Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016

Amaç: Ürtikerin kolay tanı konulabilen ancak çok farklı yaklaşımların görülebildiği bir hastalık olması, son yıllarda hastalığın tanım, sınıflama, etiyopatogenez, tanısal testler ve tedavi yaklaşımları açısından bir algoritma içerisinde değerlendirilmesi gerekliliğini doğurmuştur. Bu amaçla Dermatoimmünoloji ve Allerji Derneği ile Türk Dermatoloji Derneği Dermatoallerji Çalışma Grubu içerisinde yer alan yazarlar, ürtikerin izleminde kanıta dayalı bir yol gösterici olması açısından bu ürtiker kılavuzunu oluşturmayı hedeflemiştir.Gereç ve Yöntem: Bu kılavuz, her bölümü ayrı bir yazar tarafından yazılacak biçimde planlanmış; ürtikerle ilgili Medline verileri ve 2000-2016 yılları arasında yayımlanan tüm ürtiker tanı ve tedavi kılavuzları ve uzman görüşleri incelenmiş ve üç ayrı toplantıda tüm bu veriler ayrıntılı olarak tartışılmıştır. Dermatoloji uzmanlarına yönelik hazırlanan anket sonuçlarının değerlendirilmesinin ardından kılavuzun ana hatları belirlenmiş, hazırlanan bölümler e-posta yazışmaları ile diğer yazarlar tarafından da değerlendirilmiş ve tüm yazarlarla yapılan son toplantıda kılavuz tümüyle gözden geçirilerek hazır hale getirilmiştir. Bulgular: Kılavuz, tanım, sınıflama, fizyopatoloji, etiyoloji ve tetikleyici faktörler ile tanı ve tedavi yaklaşımlarını içermektedir. Ürtiker, akut ve kronik olarak, kronik ürtiker (KÜ) ise "spontan" ve "uyarılabilir" olmak üzere sınıflanmıştır. Tedavinin ilk basamağını standart doz ikinci kuşak antihistaminler oluşturmaktadır. İlk basamakta yanıt alınamayan hastalarda antihistamin dozu dört katına kadar artırılır. Yanıt alınamayan durumlarda, başka bir ikinci kuşak antihistamin aynı dozda verilir. Yine yanıt alınamayan olgularda omalizumab tedavisine geçilir. Omalizumabın önerilen dozuna yanıt vermeyen olgularda doz artırılabilir. Omalizumaba yanıt alınamayan hastalarda ise siklosporin verilmesi önerilir. Rutin tanısal tetkikler AÜ'de önerilmezken, KÜ'de rutin tetkik olarak eritrosit sedimentasyon hızı, tam kan sayımı ve C-reaktif protein tetkiklerinin istenmesi yeterlidir. Sonuç: Ürtiker özellikle kronikleştiğinde hekimler için tedavi ve izlem açısından güçlükler doğurabilen bir hastalıktır. Olabildiğince kanıta dayalı verilerden (ve kişisel deneyimlerden) yola çıkarak hazırlanan bu kılavuz, ürtikerli olgularda hem tanı ve tedavi yaklaşımlarının yönlendirilmesinde yol gösterici olacak, hem de hekimlerin bu süreçlerde yaşadıkları zorlukların aşılmasına katkı sunacaktır

Anahtar Kelime:

Konular: Dermatoloji

The Turkish Guideline for the Diagnosis and Management of Urticaria-2016

Öz:

Background and Design: Albeit an easily recognized disease, urticaria features many diverse approaches which rationalize the need for an algorithm for the diagnosis, classification, etiopathogenesis, diagnostic evaluation and therapeutic approach. Therefore, authors from Dermatoallergy Working Group of the Turkish Society of Dermatology and the Turkish Dermatoimmunology and Allergy Association aimed to create an urticaria guideline for the diagnosis, treatment and followup of urticaria.Materials and Methods: Each section of the guideline has been written by a different author. The prepared sections were evaluated in part by e-mail correspondence and have taken its final form after revision in the last meeting held by the participation of all authors. Results: The guideline includes the description, classification, pathophysiology as well as diagnosis and treatment of urticaria. Urticaria is classified into two main types: acute urticaria and chronic urticaria while chronic urticaria is further subdivided into spontaneous urticaria and inducible urticaria. The first step of treatment includes standard doses of H1-blockers. In patients who do not respond to the first step, antihistamine dose is increased up to four times; if unsuccessful, another second-generation antihistamine is given in the same dose. In antihistamine-resistant cases, introduction of omalizumab is required. Omalizumab dose may be increased in patients failing to respond to the standard dose. In patients unresponsive to omalizumab, cyclosporine-A may be given. Routine diagnostic tests are not recommended in acute urticaria. In chronic urticaria, erythrocyte sedimentation rate, differential blood count and C-reactive protein testing are the only investigations that are needed routinely. Conclusion: Chronic urticaria is a disease that can be challenging for the physician in terms of treatment and follow-up. Depending on evidence-based data (and individual experiences), this guideline will have a leading role in the diagnosis and treatment of urticaria and help the physician to overcome the challenges in the management

Anahtar Kelime:

Konular: Dermatoloji

Belge Türü: Makale Makale Türü: Diğer Erişim Türü: Erişime Açık

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APA	Kocatürk E, AKTAN Ş, ATAKAN Z, BÜLBÜL BAŞKAN E, ERDEM T, KOCA R, BOZKURT ŞAVK E, Taskapan O, Utas S (2016). Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016. , 82 - 98.
Chicago	Kocatürk Emek,AKTAN Şebnem,ATAKAN ZEHRA NİLGÜN,BÜLBÜL BAŞKAN Emel,ERDEM Teoman,KOCA Rafet,BOZKURT ŞAVK EKİN,Taskapan Oktay,Utas Serap Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016. (2016): 82 - 98.
MLA	Kocatürk Emek,AKTAN Şebnem,ATAKAN ZEHRA NİLGÜN,BÜLBÜL BAŞKAN Emel,ERDEM Teoman,KOCA Rafet,BOZKURT ŞAVK EKİN,Taskapan Oktay,Utas Serap Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016. , 2016, ss.82 - 98.
AMA	Kocatürk E,AKTAN Ş,ATAKAN Z,BÜLBÜL BAŞKAN E,ERDEM T,KOCA R,BOZKURT ŞAVK E,Taskapan O,Utas S Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016. . 2016; 82 - 98.
Vancouver	Kocatürk E,AKTAN Ş,ATAKAN Z,BÜLBÜL BAŞKAN E,ERDEM T,KOCA R,BOZKURT ŞAVK E,Taskapan O,Utas S Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016. . 2016; 82 - 98.
IEEE	Kocatürk E,AKTAN Ş,ATAKAN Z,BÜLBÜL BAŞKAN E,ERDEM T,KOCA R,BOZKURT ŞAVK E,Taskapan O,Utas S "Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016." , ss.82 - 98, 2016.
ISNAD	Kocatürk, Emek vd. "Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016". (2016), 82-98.

APA	Kocatürk E, AKTAN Ş, ATAKAN Z, BÜLBÜL BAŞKAN E, ERDEM T, KOCA R, BOZKURT ŞAVK E, Taskapan O, Utas S (2016). Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016. Türkderm-Deri Hastalıkları ve Frengi Arşivi, 50(3), 82 - 98.
Chicago	Kocatürk Emek,AKTAN Şebnem,ATAKAN ZEHRA NİLGÜN,BÜLBÜL BAŞKAN Emel,ERDEM Teoman,KOCA Rafet,BOZKURT ŞAVK EKİN,Taskapan Oktay,Utas Serap Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016. Türkderm-Deri Hastalıkları ve Frengi Arşivi 50, no.3 (2016): 82 - 98.
MLA	Kocatürk Emek,AKTAN Şebnem,ATAKAN ZEHRA NİLGÜN,BÜLBÜL BAŞKAN Emel,ERDEM Teoman,KOCA Rafet,BOZKURT ŞAVK EKİN,Taskapan Oktay,Utas Serap Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016. Türkderm-Deri Hastalıkları ve Frengi Arşivi, vol.50, no.3, 2016, ss.82 - 98.
AMA	Kocatürk E,AKTAN Ş,ATAKAN Z,BÜLBÜL BAŞKAN E,ERDEM T,KOCA R,BOZKURT ŞAVK E,Taskapan O,Utas S Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016. Türkderm-Deri Hastalıkları ve Frengi Arşivi. 2016; 50(3): 82 - 98.
Vancouver	Kocatürk E,AKTAN Ş,ATAKAN Z,BÜLBÜL BAŞKAN E,ERDEM T,KOCA R,BOZKURT ŞAVK E,Taskapan O,Utas S Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016. Türkderm-Deri Hastalıkları ve Frengi Arşivi. 2016; 50(3): 82 - 98.
IEEE	Kocatürk E,AKTAN Ş,ATAKAN Z,BÜLBÜL BAŞKAN E,ERDEM T,KOCA R,BOZKURT ŞAVK E,Taskapan O,Utas S "Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016." Türkderm-Deri Hastalıkları ve Frengi Arşivi, 50, ss.82 - 98, 2016.
ISNAD	Kocatürk, Emek vd. "Türkiye Ürtiker Tanı ve Tedavi Kılavuzu-2016". Türkderm-Deri Hastalıkları ve Frengi Arşivi 50/3 (2016), 82-98.