Pemfigus Vulgaris Hastasında Steroid Kaynaklı Manik Epizod : Olgu Sunumu

Yıl 2024, Cilt: 38 Sayı: 1, 47 - 51, 24.05.2024

Uğur Eray

https://doi.org/10.18614/deutip.1144093

Öz

Kortikosteroidler başta otoimmün hastalıklar olmak üzere birçok hastalığın tedavisinde kullanılmaktadır. Bu ilaçların çeşitli psikiyatrik yan etkileri de bulunmaktadır. Psikiyatrik yan etkilerin patofizyolojisi tam olarak aydınlatılmamış olup, ortaya çıkmasında önemli olan çeşitli risk faktörleri tanımlanmıştır. Steroid tedavisi sonrası ortaya çıkan psikiyatrik belirtlerin tedavisinde öncelikli olarak, kullanılan steroidin kesilmesi ve duygudurum dengeleyici ile birlikte veya tek başına antipsikotik başlanması önerilmektedir. Pemfigus Vulgaris tanılı vakamızda kortikosteorid kullanımı sonrasında ortaya çıkan manik atak , buna yol açan risk faktörleri ve tek başına olanzapin tedavisi ile hastalığın seyrinin tartışılması amaçlanmıştır.

Anahtar Kelimeler

Pemfigus Vulgaris, Steroid, Mani

Manic Episode Due to Steroid Use in Pemphigus Vulgaris Patient: Case Report

Öz

Corticosteroids are used in the treatment of numerous diseases, primarily in the treatment of autoimmune diseases. They have various side-effects. Although the pathophysiology of psychiatric side-effects have not clearly been revealed, the various risk factors leading to these have been defined. In the treatment of psychiatric symptoms which emerge after steroid treatments, it is firstly advised to discontinue the use of the steroid and initiate the use of an antipsychotic medicine together with a mood regulator or single-handedly. It is aimed at discussing the manic attack which took place after corticosteroid use in our patient diagnosed with pemphigus vulgaris, the risk factors leading to this situation and the course of the disease only with olanzapine.

Anahtar Kelimeler

Pemphigus vulgaris, Steroid, Mania

Kaynakça

• 1. Fernandes, N. C., & Perez, M. Treatment of pemphigus vulgaris and pemphigus foliaceus: experience with 71 patients over a 20 year period. Revista do Instituto de Medicina Tropical de Sao Paulo 2001; 43: 33-36
• 2. Rice, J. B., White, A. G., Scarpati, L. M., Wan, G., & Nelson, W. W. Long-term systemic corticosteroid exposure: a systematic literature review. Clinical therapeutics 2017; 39(11): 2216-2229.
• 3. Grando, S. A. Pemphigus autoimmunity: hypotheses and realities. Autoimmunity 2012; 45(1): 7-35.
• 4. Parasher, A., & Bez, J. Steroid induced psychiatric adverse effects: an overview of risk factors, clinical features and management. International Journal of Research in Medical Sciences 2020; 8:23-65
• 5. Warrington, T. P., & Bostwick, J. M. Psychiatric adverse effects of corticosteroids. In Mayo Clinic Proceedings 2006;81:10, 1361-1367.
• 6. Sirois, F. Steroid psychosis: a review. General hospital psychiatry 2003; 25(1): 27-33.
• 7. Brown, E. S., Chamberlain, W., Dhanani, N., Paranjpe, P., Carmody, T. J., & Sargeant, M. An open-label trial of olanzapine for corticosteroid-induced mood symptoms. Journal of affective disorders 2004;83(2-3): 277-281
• 8. Naranjo, C. A., Busto, U., Sellers, E. M., Sandor, P., Ruiz, I., Roberts, E. A. et al. A method for estimating the probability of adverse drug reactions. Clinical Pharmacology & Therapeutics 1981; 30(2):239-245.
• 9. Wada, K., Yamada, N., Sato, T., Suzuki, H., Miki, M., Lee, Y. et al. Corticosteroid-induced psychotic and mood disorders: diagnosis defined by DSM-IV and clinical pictures. Psychosomatics 2001;42(6): 461-466
• 10. Kino, T. Stress, glucocorticoid hormones, and hippocampal neural progenitor cells: implications to mood disorders. Frontiers in physiology 2015;6:230.
• 11. Brown, E. S., & Chandler, P. A. Mood and cognitive changes during systemic corticosteroid therapy. Primary care companion to the Journal of clinical psychiatry . 2001; 3(1): 17.
• 12. Ciriaco, M., Ventrice, P., Russo, G., Scicchitano, M., Mazzitello, G., Scicchitano, F. et al. Corticosteroid-related central nervous system side effects. Journal of pharmacology & pharmacotherapeutics 2013;4:94.
• 13. Lewis, D. A., & Smith, R. E. Steroid-induced psychiatric syndromes: a report of 14 cases and a review of the literature. Journal of affective disorders .1983;5(4): 319-332.
• 14. Goldstein, E. T., & Preskorn, S. H. Mania triggered by a steroid nasal spray in a patient with stable bipolar disorder. American Journal of Psychiatry 1989;146:1076-1077
• 15. Lu, Y., Ann, L., & McCarron, R. Steroid-induced psychiatric symptoms: What you need to know. Current Psychiatry 2021; 20(4): 33
• 16. Garner, H. H., & Falk, M. A. Toxic psychosis: pemphigus and psychiatric disease. Psychosomatics 1967; 8(3): 133-137
• 17. Demir, B., Kocamer Sahin, S., Guneysu, E., Elboga, G., & Altindag, A. Two Manias Triggering with Only Prednisolone: A Case with Immune Thrombocytopenia. Psychiatria Danubina 2021;33(1): 67-68.
• 18. Bolu, A., Erdem, M., Yalçın, F. Y., & Günay, H. Steroid kullanımına bağlı ortaya çıkan mani olgusu. Journal of Mood Disorders 2013;3(2): 74-76.
• 19. BALIBEY, H., Yaşar, H., & Tekeli, H. Periferik yüz felci geçirmiş olan bir hastada kısa süreli kortikosteroid kullanımı sonrasında ortaya çıkan karma mani atağı: Bir olgu sunumu. Journal of Mood Disorders 2012; 2(1):17-20.
• 20. Matthews, R., & Ali, Z. Comorbid mental health issues in patients with pemphigus vulgaris and pemphigus foliaceus. Clinical and Experimental Dermatology 2022; 47(1): 24-29.
• 21. Beqqal, K., Chau, E., Senouci, K., Ouahid, W., Benzekri, L., Hassam, B. et al. Pemphigus and steroid psychosis: a case report and review of literature. Clin. Pathol, 2014;1(2): 101-4.