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Kronik Böbrek Yetmezliği Tanılı Çocuk Hastada, COVİD-19 İzolasyonu Sırasında Eritropoetin’in Aşırı Kullanımından Dolayı Ortaya Çıkan Polisitemi Olgusu

Yıl 2021, Cilt: 15 Sayı: 5, 434 - 436, 23.09.2021
https://doi.org/10.12956/tchd.833625

Öz

COVID-19 izolasyonu sırasında eritrosit stimule ajanın (ESA) aşırı kullanımına bağlı gelişen polisitemi vakası sunmayı amaçladık. On iki yaşında ki kronik böbrek yetmezliği tanılı erkek hastamız , COVID-19 pandemisinden dolayı 4 ay boyunca tecritte kaldığı için rutin kontrollerine gelememişti. Bu süre zarfında haftada 150 U / kg başlangıç dozunda ESA almaya devam etti. Hasta periton diyaliz tedavisi altında idi. Laboratuvar incelemelerinde hemoglobin (Hb) seviyesi 20.8 g / dl, hematokrit % 66, kreatinin 6.5 mgr / dl bulundu. Hastaya günlük flebotomi seansları (10cc / kg / seans) uygulandı. Bu dönemde aspirin tedavisi de başlandı (5 mg / kg). Beş seans sonunda Hb seviyesi 14 gr / dl'ye, hematokriti% 40'a düştü. Kronik Böbrek yetmezliği hastalarında hemoglobin düzeyi rutin şekilde takip edilmediği takdirde ESA’ ya bağlı polisitemi gelişebileceği başta aile hekimi olmak üzere tüm hekimler tarafından bilinmeli ve izolasyonda olsa dahi hastalar gerekirse ev ziyarteleri ile takip edilmeli.

Kaynakça

  • 1. Stauffer ME, Fan T. Prevalence of anemia in chronic kidney disease in the United States. PLoS One. 2014; 9:e84943.
  • 2. National Kidney Foundation: NKF-DOQI. Clinical practice guidelines for the treatment ofAnemia of chronic renal failure. New York, National Kidney Foundation. AmJ Kidney Dis 2006;47:S11–S145
  • 3. Robinson N, Giraud S, Saudan C, Baume N, Avois L, Mangin P, Saugy M. Erythropoietin and blood doping. British Journal of Sports Medicine. 2006;40:Supplement 1, pp. i30–i34.
  • 3. Ibrahim HN, Ishani A, Foley RN, Guo H, Liu J, Collins AJ. Temporal trends in red blood transfusion among US dialysis patients, 1992-2005. Am J Kidney Dis. 2008;52:1115-1121.
  • 4.WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, revised 4th edition, Swerdlow SH, Campo E, Harris NL, et al. (Eds), International Agency for Research on Cancer (IARC), Lyon.2017
  • 5. Lawler EV, Bradbury BD, Fonda JR, Gaziano JM, Gagnon Dr. Transfusion burden among patients with chronic kidney disease and anemia. Clin J Am Soc Nephrol 2010;5:667-672.
  • 6. KDOQI. KDOQI Clinical Practice Guideline and Clinical Practice Recommendations for anemia in chronic kidney disease: 2007 update of hemoglobin target. Am J Kidney Dis 2007 50: 471-530.
  • 7. Parapia LA. History of bloodletting by phlebotomy. Br J Haematol 2008;143: 490-495.
  • 8. Fallah M, Kharazmi E, Sundquist J, Hemminki K. Higher risk of primary cancers after polycythaemia vera and vice versa. Br J Haematol 2011;153: 283-285.
  • 9. Research C for DE and. Drug Safety and Availability - FDA Drug Safety Communication: Modified dosing recommendations to improve the safe use of Erythropoiesis-Stimulating Agents (ESAs) in chronic kidney disease .
  • 10. Berk PD, Wasserman LR, Fruchtman SM, Goldberg JD. Treatment of polycythemia vera: a summary of clinical trials conducted by the Polycythemia Vera Study Group. In: Polycythemia Vera and the Myeloproliferative Disorders, Wasserman LR, Berk PD, Berlin NI (eds), WB Saunders, Philadelphia;1995; p.166

Polycythemia in a Pediatric Patient with Chronic Kidney Disease: Overuse of Erythropoerin Due COVID-19 Isolation

Yıl 2021, Cilt: 15 Sayı: 5, 434 - 436, 23.09.2021
https://doi.org/10.12956/tchd.833625

Öz

We describe a case of a patient with Chronic Kidney Disease who developed polycythemia due to Erythrocyte stimulating agents overuse during COVID-19 isolation. A 12-year-old male had not been able to attend routine controls since had been in isolation for 4 months after the COVID-19 outbreak. He had continued to take ESA during that period at the starting dose of 150 U/kg/week. He had been on peritoneal dialysis in the last year because of end-stage renal failure. Laboratory investigation revealed a hemoglobin (Hb) level of 20.8 g/dl, hematocrit level of 66%, creatinine level of 6.5 mgr/dl. He underwent daily phlebotomy sessions (10cc/kg/session). During this period aspirin was also started (5mg/kg). After 5 sessions his Hb level decreased to 14 gr/dl and hematocrit to 40%. Pediatric nephrologist should being aware that there is a potential risk of polycythemia with ESA when Hb level is not appropriately followed on a routine basis.

Kaynakça

  • 1. Stauffer ME, Fan T. Prevalence of anemia in chronic kidney disease in the United States. PLoS One. 2014; 9:e84943.
  • 2. National Kidney Foundation: NKF-DOQI. Clinical practice guidelines for the treatment ofAnemia of chronic renal failure. New York, National Kidney Foundation. AmJ Kidney Dis 2006;47:S11–S145
  • 3. Robinson N, Giraud S, Saudan C, Baume N, Avois L, Mangin P, Saugy M. Erythropoietin and blood doping. British Journal of Sports Medicine. 2006;40:Supplement 1, pp. i30–i34.
  • 3. Ibrahim HN, Ishani A, Foley RN, Guo H, Liu J, Collins AJ. Temporal trends in red blood transfusion among US dialysis patients, 1992-2005. Am J Kidney Dis. 2008;52:1115-1121.
  • 4.WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, revised 4th edition, Swerdlow SH, Campo E, Harris NL, et al. (Eds), International Agency for Research on Cancer (IARC), Lyon.2017
  • 5. Lawler EV, Bradbury BD, Fonda JR, Gaziano JM, Gagnon Dr. Transfusion burden among patients with chronic kidney disease and anemia. Clin J Am Soc Nephrol 2010;5:667-672.
  • 6. KDOQI. KDOQI Clinical Practice Guideline and Clinical Practice Recommendations for anemia in chronic kidney disease: 2007 update of hemoglobin target. Am J Kidney Dis 2007 50: 471-530.
  • 7. Parapia LA. History of bloodletting by phlebotomy. Br J Haematol 2008;143: 490-495.
  • 8. Fallah M, Kharazmi E, Sundquist J, Hemminki K. Higher risk of primary cancers after polycythaemia vera and vice versa. Br J Haematol 2011;153: 283-285.
  • 9. Research C for DE and. Drug Safety and Availability - FDA Drug Safety Communication: Modified dosing recommendations to improve the safe use of Erythropoiesis-Stimulating Agents (ESAs) in chronic kidney disease .
  • 10. Berk PD, Wasserman LR, Fruchtman SM, Goldberg JD. Treatment of polycythemia vera: a summary of clinical trials conducted by the Polycythemia Vera Study Group. In: Polycythemia Vera and the Myeloproliferative Disorders, Wasserman LR, Berk PD, Berlin NI (eds), WB Saunders, Philadelphia;1995; p.166
Toplam 11 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm CASE REPORTS
Yazarlar

Yaşar Kandur 0000-0002-8361-5558

Ayşegül Alpcan 0000-0001-9447-4263

Mehmet Yozgat Bu kişi benim 0000-0002-3001-7589

Serkan Tursun 0000-0003-3354-6360

Yayımlanma Tarihi 23 Eylül 2021
Gönderilme Tarihi 30 Kasım 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 15 Sayı: 5

Kaynak Göster

Vancouver Kandur Y, Alpcan A, Yozgat M, Tursun S. Polycythemia in a Pediatric Patient with Chronic Kidney Disease: Overuse of Erythropoerin Due COVID-19 Isolation. Türkiye Çocuk Hast Derg. 2021;15(5):434-6.

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