Yıl: 2021 Cilt: 15 Sayı: 4 Sayfa Aralığı: 203 - 209 Metin Dili: İngilizce DOI: 10.5578/ced.20219601 İndeks Tarihi: 06-06-2022

The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature

Öz:
Objective: Chronic granulomatous disease (CGD) a primary immunodeficiency disease that affects the innate immune system, and characterized by life-threatening and/or recurrent infections caused by bacteria and fungi. Invasive fungal diseases (IFDs) are the most common causes of death among CGD patients. Itraconazole is usually used for prophylaxis in CGD patients at high risk of IFD. However, patient compliance with oral itraconazole use is low due to gastrointestinal side effects. We aim to report the efficacy of long-term voriconazole prophylaxis for IFD on our CGD patients. Material and Methods: This retrospective study includes seven CGD patients. All data were recorded from their hospital registries. CGD was diagnosed with both functional and genetic analysis. Patients who had used voriconazole prophylaxis for six months or more after clinical and/ or laboratory diagnosis of IFD were included in this study. Invasive fungal diseases were classified as proven, probable, or possible according to the revised criteria of the guideline. Results: All seven patients were male. Two had an X-linked recessive subtype of CGD (X-CGD), and the others had autosomal recessive subtypes of CGD. The median age at diagnosis was 7 (4.5-19) years. Aspergillus spp was showed in three of patients. The median age at which first IFD oc-curred was 10 (4.5-19) years. The median follow-up period was 6 (3-16) years. After voriconazole prophylaxis, 6 patients did not suffer from IFD second time. Only one patient, who has X-CGD, suffered from multiple fungal osteomyelitis and recurrent IFD despite undergoing voriconazole prophylaxis. Only one patient developed a lupus-like lesion in the cheek, which resolved after discontinuation of voriconazole prophylaxis. Conclusion: Long-term voriconazole prophylaxis may be an alternative option in CGD patients with IFD in terms of patient compliance, efficacy and side effects.
Anahtar Kelime:

Kronik Granulomatoz Hastalıklı Yedi Hastada Uzun Dönem Vorikonazol Profilaksinin Etkisi ve Literatürün Gözden Geçirilmesi

Öz:
Giriş: Kronik granulomatoz hastalık (KGH) doğal bağışıklık sistemini etkileyen primer bağışıklık yetmezlik hastalığıdır. Bu hastalık bakteri ve fungus aracılığıyla hayatı tehdit eden veya tekrarlayan enfeksiyonlarla karakterizedir. KGH’li hastalarda ölümün en sık nedeni invaziv fungal hastalıklardır (IFH). İtrakonazol, yüksek IFH’ye sahip KGH’lı hastalarda profilaksi için kullanılır. Ancak oral itrakonazol kullanımına hasta uyumu gastrointestinal yan etki nedeniyle düşüktür. KGH hastalarımızda IFD için uzun süreli vorikonazol profilaksisinin etkinliğini bildirmeyi hedefliyoruz. Gereç ve Yöntemler: Bu geriye dönük çalışma yedi KGH hastasını içermektedir. Tüm veriler hastane kayıtlarından kaydedildi. KGH tanısı, fonksiyonel ve genetik analiz sonuçlarına göre konuldu. Klinik ve/veya laboratuvar olarak IFD tanısı konulduktan sonra, altı ay veya daha fazla sürede vorikonazol profilaksisi kullanılan hastalar bu çalışmaya dahil edildi. İnvazif fungal hastalıklar, revize edilmiş kılavuz kriterlerine göre kanıtlanmış, olası veya muhtemel olarak sınıflandırılmıştır. Bulgular: Yedi hastanın tamamı erkekti. İki tanesi X’e bağlı resesif KGH alt tipine (X-KGH) diğerleri otozomal resesif KGH alt tipine sahipti. KGH’nin ortanca tanı yaşı 7 (4.5-19) yıl idi. Üç hastada Aspergillus spp. kanıtlandı. İlk IFH’nin ortanca tanı yaşı 10 (4.5-19) yıl idi. Hastaların ortanca takip süresi 6 (3-16) yıl idi. Vorikonazol profilaksi sonrasında, altı hasta ikinci kez IFH’a maruz kalmadı. Sadece bir hasta (X-KGH), vorikonazol profilaksisine girmesine rağmen çoklu fungal osteomiyelit ve tekrarlayan IFD’den muzdaripti. Sadece bir hastada yanakta lupus benzeri bir lezyon gelişti ve vorikonazolün kesilmesinden sonra düzeldi. Sonuç: Uzun süreli vorikonazol profilaksisi, hasta uyumu, etkinlik ve yan etkiler açısından IFH’li KGH hastalarında alternatif seçenek olabilir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Kutluğ Ş, Kökcü karadağ Ş, ŞENSOY S, BIRINCI A, koker M, YILDIRAN A (2021). The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature. , 203 - 209. 10.5578/ced.20219601
Chicago Kutluğ Şeyhan,Kökcü karadağ Şefika ilknur,ŞENSOY S. Gülnar,BIRINCI ASUMAN,koker Mustafa Yavuz,YILDIRAN ALISAN The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature. (2021): 203 - 209. 10.5578/ced.20219601
MLA Kutluğ Şeyhan,Kökcü karadağ Şefika ilknur,ŞENSOY S. Gülnar,BIRINCI ASUMAN,koker Mustafa Yavuz,YILDIRAN ALISAN The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature. , 2021, ss.203 - 209. 10.5578/ced.20219601
AMA Kutluğ Ş,Kökcü karadağ Ş,ŞENSOY S,BIRINCI A,koker M,YILDIRAN A The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature. . 2021; 203 - 209. 10.5578/ced.20219601
Vancouver Kutluğ Ş,Kökcü karadağ Ş,ŞENSOY S,BIRINCI A,koker M,YILDIRAN A The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature. . 2021; 203 - 209. 10.5578/ced.20219601
IEEE Kutluğ Ş,Kökcü karadağ Ş,ŞENSOY S,BIRINCI A,koker M,YILDIRAN A "The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature." , ss.203 - 209, 2021. 10.5578/ced.20219601
ISNAD Kutluğ, Şeyhan vd. "The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature". (2021), 203-209. https://doi.org/10.5578/ced.20219601
APA Kutluğ Ş, Kökcü karadağ Ş, ŞENSOY S, BIRINCI A, koker M, YILDIRAN A (2021). The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature. Çocuk Enfeksiyon Dergisi, 15(4), 203 - 209. 10.5578/ced.20219601
Chicago Kutluğ Şeyhan,Kökcü karadağ Şefika ilknur,ŞENSOY S. Gülnar,BIRINCI ASUMAN,koker Mustafa Yavuz,YILDIRAN ALISAN The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature. Çocuk Enfeksiyon Dergisi 15, no.4 (2021): 203 - 209. 10.5578/ced.20219601
MLA Kutluğ Şeyhan,Kökcü karadağ Şefika ilknur,ŞENSOY S. Gülnar,BIRINCI ASUMAN,koker Mustafa Yavuz,YILDIRAN ALISAN The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature. Çocuk Enfeksiyon Dergisi, vol.15, no.4, 2021, ss.203 - 209. 10.5578/ced.20219601
AMA Kutluğ Ş,Kökcü karadağ Ş,ŞENSOY S,BIRINCI A,koker M,YILDIRAN A The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature. Çocuk Enfeksiyon Dergisi. 2021; 15(4): 203 - 209. 10.5578/ced.20219601
Vancouver Kutluğ Ş,Kökcü karadağ Ş,ŞENSOY S,BIRINCI A,koker M,YILDIRAN A The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature. Çocuk Enfeksiyon Dergisi. 2021; 15(4): 203 - 209. 10.5578/ced.20219601
IEEE Kutluğ Ş,Kökcü karadağ Ş,ŞENSOY S,BIRINCI A,koker M,YILDIRAN A "The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature." Çocuk Enfeksiyon Dergisi, 15, ss.203 - 209, 2021. 10.5578/ced.20219601
ISNAD Kutluğ, Şeyhan vd. "The Efficacy of Long-Term Voriconazole Prophylaxis on Seven Patients with Chronic Granulomatous Disease and Review of the Literature". Çocuk Enfeksiyon Dergisi 15/4 (2021), 203-209. https://doi.org/10.5578/ced.20219601