Kroni̇k Hastalığı Olan Çocuğun İzlemi̇ ve Toplumda Bakımı

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DOI :10.26650/B/CH32.2024.010.023   IUP :10.26650/B/CH32.2024.010.023    Tam Metin (PDF)

Si̇stemi̇k Lupus Eri̇tematozus Olan Çocuğun İzlemi̇ ve Toplumda Bakımı

Gülşah Kavrul Kayaalp, Nuray Aktay Ayaz

Sistemik lupus eritematozus nadir fakat ciddi bir multisistem otoimmün/inflamatuvar hastalıktır. Hastalığın 18 yaşından önce başlaması jüvenil Sistemik lupus eritematozus olarak adlandırılır. Sistemik lupus eritematozus’un etiyolojisi ve patogenezi tam olarak aydınlatılamamıştır, genetik olarak duyarlı bireylerde çevresel ve hormonal faktörlerin hastalığın gelişimini etkilediği varsayılmaktadır. Sistemik lupus eritematozus deri, eklemler, böbrekler, akciğerler, kardiyovasküler sistem, sinir sistemi, seröz membranlar ve hematolojik sistem gibi herhangi bir sistemi tutabilir. Jüvenil Sistemik lupus eritematozus tanısı alan çocuklar için genel yönetim, güneşten korunma, düşük tuz ve yeterli kalsiyum tüketimi ile dengeli bir diyet ve yaygın patojenlere karşı bağışıklamayı içerir. Sistemik lupus eritematozus tanısı olan çocukların hidroksiklorokin kullanması önerilir. Tutulan organa ve hastalığın şiddetine göre kortikosteroidler ve siklofosfamid, siklosporin, mikofenolat mofetil, azatiyopürin gibi immünsüpresif tedaviler kullanılır. Sistemik lupus ertematozus tanısı alan çocuklar büyüme geriliği, osteoporoz, gecikmiş püberte ve kardiyovasküler hastalık risk faktörler açısından izlenmelidirler. Komorbiditelerin ve kognitif performansın takibi çocukların yaşam kalitesinin iyileştirilmesi için önem taşımaktadır. Bu çocuklarda duygudurum bozuklukları da sık görülebilmektedir. Sistemik lupus eritemotozus hastalarında immun sistem disregülasyonu ve immunsupresif tedavilere bağlı olarak artmış enfeksiyon riski vardır, bu nedenle bağışıklama tedavide önemli rol oynar. Mümkün olduğunca, bu çocuklar immünsüpresif tedavi almadan önce aşılanmalıdır; tedavi alırken aşı uygulaması vaka bazında değerlendirilmeli ve aşılamaya özen gösterilmelidir. Multidisipliner yaklaşım okul başarısı ve akademic performansı için çok önemlidir.


Anahtar Kelimeler: Sistemik lupus eritematozus, çocuk
DOI :10.26650/B/CH32.2024.010.023   IUP :10.26650/B/CH32.2024.010.023    Tam Metin (PDF)

Follow-up and Community Care of the Child with Systemic Lupus Erythematosus

Gülşah Kavrul Kayaalp, Nuray Aktay Ayaz

Systemic lupus erythematosus (SLE) is a rare and serious multisystem autoimmune/inflammatory disease whose etiology and pathogenesis has not yet been elucidated. Juvenile SLE emerges before the age of 18. It is hypothesized that environmental and hormonal factors influence its development in genetically susceptible individuals. SLE can involve any system, such as the skin, joints, kidneys, lungs, cardiovascular system, nervous system, serous membranes, and hematological system. Juvenile SLE can generally managed by sun protection, balanced diet with low salt and adequate calcium consumption, immunization against common pathogens, and hydroxychloroquine administration. The use of corticosteroids and immunosuppressive treatments (e.g., cyclophosphamide, cyclosporine, mycophenolate mofetil, and azathioprine) depend on the organ involved and the severity of the disease. For these patients, follow-up should focus on treating growth retardation, osteoporosis, delayed puberty, and risk for cardiovascular disease, to improve the quality of life. Mood disorders are also common in these children. Immunization is key to treatment as immune system dysregulation and immunosuppressive treatments increase the risk of infection in patients with SLE. Whenever possible, these children should be vaccinated before receiving immunosuppressive therapy. While receiving treatment, vaccination should be evaluated on a caseby-case basis and should be performed with care. A multidisciplinary approach is crucial for the patients’ academic performance.


Anahtar Kelimeler: Systemic lupus erythematosus, child

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