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Yıl:2020; Cilt: 23; Sayı: 2>> Özet
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Klinik Psikiyatri Dergisi; 2020;23(2):232-235
Atomoksetin ilişkili kırmızı kulak: Olgu sunumu
HA Taner
Başkent Üniversitesi, Ankara
Kırmızı kulak sendromu çoğunlukla tek taraflı yanıcı ağrı ve dış kulağın kızarıklığı ile giden bir durumdur. İdiopatik ve ikincil olmak üzere iki formu vardır. İdiopatik kırmızı kulak sendromu daha çok gençlerde ve migren ile ilişkili olarak, erişkinlerde ise servikal bozukluklarla ile ilgili olabilir. Bu olgu sunumunda dikkat eksikliği hiperaktivite bozukluğu ( DEHB) ve özgül öğrenme güçlüğü tanıları bulunan bir 10 yaşında bir erkek hasta sunmaktayız. Hastaya DEHB tedavisine yönelik olarak atomoksetin başlandıktan sonra hastada kulağında kzıarıklık yakınması başladı. Kızarıklık atomoksetin alımını takiben bir saat içinde oluyordu. Kulağındaki kızarıklık tek taraflı oluyor ve 4 saat içinde kayboluyordu. Bazen kızarıklığa başağrısının da eşlik ettiğini belirtiyordu. Atomoksetin kesildikten sonra hastanın kulağındaki kızarıklık ve başağrısı kayboldu. Kırmızı kulağın patofizyolojisinde sempatik desarj disregülesyonu bulunmaktadır.Atomoksetin noradrenerjik reseptörlere karşı yüksek seçiciliği bulunan ve periferik noradrenerjik reseptörler üzerine de etkisi olan bir moleküldür. Atomoksetin sempatik vazodilatasyon / vazokonstrüksiyon dengesini bozarak kırmızı kulağa sebebp olabilir. Atomoksetin ilişkili kırmızı kulak hayatı tehdit edici bir druum olmamakla birlikte rahatsızlık ve kaygıya sebep olabilir. Bu sebeple klinisyenler atomoksetin kullanırken bu durumu akıllarında tutmalıdırlar. Bu olgu sunumu literatürdebulunan ilk atomoksetin ilişkili kırmızı kulak vakasıdır.
Atomoxetine associated red ear: A case report
Red ear syndrome is defined as mostly unilateral burning pain and redness of external ear. It has two forms idiopathic and secondary. Idiopathic red ear syndrome is mostly seen in young people and associated with migraine. Secondary red ear syndrome is more frequent in adults and releated with cervical disorder. Our patient was a 10 year old boy diagnosed with attention deficit hyperactivity disorder (ADHD) and spesific learning disorder. He had a complaint of redness in his ear, following the atomoxetine treatment for ADHD. The redness was appearing after taking atomoxetine in 1 hour. The redness in his ear was unilateral and lasted in 4 hours. Sometimes headaches were accompanied with red ear. After atomoxetine treatment was ceased the redness and the headache in his ear were dissappered. In the pathophysiology of red ear sydrome there is a disregulation of sympathic outflow. Atomoxetine has a high selectivity for noradrenergic receptors and also has an effect on periferic noradrenergic receptors. Atomoxetine could change the sympathic vasodilation/vasoconstruction balance and cause red ear. Although the red ear is not a life threating situation, it could cause discomfort and anxiety, so the clinicians should keep in mind red ear syndrome while using atomoxetine. To our best knowledge this is the first red ear case associated with atomoxetinein literature

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