Tüberoskleroz Kompleksi Tanılı Çocuk Hastalarda Everolimus Tedavisine İkincil Hiperlipidemi: Üç Olgunun Retrospektif Değerlendirmesi

Öz

Çocuklarda hiperlipidemi primer ve sekonder kaynaklı olabilir. Primer hiperlipidemi lipid ilişkili genetik nedenlere bağlı iken, sekonder hiperlipidemi altta yatan ikincil hastalıklara ve kullanılan ilaçlara bağlı olabilir. Tüberoskleroz tedavisinde kullanılan ve mTOR inhibitörü olan Everolimus, sekonder hiperlipidemiye neden olabilmektedir. Kliniğimize son iki yıl içerisinde konsülte edilen üç hastanın Everolimus tedavisi sürecindeki kan lipid değerleri geriye dönük olarak incelendi. Klinik ve biyokimyasal bulguları araştırıldı. Everolimus tedavisi alan her üç hastada sekonder hiperlipidemi gözlendi. Bir hastanın LDL kolesterol düzeyinde, bir hastanın trigliserid, bir hastanın ise hem LDL kolesterol, hem de trigliserid düzeylerinde yükselme oldu. Everolimus doz azaltımı ya da ara verilmesi ve yağdan kısıtlı diyet ile düzelme gözlendi. Bu durumda ilaç doz azaltımı, ara verilmesi ya da yağdan kısıtlı diyet ve antihiperlipidemik ilaçlar kullanılabilir. Primer hastalığın evresi ve plazma lipid düzeyleri tedavi kararında belirleyici rol oynar.

Anahtar Kelimeler

• Everolimus
• hiperlipidemi
• tüberoskleroz
• mTOR
• yan etki

Secondary Hyperlipidemia Associated with Everolimus Treatment in Pediatric Patients Diagnosed with Tuberous Sclerosis Complex: A Retrospective Evaluation of Three Cases

Öz

Hyperlipidemia in the pediatric population can be broadly categorized as either primary or secondary in origin. Primary hyperlipidemias result from inherited disorders affecting lipid metabolism, whereas secondary hyperlipidemias are typically associated with underlying systemic diseases or arise as adverse effects of pharmacological therapies. Everolimus, an mTOR inhibitor frequently utilized in the management of tuberous sclerosis, has been implicated in the development of secondary hyperlipidemia. In this retrospective evaluation, we reviewed the blood lipid profiles of three pediatric patients who were referred to our clinic within the past two years during Everolimus treatment. Relevant clinical and biochemical parameters were assessed. Secondary hyperlipidemia was identified in all three cases. One patient demonstrated isolated elevation in low-density lipoprotein (LDL) cholesterol, another exhibited marked hypertriglyceridemia, while the third patient presented with simultaneous increases in both LDL cholesterol and triglyceride levels. Lipid abnormalities showed improvement following either a reduction in Everolimus dosage or temporary discontinuation of the medication, combined with the implementation of a fat-restricted diet. In such clinical scenarios, management strategies may include dose modification, treatment interruption, dietary interventions, and, where appropriate, initiation of lipid-lowering pharmacotherapy. Therapeutic decisions should be individualized, taking into consideration both the stage of the primary disease and the severity of dyslipidemia.

Anahtar Kelimeler

• Everolimus
• hyperlipidemia
• tuberous sclerosis
• mTOR
• side effect

Kaynakça

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