md-medicaldata

Authors

 

Sonja Golubović ^1,2, Dejan Ćelić ^1,2, Dušan Božić ^1,2,, Biljana Milić^1,2, Bojana Ljubićić ³, Siniša Živković ¹, Igor Mitić <sup>1,2

1</sup>Klinički centar Vojvodine, Klinika za nefrologiju i kliničku imunologiju, Novi Sad, Srbija
²Univerzitet u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija
³Klinički centar Vojvodine, Urgentni centar, Odeljenje Urgentne interne medicine, Novi Sad, Srbija

 

UDK: 616.45-089-06(497.11)"2012/2016"

The paper was received / Rad primljen: 01.12.2019.

Accepted / Rad prihvaćen: 23.05.2020.

 

Correspondence to:

Sonja Golubović
Klinički centar Vojvodine,
Klinika za nefrologiju i kliničku imunologiju
Hajduk Veljkova 1
21000 Novi Sad, Serbia
e-mail: sonjagolubovic@gmail.com

 

 

Sažetak

 

Uvod: Glomerulonefritisi predstavljaju raznovrsnu grupu oboljenja bubrega, kod kojih prvenstveno dolazi do oštećenja funkcije i/ili strukture samog glomerulusa. Raznolikost imunofluorescentnog nalaza bioptata bubrega govori u prilog različitih imunoloških mehanizama koji mogu dovesti do oboljenja koje za posledicu ima oštećenje bubrežne funkcije. Terapija može biti simptomatska i/ili imunosupresivna, pri čemu prvu liniju terapije u većini glomerulonefritisa predstavljaju kortikosteroidi, međutim često postoji potreba za primenom drugih imunosupresivnih lekova poput ciklofosfamida. Cilj ovog rada je prikazati neke od komplikacija upotrebe ciklofosfamida nastale tokom lečenja primarnih glomerulonefritisa. Prikaz slučaja: U radu su prikazani slučajevi dve pacijentkinje lečene na Klinici za nefrologiju i kliničku imunologiju s dijagnozom mezangioproliferativnog glomerulonefritisa. Kod obe bolesnice u nalazu urina konstatovano je prisustvo proteinurije,uz laboratorijski verifikovano oštećenje bubrežne funkcije sa posledičnim smanjenjem jačine glomerularne filtracije, te je započeta terapija ciklofosfamidom, nakon čega je ubrzo došlo do razvoja pancitopenije i septičnog stanja. Zaključak: Ciklofosfamid, iako efikasan lek u terapiji glomerulonefritisa, relativno često dovodi do pojave komplikacija. Ozbiljne komplikacije su retke, ali mogu ugroziti život bolesnika i dovesti do letalnog ishoda.

                          

 

 

 

Ključne reči:

ciklofosfamid, komplikacije, glomerulonefritis, pancitopenija, sepsa

 

 

Abstract

 

Introduction: Glomerulonephritis presents a diverse group of diseases which affect the kidney by primarily damaging the function of the kidney and/or the structure of the glomeruli. The diversity of patohistological findings emphasize the complexity of immunological mechanisms which cause the disease, further resulting in the decline of kidney function. Therapy can be symptomatic and/or immunosuppressive, whilst the first line of therapy in most of the cases includes corticosteroids. However, quite often there is a need for further administration of other immunosuppressants such as cyclophosphamide. The goal of this paper is to present some of the complications caused by the usage of cyclophosphamide in primary glomerulonephritis treatment. Case report: We presenttwo cases of female patients with mesangioproliferative glomerulonephritis treated at the Clinic for Nephrology and Clinical Immunology of Clinical Centre of Vojvodina. In both patients urin samples indicated the presence of proteinuria, with damaged kidney function and consequential decline in glomerular filtration rate. Cyclophosphamide treatment was started which was soon followed by the development of pancytopenia and septical state Conclusion: Cyclophosphamide is an efficient drug in the treatment of glomerulonephritis, however relatively frequently leads to complications. Serious complication are rare, however can be life threatening and have a lethal result.

 

 

Key words:

cyclophosphamide, complications, glomerulonephritis, pancytopenia, sepsis.

 

 

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