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ÇOCUKLUK ÇAĞININ KRONİK BÜLLÖZ HASTALIĞI TANILI BİR OLGUDA İNTRAVENÖZ İMMUNGLOBULİN TEDAVİSİ

Year 2009, Volume: 10 Issue: 2, 33 - 35, 01.08.2009

Abstract

Çocukluk çağının kronik büllöz hastalığı nadir görülen, etiyolojisi tam olarak bilinmeyen subepidermal büllühastalıklardandır. Bu hastalıkta direkt immunofloresan yöntemi ile epidermal bazal membranda IgA'nın lineerdepolanması patognomoniktir. Tedavide sıkılıkla dapson kullanılır. İntravenöz immunglobulin tedavide yeni biryaklaşımdır. Oniki aylık erkek hasta özellikle ağız çevresinde olmak üzere yüzünde, kalçasında, kol vebacaklarında çok sayıda bül varlığı yakınması ile başvuru üzerine hastaneye yatırıldı. Cilt biyopsi örneğinindirekt immunofloresan yöntemiyle incelenmesinde dermoepidermal hat boyunca IgA depolandığı görüldü. Bubulgularla olguya çocukluk çağı kronik büllöz hastalığı tanısı konuldu. Olguda tedavi amacıyla intravenözimmunglobulin kullanıldı ve üç gün içinde tüm lezyonların tamamen iyileştiği belirlendi. Hasta bir yıldırherhangibir tekrarlama görülmeksizin takip edilmektedir

References

  • 1. Powell JJ, Wojnarowska F. Chronic bullous disease of childhood: Linear IgA disease of childhood and mixed immunobullous disease. In: Harper J, Oranje A, Prose N, eds. Textbook of pediatric dermatology 2nd ed. Blackwell Publishing, Massachusetts,2006:835-47.
  • 2. Morelli JG. Linear IgA Dermatosis (Chronic Bullous Dermatosis of Childhood). In: Kliegman, Behrman, Jenson, Stanton eds. Nelson textbook of pediatrics 18th ed. Saunders, Philadelphia, 2007:2692-3.
  • 3. Bayram N, Eşrefoğlu M. Otoimmün büllöz hastalıklarda güncel tedavi yaklaşımları. İnönü Üniversitesi Tıp Fakültesi Dergisi 2002;9:67-76.
  • 4. Ang P, Tay YK. Treatment of linear IgA bullous dermatosis of childhood with colchicine. Pediatr Dermatol 1999;16:50-2.
  • 5. Siegfried CE. Chronic bullous diseases of chidhood succesfull treatment with dicloxacilline. J Am Acad Dermatol 1998;39:797-800.
  • 6. Cooper SM, Powell J, Wojnarowska F. Linear IgA disease: successful treatment with erythromycin. Clin Exp Dermatol 2002; 27: 677-9.
  • 7. K ha n IU, B h ol KC, A hme d AR. Li nea r immunglobuline A bullous dermatosis patient with chronic renal failure: response to intravenous immunglobuline therapy. J Am Acad Dermatol 1999;40:485-8.
  • 8. Segura S, Iranzo P, Martínez-de Pablo I, Mascaró JM Jr, Alsina M, Herrero J, Herrero C. High-dose intravenous immunoglobulins for the treatment of autoimmune mucocutaneous blistering diseases: evaluation of its use in 19 cases. J Am Acad Dermatol 2007;56:960-7.
  • 9. Waldman MA, Black DR, Callen JP. Vancomycininduced linear IgA bullous disease presenting as toxic epidermal necrolysis. Clin Exp Dermatol 2004;29:633- 6.
  • 10. Shimanovich I, Rose C, Sitaru C, Brocker EB, Zillikens D. Localized linear IgA disease induced by ampicillin/sulbactam. J Am Acad Dermatol 2004;51:95-8.
  • 11. Cohen LM, Ugent RB. Linear IgA bullous dermatitis occuring after carbamazepine. J Am Acad Dermatol 2002;46:S32-3.
  • 12. Avcı O, Ökmen M, Çetiner S. Acetaminophen induced linear IgA bullous dermatosis. J Am Acad Dermatol 2003;48:299-301.
  • 13. Ho JC, Ng PL, Tan SH, GiamYC. Childhood linear IgA bullous disease triggered by amoxicillin-clavulanic acid. Pediatr Dermatol 2007;24:40-3.
  • 14. Salmhofer W, Soyer HP, Wolf P, Fodinger D, Hodl S, Kerl H. UV light-induced linear IgA dermatosis. J Am Acad Dermatol 2004;50:109-15.
  • 15. Powell J, Kirtcschig. Mixed Immunobullos diseases of childhood: A good response to antimicrobials. Br J Dermatol 2001;144:769-74.
  • 16. AlajlanA,Al-Khawajah M,Al-Sheikh O,Al-Saif F,AlRasheed S, Al-Hoqail I, Hamadah IR. Treatment of linear IgA bullous dermatosis of childhood with flucloxacillin. JAmAcad Dermatol 2006;54:652-6.

Intravenous Immunglobulin Therapy In A CaseWith Chronic Bullous Disease of Childhood

Year 2009, Volume: 10 Issue: 2, 33 - 35, 01.08.2009

Abstract

Chronic bullous disease of childhood, one of the subepidermal bullous diseases is uncommon, and its etiology has not fully understood. A linear deposition of IgA at the epidermal basement membrane on direct immunoflorescence is pathognomonic for the disease. Dapson is commonly used in the therapy. Intravenous immunglobulin is a recent choice in the treatment. A twelve-months old boy was admitted to the hospital with the complaints of mutipl blisters on his face, especially perioral region, buttocks and extremities. Examination of the skin biopsy specimen with direct immunoflorescence method showed linear deposits of IgA along the dermoepidermal junction. In the light of the findings, condition was diagnosed as chronic bullous disease of childhood. Following the intravenous immunglobulin use for treatment, the skin lesions revealed rapid healing within three days.

References

  • 1. Powell JJ, Wojnarowska F. Chronic bullous disease of childhood: Linear IgA disease of childhood and mixed immunobullous disease. In: Harper J, Oranje A, Prose N, eds. Textbook of pediatric dermatology 2nd ed. Blackwell Publishing, Massachusetts,2006:835-47.
  • 2. Morelli JG. Linear IgA Dermatosis (Chronic Bullous Dermatosis of Childhood). In: Kliegman, Behrman, Jenson, Stanton eds. Nelson textbook of pediatrics 18th ed. Saunders, Philadelphia, 2007:2692-3.
  • 3. Bayram N, Eşrefoğlu M. Otoimmün büllöz hastalıklarda güncel tedavi yaklaşımları. İnönü Üniversitesi Tıp Fakültesi Dergisi 2002;9:67-76.
  • 4. Ang P, Tay YK. Treatment of linear IgA bullous dermatosis of childhood with colchicine. Pediatr Dermatol 1999;16:50-2.
  • 5. Siegfried CE. Chronic bullous diseases of chidhood succesfull treatment with dicloxacilline. J Am Acad Dermatol 1998;39:797-800.
  • 6. Cooper SM, Powell J, Wojnarowska F. Linear IgA disease: successful treatment with erythromycin. Clin Exp Dermatol 2002; 27: 677-9.
  • 7. K ha n IU, B h ol KC, A hme d AR. Li nea r immunglobuline A bullous dermatosis patient with chronic renal failure: response to intravenous immunglobuline therapy. J Am Acad Dermatol 1999;40:485-8.
  • 8. Segura S, Iranzo P, Martínez-de Pablo I, Mascaró JM Jr, Alsina M, Herrero J, Herrero C. High-dose intravenous immunoglobulins for the treatment of autoimmune mucocutaneous blistering diseases: evaluation of its use in 19 cases. J Am Acad Dermatol 2007;56:960-7.
  • 9. Waldman MA, Black DR, Callen JP. Vancomycininduced linear IgA bullous disease presenting as toxic epidermal necrolysis. Clin Exp Dermatol 2004;29:633- 6.
  • 10. Shimanovich I, Rose C, Sitaru C, Brocker EB, Zillikens D. Localized linear IgA disease induced by ampicillin/sulbactam. J Am Acad Dermatol 2004;51:95-8.
  • 11. Cohen LM, Ugent RB. Linear IgA bullous dermatitis occuring after carbamazepine. J Am Acad Dermatol 2002;46:S32-3.
  • 12. Avcı O, Ökmen M, Çetiner S. Acetaminophen induced linear IgA bullous dermatosis. J Am Acad Dermatol 2003;48:299-301.
  • 13. Ho JC, Ng PL, Tan SH, GiamYC. Childhood linear IgA bullous disease triggered by amoxicillin-clavulanic acid. Pediatr Dermatol 2007;24:40-3.
  • 14. Salmhofer W, Soyer HP, Wolf P, Fodinger D, Hodl S, Kerl H. UV light-induced linear IgA dermatosis. J Am Acad Dermatol 2004;50:109-15.
  • 15. Powell J, Kirtcschig. Mixed Immunobullos diseases of childhood: A good response to antimicrobials. Br J Dermatol 2001;144:769-74.
  • 16. AlajlanA,Al-Khawajah M,Al-Sheikh O,Al-Saif F,AlRasheed S, Al-Hoqail I, Hamadah IR. Treatment of linear IgA bullous dermatosis of childhood with flucloxacillin. JAmAcad Dermatol 2006;54:652-6.
There are 16 citations in total.

Details

Other ID JA45DZ33RK
Journal Section Case Report
Authors

Pamir Gülez This is me

Murat Hızarcıoglu This is me

Ertan Kayserılı This is me

Sule Afsar This is me

Ragıp Ortaç This is me

Hursit Apa This is me

Publication Date August 1, 2009
Published in Issue Year 2009 Volume: 10 Issue: 2

Cite

EndNote Gülez P, Hızarcıoglu M, Kayserılı E, Afsar S, Ortaç R, Apa H (August 1, 2009) Intravenous Immunglobulin Therapy In A CaseWith Chronic Bullous Disease of Childhood. Meandros Medical And Dental Journal 10 2 33–35.