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Adölesan Bir Kız Hastada Mikofenolat İlişkili Alopesi Mikofenolat ve Alopesi

Mycophenolate-Associated Alopecia in an Adolescent Girl Mycophenolate and Alopecia

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2014
DOI: 
10.5262/tndt.2014.1001.12

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
PURPOSE: To report a patient treated with enteric-coated mycophenolate sodium (EC-MPS), in whom infrequent side effects developed. CASE REPORT: A 14-year-old girl presented with hair loss after starting EC-MPS. She had her fi rst nephrotic syndrome attack when she was 7 years old. During the next six years, she had six attacks and two biopsies without fi ndings of segmental sclerosis. She received steroids and 55 months of CsA. She was evaluated as steroid and CsA dependent when she had a relapse a month after cessation of treatment. The last biopsy showed CsA toxicity. EC-MPS was institituted (1080 mg/d). Alopecia developed at the second month. The dose was decreased by two third and hair loss stopped within a month. Her menstrual cycles also ceased after EC-MPS treatment and resumed two months after dose reduction. She remained in remission during the following 8 months and had a new relapse thereafter, which responded to a short term of high dose steroid treatment. She is still on the 20th month of EC-MPS and had no relapse. CONCLUSION:This is the fi rst adolescent with alopecia and menstrual irregularity during EC-MPS treatment, which may be effective even at a two third of the suggested dose.
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Abstract (Original Language): 
AMAÇ: Enterik kaplı mikofenolat sodyum (EC-MPS) ile tedavi edilen ve nadir görülen yan etkilerin geliştiği bir olguyu bildirmek. OLGU SUNUMU: On dört yaşında kız hasta EC-MPS tedavisi sonrası gelişen saç kaybı ile başvurdu. Hastanın ilk nefrotik sendrom atağını 7 yaşında iken geçirdiği, takip eden 6 yıl boyunca 6 atak daha geçirdiği, bu sürede yapılan iki renal biyopside segmental skleroz bulgularına rastlanmadığı, steroid tedavisi ve 55 ay süren siklosporin A (CsA) tedavisi aldığı kaydedildi. Tedavi kesiminden bir ay sonra relaps olması üzerine steroid ve CsA bağımlı olarak değerlendirilen olgunun tekrarlanan biyopsisinde CsA toksisitesi izlendi. Bunun üzerine başlanan EC-MPS (1080 mg/gün) tedavisinin ikinci ayında alopesi gelişti. Doz üçte iki oranında azaltılınca saç dökülmesi bir ay içinde durdu. Ayrıca, EC-MPS tedavisinden sonra duraklamış olan adet döngüsü dozun azaltılmasından iki ay sonra tekrar başladı. Takip eden 8 ay boyunca remisyonda kalan olgunun tekrarlayan atağı kısa süreli yüksek doz steroid tedavisine yanıt verdi. Halen EC-MPS tedavisinin 20. ayında olan olgu sorunsuz izlenmektedir. SONUÇ: Olgumuz, EC-MPS tedavisi sırasında alopesi ve adet düzensizliği bildirilen ilk adölesan olgudur. EC-MPS, önerilen dozun üçte ikisinde bile etkili olabilmektedir.
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