The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases

TAŞDEMİR, Arzu Erdem; TEKE ÜSKÜDAR, Hava; ÖZEN, Mustafa

The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases

Hava TEKE ÜSKÜDAR, (Eskişehir Osmangazi Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Eskişehir, Türkiye)

Arzu Erdem TAŞDEMİR, (Kayseri Eğitim ve Araştırma Hastanesi, Patoloji Bölümü, Kayseri, Türkiye)

Mustafa ÖZEN (Sağlık Bakanlığı, Kayseri Eğitim ve Araştırma Hastanesi, İç Hastalıkları Kliniği, Kayseri, Türkiye)

Turkish Journal of Rheumatology(.)Archives of Rheumatology

0 0

Yıl: 2013 Cilt: 28 Sayı: 2 Sayfa Aralığı: 123 - 127 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases

Öz:

Metotreksat (MTX), romatoid artrit (RA) tedavisinde en sık kullanılan ilaçtır. Metotreksat ile tedavi edilen RA'lı hastalarda pansitopeni prevalansı yaklaşık %3'tür. İlave sistemik hastalığı olan RA hastalarına çeşitli ilaçlar reçete edilebilir. Bu ilaçlar kemik iliği toksisitesine yol açarak, hangi ilacın pansitopeniden sorumlu olduğunun tespitini güçleştirebilir. Bu nedenle, kemik iliği aspirasyonu ve numunelerin biyopsi sonuçları ile sorumlu ilacın tespiti, pansitopeninin en iyi tedavisinin belirlenmesi için çok önemlidir. Anlamlı düzeyde artmış kemik iliğindeki eozinofil miktarı, pansitopeni tablosunun nedeni olarak MTX'i işaret etmektedir.

Anahtar Kelime:

Konular: Romatoloji

Romatoid Artrit ve İlave Sistemik Hastalığı Olan Kişilerde Pansitopeniden Sorumlu İlacın Belirlenmesinin Önemi

Öz:

Methotrexate (MTX) is the most commonly used drug in the treatment of rheumatoid arthritis (RA). In MTX- treated RA patients, the prevalence of pancytopenia is nearly 3%. Several medications may be prescribed for RA patients with an additional systemic disease. This may result in bone marrow toxicity, making it difficult to know which drug induced the pancytopenic condition. Therefore, identifying the culprit agent through bone marrow aspiration and biopsy findings of the samples is critical for determining the best course of treatment for pancytopenia. Significantly increased amounts of eosinophilia in the bone marrow indicate that MTX is the culprit for the presentation of pancytopenia.

Anahtar Kelime:

Konular: Romatoloji

Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık

Weinblatt ME. Toxicity of low dose methotrexate in rheumatoid arthritis. J Rheumatol Suppl 1985;12 Suppl 12:35-9.
Preet Singh Y, Aggarwal A, Misra R, Agarwal V. Low-dose methotrexate-induced pancytopenia. Clin Rheumatol 2007;26:84-7.
Gutierrez-Ureña S, Molina JF, García CO, Cuéllar ML, Espinoza LR. Pancytopenia secondary to methotrexate therapy in rheumatoid arthritis. Arthritis Rheum 1996;39:272-6.
Gayathri BN, Rao KS. Pancytopenia: a clinico hematological study. J Lab Physicians 2011;3:15-20. doi: 10.4103/0974-2727.78555.
O'brien WM. Adverse reactions to nonsteroidal anti- inflammatory drugs. Diclofenac compared with other nonsteroidal anti-inflammatory drugs. Am J Med 1986;80:70-80.
Grove ML, Hassell AB, Hay EM, Shadforth MF. Adverse reactions to disease-modifying anti-rheumatic drugs in clinical practice. QJM 2001;94:309-19.
Winchester RJ, Koffler D, Litwin SD, Kunkel HG. Observations on the eosinophilia of certain patients with rheumatoid arthritis. Arthritis Rheum 1971;14:650-65.
Savolainen HA, Leirisalo-Repo M. Eosinophilia as a side- effect of methotrexate in patients with chronic arthritis. Clin Rheumatol 2001;20:432-4.
Eustace S, O'Neill T, McHale S, Molony J. Fatal aplastic anaemia following prolonged diclofenac use in an elderly patient. Ir J Med Sci 1989;158:217.
Ciucci AG. A review of spontaneously reported adverse drug reactions with diclofenac sodium (Voltarol). Rheumatol Rehabil 1979;Suppl 2:116-21.
Trivier JM, Caron J, Mahieu M, Cambier N, Rose C. Fatal aplastic anaemia associated with clopidogrel. Lancet 2001;357:446.
Meyer B, Staudinger T, Lechner K. Clopidogrel and aplastic anaemia. Lancet 2001;357:1446-7.
Güler N, Tander B, Kısacık B, Utku U, Çevik A, Erçolak V, et al. Low-dose methotrexate associated pancytopenia in a patient with rheumatoid arthritis. Turk J Phys Med Rehab 2008;54:79-81
Bruyn GA, Velthuysen E, Joosten P, Houtman PM. Pancytopenia related eosinophilia in rheumatoid arthritis: a specific methotrexate phenomenon? J Rheumatol 1995;22:1373-6.

APA	TEKE ÜSKÜDAR H, TAŞDEMİR A, ÖZEN M (2013). The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases. , 123 - 127.
Chicago	TEKE ÜSKÜDAR Hava,TAŞDEMİR Arzu Erdem,ÖZEN Mustafa The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases. (2013): 123 - 127.
MLA	TEKE ÜSKÜDAR Hava,TAŞDEMİR Arzu Erdem,ÖZEN Mustafa The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases. , 2013, ss.123 - 127.
AMA	TEKE ÜSKÜDAR H,TAŞDEMİR A,ÖZEN M The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases. . 2013; 123 - 127.
Vancouver	TEKE ÜSKÜDAR H,TAŞDEMİR A,ÖZEN M The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases. . 2013; 123 - 127.
IEEE	TEKE ÜSKÜDAR H,TAŞDEMİR A,ÖZEN M "The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases." , ss.123 - 127, 2013.
ISNAD	TEKE ÜSKÜDAR, Hava vd. "The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases". (2013), 123-127.

APA	TEKE ÜSKÜDAR H, TAŞDEMİR A, ÖZEN M (2013). The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases. Turkish Journal of Rheumatology(.)Archives of Rheumatology, 28(2), 123 - 127.
Chicago	TEKE ÜSKÜDAR Hava,TAŞDEMİR Arzu Erdem,ÖZEN Mustafa The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases. Turkish Journal of Rheumatology(.)Archives of Rheumatology 28, no.2 (2013): 123 - 127.
MLA	TEKE ÜSKÜDAR Hava,TAŞDEMİR Arzu Erdem,ÖZEN Mustafa The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases. Turkish Journal of Rheumatology(.)Archives of Rheumatology, vol.28, no.2, 2013, ss.123 - 127.
AMA	TEKE ÜSKÜDAR H,TAŞDEMİR A,ÖZEN M The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases. Turkish Journal of Rheumatology(.)Archives of Rheumatology. 2013; 28(2): 123 - 127.
Vancouver	TEKE ÜSKÜDAR H,TAŞDEMİR A,ÖZEN M The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases. Turkish Journal of Rheumatology(.)Archives of Rheumatology. 2013; 28(2): 123 - 127.
IEEE	TEKE ÜSKÜDAR H,TAŞDEMİR A,ÖZEN M "The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases." Turkish Journal of Rheumatology(.)Archives of Rheumatology, 28, ss.123 - 127, 2013.
ISNAD	TEKE ÜSKÜDAR, Hava vd. "The Importance of Determining the Drug Agent Responsible for Pancytopenia in Patients with Rheumatoid Arthritis and Additional Systemic Diseases". Turkish Journal of Rheumatology(.)Archives of Rheumatology 28/2 (2013), 123-127.