MİYELODİSPLASTİK SENDROMDA TALİDOMİD KULLANIMINA BAĞLI VENÖZ TROMBOEMBOLİZM: OLGU SUNUMU

Öz

Talidomid Multipl Miyelom ve düşük risk miyelodisplastik sendrom tedavisinde kullanılan immünmodülatör bir ajan olup, Venöz Tromboemboli riskini arttırmaktadır. Olgumuz 77 yaşında kadın hasta olup, 2 yıldır düşük risk Miyelodisplastik Sendrom tanısı ile Talidomid kullanmaktaydı. Ani başlayan dispne ve göğüs ağrısı sonrası çekilen Toraks Bilgisayarlı Tomografide sağ ana pulmoner arter ile sol üst ve alt lob arter dallarında trombüs, alt ekstremite venöz doppler ultrasonogrofide ise bilateral akutsubakut derin ven trombüs saptandı. B-tip Natriüretik peptid (BNP), Troponin normal olup, ekokardiyografide sağ ventrikül disfonksiyonunu gösteren patoloji saptanmadı. Düşük mortalite riskli Pulmoner Tromboemboli kabul edilen hastaya enoksaparin ve oral warfarin tedavisi verilerek taburcu edildi. Talidomid tedavisi kesildi. Bu yazıda Talidomid kullanımına bağlı gelişen ve nadir görülen Venöz Tromboembolizm vakası sunulmuştur.

Anahtar Kelimeler

• Miyelodisplastik Sendrom, Venöz Tromboembolizm, Talidomid

VENOUS THROMBOEMBOLISM DUE TO THE USE OF THALIDOMIDE IN MYELODYSPLASTIC SYNDROME: CASE REPORT

Öz

Thalidomide is an immunomodulatory agent used in the treatment of multiple myeloma and low risk myelodysplastic syndrome and it has an increasing affect for venous thromboembolism. Our case is a 77 year old female patient who was using thalidomide for 2 years with the diagnosis of low-risk myelodysplastic syndrome. Chest computed tomography done after sudden onset of dyspnea and chest pain determined thrombus in the right main pulmonary artery and in the left upper and lower lobe pulmonary arteries and venous doppler ultrasonography revealed acute and sub-acute deep vein thrombosis in bilateral lower extremity. B-type natriuretic peptide (BNP) and troponin were normal. Echocardiography did not show any right ventricular dysfunction pathology. Patient who was accepted as ‘Pulmonary Thromboembolism with low mortality risk' was given enoxaparin and oral warfarin therapy. Thalidomide therapy was stopped. In this paper a rare case of venous thromboembolism due to the use of thalidomide is reported.

Anahtar Kelimeler

• Myelodysplastic Syndrome, Venous Thromboembolism, Thalidomide

Kaynakça

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