Uzamış nötropenili COVID-19 vakası

Yıl 2022, Cilt 15, Sayı 2, 391 - 394, 01.04.2022

Nilüfer YİĞİT Başak ÜNVER KOLUMAN Erhan UGURLU Göksel ALTINIŞIK ERGUR

https://doi.org/10.31362/patd.1017368

Öz

Bu yazıda sağlıklı bir erişkinde COVID-19 enfeksiyonu sırasında gelişen ve yaklaşık 1,5 ay devam eden nötropeni tablosunun takip ve tedavi sürecini sunuyoruz. Halsizlik ve eklem ağrısı şikayeti ile başvurusunda pcr pozitifliği ve laboratuvar incelemesinde nötropeni, lenfopeni saptanması ile COVID-19 tedavisi devam ederken nötropeni için ek medikal tedavi verilmesi açısından değerlendirilen hastaya sekonder enfeksiyonların gelişimini önlemek amacıyla G-CSF tedavisi başlandı. Yaklaşık 1,5 ay devam eden nötropeni durumu 1,5 ayın sonunda tamamen normale döndüğü görüldü. Sağlıklı erişkinde COVID-19 enfeksiyonuna sekonder nötropeni görülebilmektedir ve tedavide G-CSF kullanımının yararlı olacağı düşünülmektedir.

Anahtar Kelimeler

COVID-19, G-CSF, nötropeni

COVID-19 case with prolonged neutropenia

Öz

In this article, we present the follow-up and treatment process of neutropenia, which develops during COVID-19 infection in a healthy adult and lasts for approximately 45 days. When the patient applied with the complaints of weakness and joint pain, the PCR test was positive and neutropenia and lymphopenia were detected in the laboratory examination. Granulocyte-Colony Stimulating Factor (G-CSF) treatment was started in order to prevent the development of secondary infection to the patient, who was evaluated for additional medical treatment for neutropenia while the COVID-19 treatment was continuing. However, it was observed that neutropenia returned to normal after 1.5 months. Neutropenia secondary to COVID-19 infection can be seen in healthy adults and it is thought that the use of G-CSF in the treatment will be beneficial.

Anahtar Kelimeler

COVID-19, G-CSF, neutropenia

Kaynakça

• References [1] Aydoğdu S, Celik A, Karakas Z. Nötropeniye yaklaşım. J Child 2015; 15(1):3-9.
• [2] Husain EH, Mullah-Ali A, Al-Sharidah S, Azab AF, Adekile A. Infectious etiologies of transient neutropenia in previously healthy children.. Pediatr Infect Dis J. 2012;31:575–577.
• [3] Sloand E. Hematologic complications of HIV infection. AIDS Rev. 2005;7:187–196.
• [4] Pourbagheri-Sigaroodi A, Bashash D, Fateh F, Abolghasemi H. Laboratory findings in COVID-19 diagnosis and prognosis. Clin Chim Acta. 2020 Nov; 510: 475–482.
• [5] Singh N, Lubana SS, Dabrowski L. Isolated Chronic and Transient Neutropenia. Cureus 2019 Sep 10;11(9):e5616.
• [6] Newburger PE, Dale DC. Evaluation and management of patients with isolated neutropenia. Semin Hematol. 2013;50:198–206.
• [7] Huang W, Berube J, McNamara M, Saksena S, Hartman M, Arshad T, Bornheimer SJ, O'Gorman M. Lymphocyte Subset Counts in COVID-19 Patients: A Meta-Analysis. Cytometry A. 2020 Aug;97(8):772-776.
• [8] Celkan T, Şirin Koç B. Approach to the patient with neutropenia in childhood. Turk Pediatri Ars 2015 Sep 1;50(3):136-44.
• [9] Vehreschild JJ, Böhme A, Cornely OA, Kahl C, Karthaus M, Kreuzer KA, Maschmeyer G, Mousset S, Ossendorf V, Penack O, Vehreschild MJGT, Bohlius J. Prophylaxis of infectious complications with colony-stimulating factors in adult cancer patients undergoing chemotherapy-evidence-based guidelines from the Infectious Diseases Working Party AGIHO of the German Society for Haematology and Medical Oncology (DGHO). Ann Oncol 2014 Sep;25(9):1709-1718.
• [10] Antonino C. Tralongo , Marco Danova. Granulocyte colony-stimulating factors (G-CSF) and COVID-19: a double-edged sword? Infez Med. 2020 Sep 1;28(3):459-460.
• [11] Potey PMD, Rossi AG, Lucas CD, Dorward DA. Neutrophils in the initiation and resolution of acute pulmonary inflammation: understanding biological function and therapeutic potential. J. Pathol. 2019;247:672–685.
• [12] Siddiqi HK, Mehra MR. COVID-19 illness in native and immunosuppressed states: a clinical-therapeutic staging proposal. J. Heart Lung Transplant. 2020;39:405–407.
• [13] Frederick M. Lang, Kevin M.-C. Lee, John R. Teijaro, Burkhard Becher, and John A. Hamilton. GM-CSF-based treatments in COVID-19: reconciling opposing therapeutic approaches. Nat Rev Immunol. 2020 Jun 23 : 1–8.