Sistemik Mastositoz Tanılı Hastaya Yaklaşım
Özet
Olgumuz, 56 yaş kadın hasta, kas ve kemik ağrısı, baş ağrısı, tekrarlayan alerjik ürtiker ve anafilaksiye kadar ilerleyen şikayetler ile ilk başvurusu 3 yıl önce oldu. Yapılan değerlendirmeler ile hastaya indolen sistemik mastositoz (İSM) tanısı konuldu. Hastanın semptomatik olması nedeni ile tedavi ihtiyacı mevcuttu. Semptomatik hastalık antihistaminik tedaviler ve montelukast ile kontrol altına alınırken, hastalık kontrolü ve mast hücre yükünü azaltmak için imatinib mesilat (İM) planlandı. Mevcut tedavi altında hem hastalık kontrolü sağlanmış olup hem klinik olarak yanıt alındı. Hasta hayatı tehdit eden anafilaktik reaksiyon tekrar yaşamadı. 2,5 yılın sonunda halen bu tedavi ile kontrol altında seyretmektedir. 56 yaşındaki kadın hasta, 3 yıl önce kas ve kemik ağrısı, baş ağrısı, tekrarlayan ürtiker ve anafilaksiye kadar ilerleyen şikayetlerle başvurdu. Yapılan değerlendirmeler sonucunda hastaya indolen sistemik mastositoz (İSM) tanısı konuldu. Şikayetlerinin belirgin olması nedeniyle tedaviye başlanmasına karar verildi. Semptomlar antihistaminik ilaçlar ve montelukast ile kontrol altına alınırken, hastalığı kontolü ve mast hücre yükünü azaltmak için imatinib mesilat (İM) tedavisi başlandı. Bu tedavi sayesinde hem klinik olarak olumlu yanıt alındı hem de hastalık kontrolü sağlandı. Hasta bir daha hayatı tehdit eden anafilaktik reaksiyon geçirmedi. İki buçuk yılın sonunda, hastanın durumu bu tedaviyle halen başarılı bir şekilde kontrol altında tutulmaktadır.
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