Yıl: 2015 Cilt: 12 Sayı: 1 Sayfa Aralığı: 56 - 59 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Wilson's disease presenting with HELLP syndrome; A case report

Öz:
Wilson hastalığı (WH) otozomal resesif bir hastalıktır. Bakır metalinin safra atılım sisteminin bozukluğundan dolayı, özellikle karaciğer, böbrek, kornea ve beyin dokusunda, toksik dozda birikimi ile karakterizedir. Hepatik bulgular oldukça değişkendir; aminotransferazların asemptomatik yükselmesinden, kronik hepatit, siroz, akut veya fulminant karaciğer yetmezliğine kadar değişim gösteren bir klinik tablo izlenebilir. WHde akut karaciğer yetmezliği, akut intravasküler hemolitik anemi ile karakterizedir. WH olduğu bilinen bir gebede, görülen hemoliz ve trombositopeni bulgusu karaciğer yetmezliğinin yanısıra Hemolysis, Elevated Liver Enzymes, Low Platelet Count (HELLP) sendromuna bağlı olarak geliştiği yorumlanabilir. Ancak tanı koymak oldukça güçtür. Burada HELLP sendromu ile prezente olan, postpartum dönemde akut karaciğer yetmezliği bulguları da gelişen WH olgusu literatür eşliğinde tartışılmıştır.
Anahtar Kelime:

Konular: Cerrahi

HELLP sendromu ile prezente olan Wilson hastalığı: Olgu sunumu

Öz:
Wilson s disease (WD) is an autosomal recessive disorder. It is characterized by toxic accumulation of copper mainly in the liver and brain but also in cornea and kidney due to a defect in biliary excretion of copper. The hepatic manifestation of WD is diverse and may include asymptomatic elevation of aminotransferase, chronic hepatitis, cirrhosis, or acute/fulminant hepatic failure. Characteristic of acute hepatic failure in WD is concomitance of acute intravascular hemolytic anemia. Acute intravascular hemolytic anemia and thrombocytopenia in WD may be interpreted as a feature of Hemolysis, Elevated Liver Enzymes, Low Platelet Count (HELLP) syndrome besides acute liver failure. The differential diagnosis may be very difficult. Here, WD in pregnancy presenting with clinical symptoms of HELLP syndrome and developing acute liver failure in postpartum period is discussed.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık
  • 1. Schilsky ML. Wilson disease: new insights into pathogenesis, diagnosis, and future therapy. Curr Gastroenterol Rep 2005;7:26-31.
  • 2. Pfeiffer RF. Wilson’s disease. Semin Neurol 2007;27:123-32.
  • 3. Üstüner I, Keskin L, Uzun M, Çankaya A, Gündüz B, Ceylan GG, ve ark. Wilson Hastalığı ve Gebelik:Olgu Sunumu. TJOD Derg 2009;6:279-82.
  • 4. Czionkowska A, Gromadzka G Büttner J, Chabik G. Clinical features of hemolysis, elevated liver enzymes, and low platelet count syndrome in undiagnosed Wilson disease: report of two cases. Arch Gynecol Obstet 2010;281:129-34.
  • 5. Sheikh SM, Khair H. Pregnancy With Wilson’s Disease-A case Report. Isra Med J 2013;5:151-2.
  • 6. Ala A, Walker AP, Ashkan K. Wilson’s disease. Lancet 2007;369:397-408.
  • 7. Balkema S, Hamaker ME, Visser HP. Haemolytic anaemia as a first sign of Wilson’s disease. Neth J Med 2008;66:344-7.
  • 8. Korman JD, Volenberg I, Balko J. Pediatric and Adult Acute Liver Failure Study Groups. Screening for Wilson disease in acute liver failure: a comparison of currently available diagnostic tests. Hepatology 2008;48:1167-74.
  • 9. Mihu D, Costin N, Mihu CM. Seicean A, Ciortea R. HELLP syndrome-a multisystemic disorder. J Gastrointestin Liver Dis 2007;16:419-24.
  • 10. Riordan SM, Williams R. The Wilson’s disease gene and phenotypic diversity. J Hepatol 2001; 34:165-171.
  • 11. Anne M. Rich, M.D., Travis M. Lajoie, D.O. Wilson’s DiseaseTreatment of Psychiatric Manifestations in Pregnancy Psychosomatics 2012;53:175-7.
  • 12. Kuloğlu Z, Girgin N. Wilson hastalığı. T Klin J Pediatr 2004;13:246- 53.
  • 13. Atay Y, Coşkun A, Demir C, Altıntaş A, Köker I. Wilson Hastalığı Olan Gebelerde Penisilamin Kullanımının Sonuçları. T Klin Jinekol Obst 1992;2:174-5.
  • 14. Stahler E, Stahler F, Sturm G. Graviditat beiWilsonscher Kupferstoffwechselstorung. Geburtsh Frauenheilk 1972;32:590-3.
  • 15. Sinha S, Taly AB, Prashanth LK. Successful pregnancies and abortions in symptomatic and asymptomatic Wilson’s disease. J Neurol Sci 2004;217:37-40.
  • 16. Schagen van Leeuwen JH, Christiaens GC, Hoogenraad TU.Recurrent abortion and the diagnosis of Wilson disease. Obstet Gynecol 1991;78:547-9.
  • 17. Sternlieb I. Wilson’s disease and pregnancy. Hepatology 2000;31:531- 2.
  • 18. Almashhrawi AA, Ahmed KT, Rahman RN, Hammoud GM, Ibdah JA. Liver diseases in pregnancy: Diseases not unique to pregnancy. World J Gastroenterol 2013;19:7630-8.
  • 19. Roberts EA, Schilsky ML; American Association for Study of Liver Diseases (AASLD). Diagnosis and treatment of Wilson disease: an update. Hepatology 2008;47:2089-111.
  • 20. Shimono N, Ishibashi H, Ikematsu H, Kudo J, Shirahama M, Inaba S, et al. Fulminant hepatic failure during perinatal period in a pregnant woman with Wilson’s disease. Gastroenterol Jpn 1991;26:69-73.
  • 21. Steingrub JS. Pregnancy-associated severe liver dysfunction. Crit Care Clin 2004;20:763-76.
  • 22. Ferenci P. Review article: diagnosis and current therapy of Wilson’s disease. Aliment Pharmacol Ther 2004;19:157-65.
  • 23. Mihu D, Costin N, Mihu CM. HELLP syndrome-a multisystemic disorder. J Gastrointestin Liver Dis 2007;16:419-24.
APA NERGİZ AVCIOĞLU S, ALTINKAYA S, KÜÇÜK M, ZAFER E, DEMİRCAN SEZER S, ODABAŞI A (2015). Wilson's disease presenting with HELLP syndrome; A case report. , 56 - 59.
Chicago NERGİZ AVCIOĞLU SÜMEYRA,ALTINKAYA Sündüz Özlem,KÜÇÜK Mert,ZAFER EMRE,DEMİRCAN SEZER Selda,ODABAŞI Ali Rıza Wilson's disease presenting with HELLP syndrome; A case report. (2015): 56 - 59.
MLA NERGİZ AVCIOĞLU SÜMEYRA,ALTINKAYA Sündüz Özlem,KÜÇÜK Mert,ZAFER EMRE,DEMİRCAN SEZER Selda,ODABAŞI Ali Rıza Wilson's disease presenting with HELLP syndrome; A case report. , 2015, ss.56 - 59.
AMA NERGİZ AVCIOĞLU S,ALTINKAYA S,KÜÇÜK M,ZAFER E,DEMİRCAN SEZER S,ODABAŞI A Wilson's disease presenting with HELLP syndrome; A case report. . 2015; 56 - 59.
Vancouver NERGİZ AVCIOĞLU S,ALTINKAYA S,KÜÇÜK M,ZAFER E,DEMİRCAN SEZER S,ODABAŞI A Wilson's disease presenting with HELLP syndrome; A case report. . 2015; 56 - 59.
IEEE NERGİZ AVCIOĞLU S,ALTINKAYA S,KÜÇÜK M,ZAFER E,DEMİRCAN SEZER S,ODABAŞI A "Wilson's disease presenting with HELLP syndrome; A case report." , ss.56 - 59, 2015.
ISNAD NERGİZ AVCIOĞLU, SÜMEYRA vd. "Wilson's disease presenting with HELLP syndrome; A case report". (2015), 56-59.
APA NERGİZ AVCIOĞLU S, ALTINKAYA S, KÜÇÜK M, ZAFER E, DEMİRCAN SEZER S, ODABAŞI A (2015). Wilson's disease presenting with HELLP syndrome; A case report. Türk Jinekoloji ve Obstetrik Derneği Dergisi, 12(1), 56 - 59.
Chicago NERGİZ AVCIOĞLU SÜMEYRA,ALTINKAYA Sündüz Özlem,KÜÇÜK Mert,ZAFER EMRE,DEMİRCAN SEZER Selda,ODABAŞI Ali Rıza Wilson's disease presenting with HELLP syndrome; A case report. Türk Jinekoloji ve Obstetrik Derneği Dergisi 12, no.1 (2015): 56 - 59.
MLA NERGİZ AVCIOĞLU SÜMEYRA,ALTINKAYA Sündüz Özlem,KÜÇÜK Mert,ZAFER EMRE,DEMİRCAN SEZER Selda,ODABAŞI Ali Rıza Wilson's disease presenting with HELLP syndrome; A case report. Türk Jinekoloji ve Obstetrik Derneği Dergisi, vol.12, no.1, 2015, ss.56 - 59.
AMA NERGİZ AVCIOĞLU S,ALTINKAYA S,KÜÇÜK M,ZAFER E,DEMİRCAN SEZER S,ODABAŞI A Wilson's disease presenting with HELLP syndrome; A case report. Türk Jinekoloji ve Obstetrik Derneği Dergisi. 2015; 12(1): 56 - 59.
Vancouver NERGİZ AVCIOĞLU S,ALTINKAYA S,KÜÇÜK M,ZAFER E,DEMİRCAN SEZER S,ODABAŞI A Wilson's disease presenting with HELLP syndrome; A case report. Türk Jinekoloji ve Obstetrik Derneği Dergisi. 2015; 12(1): 56 - 59.
IEEE NERGİZ AVCIOĞLU S,ALTINKAYA S,KÜÇÜK M,ZAFER E,DEMİRCAN SEZER S,ODABAŞI A "Wilson's disease presenting with HELLP syndrome; A case report." Türk Jinekoloji ve Obstetrik Derneği Dergisi, 12, ss.56 - 59, 2015.
ISNAD NERGİZ AVCIOĞLU, SÜMEYRA vd. "Wilson's disease presenting with HELLP syndrome; A case report". Türk Jinekoloji ve Obstetrik Derneği Dergisi 12/1 (2015), 56-59.