Pojava Kronove bolesti kod bolesnika sa ankilozirajućim spondilitisom i esencijalnom trombocitemijom tokom terapije etanerceptom
Sažetak
Uvod. Tokom terapije inhibitorima faktora nekroze tumora alfa kod bolesnika sa ankilozirajućim spondilitisom može doći do nastanaka inflamatorne bolesti creva. Kronova bolest je najčešća forma, a etanercept je lek koji se najviše povezuje sa pojavom bolesti. Iako se trombocitoza često javlja kod bolesnika sa ankilozirajućim spondilitisom kao rezultat hronične inflamacije, sideropenijske anemije ili primene lekova, pojava esencijalne trombocitemije nije česta. Nema objavljenih radova o koegzistenciji ove tri bolesti kod jednog bolesnika. Prikaz bolesnika. Prikazali smo složen slučaj bolesnika starog 35 godina sa istovremenom pojavom ankilozirajućeg spondilitisa i esencijalne trombocitemije. S obzirom na hepatotoksičnost izazazvanu inicijalno uvedenim lekovima, sulfasalazinom i metotreksatom, započeto je lečenj etanerceptom, inhibotorom faktora nekroze tumora alfa. Obe bolesti su bile zadovoljavajuće kontrolisane sve dok nije dijagnostikovana Kronova bolest. Dve godine nakon zamene etanercepta adalimumabom, sve tri bolesti su bile u remisiji. Zaključak. Terapija inhibitorom faktora nekroze tumora alfa je značajno poboljšala klinički ishod lečenja bolesnika sa hroničnim inflamatornim bolestima. Ipak, pojava neželjenih efekata može usloviti prekid ili promenu leka. Prisustvo komorbiditeta dodatno komplikuje terapijski pristup tim bolesnicima.
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