Otoimmün Hepatit Hastalarında Tek Merkez Tedavi Deneyimi

Osman Sütçüoğlu, Zeynep Gök Sargın, Naser Alizadeh Haghighi, Selma Demirbaş Yüceldi, Ali Karataş, İbrahim Koral Önal, Şükrü Dumlu, Seren Özenirler, Mehmet Cindoruk, İbrahim Doğan, Tarkan Karakan, Mehmet Arhan, Mehmet İbiş

Abstract


Amaç: Bu çalışmada otoimmun hepatit (OİH) tedavi rejimlerinin etkinliğinin değerlendirilmesi amaçlandı.

Yöntem:OİH tanısı ile takip edilen hastaların klinik, demografik verileri, aldıkları tedaviler ve tedavi yanıtları retrospektif olarak değerlendirildi.

Bulgular:Çalışmaya dahil edilen 66 hastanın 61’i (%92.4) birinci basamak tedavi rejimi olarak kortikosteroid ve azatiopürin(AZA) kombinasyonu almaktaydı ve 45 hastada (%73.8)  tam yanıt gözlendi. Kombinasyon tedavisi alan 21 hastada (%34); tedavi yanıtsızlığı (16 hasta) ve yan etkiler (5 hasta) nedeniyle tedavi değişikliğine gidilmiş ve 10 hastada (%16) ikinci basamak rejim olarak mikofenolatmofetil (MMF) tedavisine geçilmiştir. MMF başlanan hastaların 8’inde (%80) tam yanıt, 1’inde (%10) inkomplet yanıt saptanmış, 2 hastada (%20) lökopeni görülmüş ancak tedaviyi kesmeyi gerektirmemiştir.

Sonuç:OİH tedavisinde konvansiyonel tedavi olan AZA + kortikosteroid kombinasyonu ile hastaların yaklaşık dörtte birinde tam yanıt alınamamaktadır. Alternatif tedaviler sınırlı olmakla birlikte MMF  bu konuda umut vaat edici görünmektedir.


Keywords


Otoimmün hepatit, tedavi yanıtı, azatiopürin, steroid, mikofenolat mofetil

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