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Yıl:2019; Cilt: 56; Sayı: 1>> Özet
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Nöropsikiyatri Arşivi; 2019;56(1):3-6
Tekrarlayan Optik Nöritli Hastalarda İntravenöz İmmunoglobulin Tedavisi
B Altunrende, G Akdal, MS Bajın, A Yaman, M Kocaslan, M Nalbantoğlu, H Ertaşoğlu, G Akman
Dokuz Eylül University, Izmir,
Amaç: Tekrarlayan optik nörit (rON) sebebi bilinmeyen otoimmün kökenli bir inflamatuar hastalıktır. İntravenöz immünglobulin (IVIg) tedavisi pek çok otoimmün hastalık için kullanılmaktadır; ancak rON hastalarındaki etkisine dair olgu sunumları dışında fazla bir bilgi yoktur. Bu çalışmada IVIg tedavisi almış olan rON hastalarımızın değerlendirilmesi amaçlanmıştır. Yöntem: Nisan 2011 ile Ekim 2015 arasında kliniğimizde rON tanısıyla izlenmiş olan ve IVIg tedavisi verilmiş olan anti aquaporin4 (AQP4) seropozitif ve seronegatif hastalar retrospektif olarak değerlendirilmiştir. Bulgular: rOn tanılı dokuz hasta (hepsi kadın) IVIg tedavisi almıştır. Hastaların yaşları 34 ile 65 arasında değişmekteydi ve hastalığın başlangıcından 6–58 ay sonra IVIg tedavisi almaya başlamışlardı. Hastaların üçünde serum AQP4 antikorları pozitifti. Hastalar mevcut immunsupresif tedavileri altında atak geçirmeye devam ettikleri için ek olarak aylık IVIg tedavisine başlanmıştı. Takip süresi 6–31 aydı. IVIg tedavisi altında üç hasta birer atak geçirmişti. IVIg tedavisine başlanmadan önceki bir yıl içindeki ortalama atak sayısı 1,4±0,72 iken, IVIg tedavisinden sonraki yıl içinde ise 0,3±0,5 idi. Hastalarda IVIg uygulaması sırasında bir hastada ateş görüldü; başka herhangi bir yan etki kaydedilmedi. Sonuç: rOn hastalarında immünsupresif tedaviye ek olarak verilen aylık IVIg tedavisinin iyi tolere edildiği ve güvenli bir tedavi olduğu ve etkili olabileceği görülmektedir. Ancak, bu çalışma retrospektif bir gözlem çalışması olduğundan dolayı, daha kesin bir çıkarım için IVIg ile randomize kontrollü çalışmalara gereksinim vardır. © All Right Reserve
Intravenous Immunoglobulin Treatment for Recurrent Optic Neuritis
Conclusion: Monthly IVIg is well-tolerated and safe and it seems to be effective in rON as an add on treatment. However, since our study is a retrospective case series, future randomized controlled trials with IVIg are needed.

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