Abstract
Şilotoraks plevral aralıkta lenfatik sıvı birikmesi olarak tanımlanır, konjenital ve akkiz nedenlerle ortaya çıkar. Konjenital şilotoraksın etiyolojisi tam anlaşılamamış olmakla birlikte, lenfatik sistemin gelişimsel bozukluğu sonucu olduğu düşünülmektedir. Konjenital şilotoraks sıklıkla hidrops fetalisle birlikte görülür. Tanı plevral sıvıda trigliserit düzeyinin 110 mg/dl ve total hücre sayısının 1000/ml’nin üstünde olması, %80’den fazla lenfosit içermesi ile konulur. Şilotoraksta klinik durumun şiddetini şilöz mayi miktarı belirler. Bazı bebekler asemptomatik veya hafif solunum sıkıntısı ile klinik bulgu verirken, çoğu olguda tedavi edilmezse potansiyel yaşamı tehdit eden solunum sıkıntısı ile bulgu verir. Şilotoraks tedavisinde konservatif ve cerrahi yöntemler kullanılmaktadır. Konservatif yaklaşım altta yatan hastalığın tedavisi, tekrarlanan torasentez veya toraks tüpü ile sürekli drenaj, enteral beslenmeye ara verilerek total parenteral nutrisyon uygulanması ve orta zincirli trigliseritleri içeren diyet uygulanmasını içerir. Bu yöntemlere yanıt alınamazsa oktreotid kullanılması önerilmektedir. Konservatif tedavi başarısızlığını tanımlamak için kullanılan iki parametre devam eden lenfatik drenajın süresi ve hacmidir. Oktreotid tedavisinin yanıtsız olduğu durumlarda kimyasal plörodezis ve cerrahi tedavi denenmelidir. Cerrahi tedavi yaklaşımları torakoskopik plörodezis, cerrahi abrazyon, pleuroperitoneal şant uygulanması, torasik duktus ligasyonunu içerir. Şilotoraksta prognoz altta yatan etiyolojiye göre değişir. Uygun tedavi ile konjenital şilotoraksın prognozu genellikle iyi seyreder. Bununla beraber eşlik eden pulmoner hipoplazinin derecesi, prematürite ve hidropsun varlığı mortaliteyi artıran nedenler olarak bildirilmektedir.
Keywords
References
- Tani LY. Rheumatic fever and rheumatic heart disease. In: Allen HD, Driscoll MD, Shaddy RE, Feltes TF, (eds). Moss and Adams’ Heart Disease in Infants, Children, and Adolescents. 8th ed. Philadelphia, PA: Lippincott Williams &Wilkins, 2013:1303-30.
- Seckeler MD, Hoke TR. The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease. Clin Epidemiol 2011;3:68-84.
- Tibazarwa KB, Volmink JA, Mayosi BM. Incidence of acute rheumatic fever in the world: A systematic review of population- based studies. Heart 2008;94:1534-40.
- Dajani AS, Ayoub E, Bierman FZ, Bisno AL, Denny FW, Durack DT, et al. Special Writing Group of the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease of the Council on Cardiovascular Disease in the Young. The American Heart Association. Guidelines for the diagnosis of rheumatic fever. Jones criteria, 1992 update. JAMA 1992;268:2069-73.
- Carapetis JR, Brown A, MAguire G, Walsh W, Noonan S, Thompson D. The Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease. 2nd ed. Sydney: Heart Foundation and Cardiac Society of Australia and New Zealand, 2012.
- Atatoa-Carr P, Lennon D, Wilson N. New Zealand Rheumatic Fever Guidelines Writing Group. Rheumatic fever diagnosis, management, and secondary prevention: A New Zealand guideline. N Z Med J 2008;121:59-69.
- Gewitz MH, Baltimore RS, Tani LY, Sable CE, Shulman ST, Carapetis J, et al. Revision of the Jones criteria for the diagnosis of the rheumatic fever in the era of Doppler echocardiography: A scientific statement of the American Heart Association. Circulation 2015;131:1806-18.
- Carapedis JR, McDonald M, Wilson NJ. Acute rheumatic fever. Lancet 2005;366:155-68.
- Parnaby MG, Carapetis JR. Rheumatic fever in indigenous Australian children. J Paediatr Child Health 2010;46:527-33.
- Karademir S, Demirçeken F, Atalay S, Demircin G, Sipahi T, Teziç T. Acute rheumatic fever in children in the Ankara area in 1990-1992 and comparison with a previous study in 1980-1989. Acta Paediatr 1994;83:862-5.
- Orun UA, Ceylan O, Bilici M, Karademir S, Ocal B, Senocak F, et al. Acute rheumatic fever in the Central Anatolia Region of Turkey: A 30-year experience in a single center. Eur J Pediatr 2012;171:361- 8.
- Imamoglu A, Ozen S. Epidemiology of rheumatic heart disease. Arch Dis Child 1988;63:1501-3.
- Carapetis JR, Currie BJ. Rheumatic fever in a high incidence population: The importance of monoarthritis and low grade fever. Arch Dis Child 2001;85:223-7.
- Parks T, Kado J, Colquhoun S, Carapetis J, Steer A. Underdiagnosis of acute rheumatic fever in primary care settings in a developing country. Trop Med Int Health 2009;14:1407-13.
- Noonan S, Zurynski YA, Currie BJ, McDonald M, Wheaton G, Nissen M, et al. A national prospective surveillance study of acute rheumatic fever in Australian children. Pediatr Infect Dis J 2013;32:26-32.
- Sanyal SK, Thapar MK, Ahmed SH, Hooja V, Tewari P. The initial attack of acute rheumatic fever during childhood in North India: A prospective study of the clinical profile. Circulation 1974;49:7-12.
- Cann MP, Sive AA, Norton RE, McBride WJ, Ketheesan N. Clinical presentation of rheumatic fever in an endemic area. Arch Dis Child 2010;95:455-7.
Abstract
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Keywords
References
- Tani LY. Rheumatic fever and rheumatic heart disease. In: Allen HD, Driscoll MD, Shaddy RE, Feltes TF, (eds). Moss and Adams’ Heart Disease in Infants, Children, and Adolescents. 8th ed. Philadelphia, PA: Lippincott Williams &Wilkins, 2013:1303-30.
- Seckeler MD, Hoke TR. The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease. Clin Epidemiol 2011;3:68-84.
- Tibazarwa KB, Volmink JA, Mayosi BM. Incidence of acute rheumatic fever in the world: A systematic review of population- based studies. Heart 2008;94:1534-40.
- Dajani AS, Ayoub E, Bierman FZ, Bisno AL, Denny FW, Durack DT, et al. Special Writing Group of the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease of the Council on Cardiovascular Disease in the Young. The American Heart Association. Guidelines for the diagnosis of rheumatic fever. Jones criteria, 1992 update. JAMA 1992;268:2069-73.
- Carapetis JR, Brown A, MAguire G, Walsh W, Noonan S, Thompson D. The Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease. 2nd ed. Sydney: Heart Foundation and Cardiac Society of Australia and New Zealand, 2012.
- Atatoa-Carr P, Lennon D, Wilson N. New Zealand Rheumatic Fever Guidelines Writing Group. Rheumatic fever diagnosis, management, and secondary prevention: A New Zealand guideline. N Z Med J 2008;121:59-69.
- Gewitz MH, Baltimore RS, Tani LY, Sable CE, Shulman ST, Carapetis J, et al. Revision of the Jones criteria for the diagnosis of the rheumatic fever in the era of Doppler echocardiography: A scientific statement of the American Heart Association. Circulation 2015;131:1806-18.
- Carapedis JR, McDonald M, Wilson NJ. Acute rheumatic fever. Lancet 2005;366:155-68.
- Parnaby MG, Carapetis JR. Rheumatic fever in indigenous Australian children. J Paediatr Child Health 2010;46:527-33.
- Karademir S, Demirçeken F, Atalay S, Demircin G, Sipahi T, Teziç T. Acute rheumatic fever in children in the Ankara area in 1990-1992 and comparison with a previous study in 1980-1989. Acta Paediatr 1994;83:862-5.
- Orun UA, Ceylan O, Bilici M, Karademir S, Ocal B, Senocak F, et al. Acute rheumatic fever in the Central Anatolia Region of Turkey: A 30-year experience in a single center. Eur J Pediatr 2012;171:361- 8.
- Imamoglu A, Ozen S. Epidemiology of rheumatic heart disease. Arch Dis Child 1988;63:1501-3.
- Carapetis JR, Currie BJ. Rheumatic fever in a high incidence population: The importance of monoarthritis and low grade fever. Arch Dis Child 2001;85:223-7.
- Parks T, Kado J, Colquhoun S, Carapetis J, Steer A. Underdiagnosis of acute rheumatic fever in primary care settings in a developing country. Trop Med Int Health 2009;14:1407-13.
- Noonan S, Zurynski YA, Currie BJ, McDonald M, Wheaton G, Nissen M, et al. A national prospective surveillance study of acute rheumatic fever in Australian children. Pediatr Infect Dis J 2013;32:26-32.
- Sanyal SK, Thapar MK, Ahmed SH, Hooja V, Tewari P. The initial attack of acute rheumatic fever during childhood in North India: A prospective study of the clinical profile. Circulation 1974;49:7-12.
- Cann MP, Sive AA, Norton RE, McBride WJ, Ketheesan N. Clinical presentation of rheumatic fever in an endemic area. Arch Dis Child 2010;95:455-7.
Details
| Other ID | JA72MB23TZ |
|---|---|
| Journal Section | Letter to Editor |
| Authors | |
| Publication Date | April 1, 2017 |
| Submission Date | April 1, 2017 |
| Published in Issue | Year 2017 Volume: 11 Issue: 1 |
The publication language of Turkish Journal of Pediatric Disease is English.
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