürren miyoperikarditli vakalar dosya sisteminden taranarak analiz edildi. Bulgular: Toplamda 5 hasta tespit edildi. Yaş aralığı 10-14 yıl arasında değişiyordu (3 kız, 2 erkek, ortalama yaş 11.8 yıl, aralık 10-14 yıl). Troponin I değerleri ortalama 10.672 ng/L , median 250 ng/L (aralık 143-26.638 ng/L, üst sınır 20) idi. Ekokardiyografide her hastada minimal perikardiyal efüzyon görüldü. Kardiyak MRG çekilebilen 4 hastada miyoperikardit lehinde tutulum izlendi. Ortalama 4.4 ay (aralık 2-7 ay) sonrasında tekrar göğüs ağrısı ile başvurduklarında bakılan Troponin I değerleri yüksekti (ortalama 3425.4 ng/L, median: 557, aralık 350-13.801). Rekürren miyokperikardit düşünülen hastaların 3’ünde altta yatan ek hastalık (konjenital adrenal yetmezlik, Duchenne Musküler Distrofi ve Ailevi Akdeniz Ateşi) mevcuttu. Takiplerinde ek sorun olmayan ve kardiyak fonksiyonlar da bozulma olmayan hastalar kolşisin tedavisi ile taburcu edildiler. Sonuç: Göğüs ağrısı olan ve daha önce miyoperikardit geçirme öyküsü olan çocuklarda, rekürren miyoperikardit görülebilir. Altta yatan hastalıklar araştırılmalıdır. Kolşisin tedavisi iyileşme döneminde de bir müddet daha devam ettirilmelidir.
References
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Abstract
References
- 1. Floyd A, Lal A, Molina K, Puchalski M, Miller D, May L. When lightning strikes twice in pediatrics: case report and review of recurrent myocarditis. Pediatrics. 2018;141(3).
- 2. Vigneswaran TV, Brown JR, Breuer J, Burch M. Parvovirus B19 myocarditis in children: an observational study. Arch Dis Child. 2016;101(2):177-80.
- 3. Lee AF, Chiasson DA, Smythe JF, Sanatani S. Recurrent congestive heart failure in a child due to probable myocarditis. Pediatr Cardiol. 2012;33(1):176-81.
- 4. Law YM, Lal AK, Chen S, Čiháková D, Cooper Jr LT, Deshpande S, et al. Diagnosis and management of myocarditis in children: a scientific statement from the American Heart Association. Circulation. 2021;144(6):e123-e35.
- 5. Ghelani SJ, Spaeder MC, Pastor W, Spurney CF, Klugman D. Demographics, trends, and outcomes in pediatric acute myocarditis in the United States, 2006 to 2011. Circ Cardiovasc Qual Outcomes. 2012;5(5):622-7.
- 6. Ammirati E, Frigerio M, Adler ED, et al. Management of Acute Myocarditis and Chronic Inflammatory Cardiomyopathy: An Expert Consensus Document. Circ Heart Fail. 2020;13(11):e007405.
- 7. Imazio M, Brucato A, Trinchero R, Spodick D, Adler Y. Individualized therapy for pericarditis. Expert Rev Cardiovasc Ther. 2009;7(8):965-75.
- 8. Maisch B, Seferović PM, Ristić AD, et al. Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology. Eur Heart J. 2004;25(7):587-610.
- 9. Alsarah A, Alsara O, Laird-Fick HS. Cardiac manifestations of Familial Mediterranean fever. Avicenna J Med. 2017;7(4):158-63
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Sözlü Bildiriler |
| Authors | |
| Publication Date | June 30, 2022 |
| Submission Date | February 26, 2022 |
| Acceptance Date | March 10, 2022 |
| Published in Issue | Year 2022 Volume: 15 Issue: (Özel Sayı-1) 21. Mersin Pediatri Günleri Bildiri Kitabı |
Cite
MEU Journal of Health Sciences Assoc was began to the publishing process in 2008 under the supervision of Assoc. Prof. Gönül Aslan, Editor-in-Chief, and affiliated to Mersin University Institute of Health Sciences. In March 2015, Prof. Dr. Caferi Tayyar Şaşmaz undertook the Editor-in Chief position and since then he has been in charge.
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