Giant peritoneal cyst hydatid and albendazole-induced aplastic anemia in noncirrhotic portal hypertensive patient

Öz

Albendazole has broad-spectrum coverage as an antiparasitic drug, and the reported side effects have been minimal. We report the case of a patient with febrile neutropenia beginning during the second week of therapy for a hepatic, splenic and peritoneal echinococcal cyst. This case was a 49-year-old man who presented with a large cystic abdominal mass. His medical history was significant for non-cirrhotic portal hypertension and recurrent cholangitis. Albendazole sulfoxide peak dose and half-life are significantly prolonged by liver disease and concomitant administration of certain drugs. The severity and duration of albendazole-induced neutropenia in this case was likely related to the underlying liver disease. Frequent serial monitoring of blood counts and cessation of medication with any evidence of marrow toxicity in such patients are warranted.

Anahtar Kelimeler

• Cyst hydatid, albendazole

Nonsirotik portal hipertansiyonlu hastada dev peritoneal kist hidatik ve albendazole bağlı aplastik anemi

Öz

Albendazol geniş spektrumlu antiparazitik bir ilaçtır. Yan etkilerinin minimal olduğu bildirilmiştir. Hepatik, splenik ve peritoneal ekinokokkal kist nedeniyle albendazol başlanan, ikinci haftada febril nötropeni gelişen bir vaka sunulmuştur. 49 yaşında erkek hasta karında büyük kistik kitleleri nedeniyle müracaat etti. Hastanın hikayesinde nonsirotik portal hipertansiyon ve tekrarlayan kolanjit atakları dikkat çekmekte idi. Albendazol sulfoksit peak dozu ve yarılanma ömrü karaciğer hastalıklarında ve başka ilaçlar kullanıldığında artmaktadır. Bu vakada ciddi nötropeni gelişmiş olmasının altta yatan karaciğer hastalığına bağlı olduğu düşünülmüştür. Albendazol başlanacak bu tür hastalar kemik iliği toksisitesi yönünden sık kan sayımları ile yakından takip edilmeli, verilecek diğer ilaçlara dikkat edilmelidir.

Anahtar Kelimeler

• Kist hidatik, albendazol

Kaynakça

1. Asri F, Tazi I, Maaroufi K, et al. Cerebral hydatic cyst and psychiatric disorders. Two cases. Encephale 2007; 33(2): 216-9.
2. Filip V, Niculescu D, Tarcoveanu E, et al. [Hydatic cyst of the liver. Considerations on 337 cases.] Rev Med Chir Soc Med Nat Iasi 2005; 109: 294-9.
3. Motie MR, Ghaemi M, Aliakbarian M, Saremi E. Study of the radical vs. conservative surgical treatment of the hepatic hydatid cyst: a 10-year experience. Indian J Surg 2010; 72: 448-52.
4. Yetim I, Erzurumlu K, Hokelek M, et al. Results of alcohol and albendazole injections in hepatic hydatidosis: experimental study. J Gastroenterol Hepatol 2005; 20: 1442-7.
5. Rami M, Khattala K, Elmadi A, et al. The renal hydatid cyst: report on 4 cases. Pan Afr Med J 2011; 8: 31.
6. Leila A, Laroussi L, Abdennadher M, et al. A cardiac hydatid cyst underlying pulmonary embolism: a case report. Pan Afr Med J 2011; 8: 12.
7. Suryawanshi P, Khan AQ, Jatal S. Primary hydatid cyst of pancreas with acute pancreatitis. Int J Surg Case Rep 2011; 2: 122-4. Epub 2011 Mar 29.
8. Cattorini L, Trastulli S, Milani D, et al. Ovarian hydatid cyst: a case report. Int J Surg Case Rep 2011; 2: 100-2.

9. Arkun R, Mete BD. Musculoskeletal hydatid disease. Semin Musculoskelet Radiol 2011; 15: 527-40.
10. Akkoyun I, Akb›y›k F, Altunkeser A. Laparoscopic cystectomy for splenic hydatid cyst: a case report. J Pediatr Surg 2011; 46: e1-3.
11. Duishanbai S, Geng D, Liu C, et al; Research Group of Hydatid Diseases. Treatment of intracranial hydatid cysts. Chin Med J (Engl) 2011; 124: 2954-8.
12. Arifi M, Kaddouri N, Abdelhak M, et al. Peritoneal hydatidosis in children. Report of a historical case. Arch Pediatr 2003; 10: 895-7.
13. Mergen H, Genç H, Tavusbay C. Assessment of liver hydatid cyst cases -- 10 years experience in Turkey. Trop Doct 2007; 37: 54-6.
14. Settaf A, Mansori F, Sefrioui A, Slaoui A. Hydatid cysts of the liver. Therapeutic and prognostic classification. 378 cases. Presse Med 1994; 23: 362-6.