Yayg\u0131n a\u011fr\u0131 yapan hastal\u0131klar konusunda vatanda\u015flar\u0131 bilgilendiren Romatoloji Uzm. Dr. Orhan Eren, ba\u015fta Bruselle olmak \u00fczere uzun s\u00fcre devam eden enfeksiyon hastal\u0131klar\u0131nda yayg\u0131n a\u011fr\u0131 olabilece\u011fini s\u00f6yledi.<\/p>\n
VM Medical Park Kocaeli Hastanesi Romatoloji Uzm. Dr. Orhan Eren, yayg\u0131n a\u011fr\u0131 yapan hastal\u0131klar konusunda bilgilendirdi. Grip gibi vir\u00fcslere ba\u011fl\u0131 veya mikroplara ba\u011fl\u0131 enfeksiyon hastal\u0131klar\u0131n\u0131n \u00e7o\u011fu kez ba\u011f\u0131\u015f\u0131kl\u0131k sisteminin mikroplara kar\u015f\u0131 yapt\u0131\u011f\u0131 sava\u015f\u0131 kazanmas\u0131yla kendili\u011finden iyile\u015fti\u011fini belirten Eren, baz\u0131 romatizmal ve sistemik hastal\u0131klar\u0131n ise tedavi olup, do\u011fru te\u015fhis konulmad\u0131k\u00e7a ge\u00e7meyece\u011fini ifade etti. Uzm. Dr. Eren, “Grip oldu\u011fumuzda, ate\u015fli bir hastal\u0131k ge\u00e7irildi\u011finde bizi \u00f6ks\u00fcr\u00fckten ate\u015ften daha fazla rahats\u0131z eden yayg\u0131n v\u00fccut a\u011fr\u0131lar\u0131n\u0131 \u00e7o\u011fumuz ya\u015fam\u0131\u015f\u0131zd\u0131r ve bunun ne kadar zor bir s\u00fcre\u00e7 oldu\u011funu, \u00fc\u00e7 be\u015f g\u00fcn\u00fcn bile ne kadar zor ge\u00e7ti\u011fini biliriz. Grip olduktan sonra \u2018b\u00fct\u00fcn v\u00fccudum a\u011fr\u0131yor\u2019 diye \u015fikayet eden ki\u015fileri \u00e7ok duymu\u015fuzdur. Grip gibi vir\u00fcslere ba\u011fl\u0131 veya mikroplara ba\u011fl\u0131 enfeksiyon hastal\u0131klar\u0131 \u00e7o\u011fu kez ba\u011f\u0131\u015f\u0131kl\u0131k sistemimizin mikroplara kar\u015f\u0131 yapt\u0131\u011f\u0131 sava\u015f\u0131 kazanmas\u0131yla kendili\u011finden iyile\u015fir. Ancak baz\u0131 romatizmal ve sistemik hastal\u0131klar vard\u0131r ki, bu yayg\u0131n a\u011fr\u0131lar tedavi olmad\u0131k\u00e7a do\u011fru te\u015fhis konmad\u0131k\u00e7a ge\u00e7mez” dedi.<\/p>\n
\u201cBa\u015fta brusella olmak \u00fczere kronik enfeksiyon hastal\u0131klar\u0131nda yayg\u0131n a\u011fr\u0131lar olabilir”<\/p>\n
\u0130ltihapl\u0131 romatizmal hastal\u0131klar\u0131n \u00e7o\u011funda yayg\u0131n a\u011fr\u0131 oldu\u011funu s\u00f6yleyen Uzm. Dr. Orhan Eren, “Ba\u015fta Brusella olmak \u00fczere kronik (uzun s\u00fcre devam eden) enfeksiyon hastal\u0131klar\u0131nda yayg\u0131n a\u011fr\u0131lar olabilir. Brusella dedi\u011fimiz \u00e7i\u011f s\u00fct ve s\u00fct \u00fcr\u00fcnleri ile ge\u00e7en hastal\u0131kta hastalar sanki devaml\u0131 gripmi\u015f gibi \u2018her taraf\u0131m a\u011fr\u0131yor\u2019 \u015feklinde \u015fikayetlerini dile getirirler. Kronik enfeksiyon hastal\u0131klar\u0131nda a\u011fr\u0131 \u015fikayetlerine \u00e7o\u011fu kez hafif veya ara ara gelen ate\u015f, terleme, bazen \u00fc\u015f\u00fcme ve titreme e\u015flik eder. Kan tahlillerinde CRP ve sedimentasyon (v\u00fccuttaki iltihap oran\u0131n\u0131 ve \u015fiddetini \u00f6l\u00e7en kan testleri) \u00e7o\u011fu kez y\u00fcksektir. Yine kanser hastalar\u0131nda yayg\u0131n a\u011fr\u0131ya ek olarak t\u00fcm\u00f6r dokusunun oldu\u011fu b\u00f6lgede daha belirgin b\u00f6lgesel a\u011fr\u0131 da e\u015flik eder. Bu hastalarda kilo kayb\u0131, halsizlik, yorgunluk gibi genel \u015fikayetler de g\u00f6r\u00fcl\u00fcr. Yayg\u0131n a\u011fr\u0131 yapan romatizmal hastal\u0131klara bakt\u0131\u011f\u0131m\u0131zda ise fibromiyalji ve yayg\u0131n osteoartrit, en s\u0131k nedenlerdir. Bu iki hastal\u0131kta CRP ve sedimentasyon y\u00fckselmez, di\u011fer bir deyi\u015fle iltihapl\u0131 olmayan romatizmal hastal\u0131klard\u0131r. Yine iltihapl\u0131 (enflamatuar) romatizmal hastal\u0131klar\u0131n \u00e7o\u011funda da yayg\u0131n a\u011fr\u0131 olur” diye konu\u015ftu.<\/p>\n
“Romatizmal hastal\u0131klar\u0131n yayg\u0131n a\u011fr\u0131 yapabilece\u011fi bilinmelidir”<\/p>\n
T\u00fcm iltihapl\u0131 romatizmal hastal\u0131klar\u0131n yayg\u0131n a\u011fr\u0131 yapabilece\u011fini ifade eden Romatoloji Uzman\u0131 Dr. Orhan Dr. Eren, “Kronik yayg\u0131n a\u011fr\u0131 yapan hastal\u0131klar birbirleriyle \u00e7ok benzedikleri i\u00e7in s\u0131kl\u0131kla kar\u0131\u015ft\u0131r\u0131l\u0131rlar. Bu hastalar do\u011fru te\u015fhis konulamazsa tedavi de olamazlar. Gezmedikleri hastane, muayene olmad\u0131klar\u0131 doktor kalmamas\u0131na ra\u011fmen a\u011fr\u0131lar\u0131 ge\u00e7meyebilir. Fibromiyalji tan\u0131s\u0131 alm\u0131\u015f olan birinin ila\u00e7 ve fizik tedavi almas\u0131na ra\u011fmen a\u011fr\u0131lar\u0131 devam ediyorsa fibromiyalji hastal\u0131\u011f\u0131na e\u015flik eden ba\u015fka bir romatizmal veya mikrobik hastal\u0131\u011f\u0131n\u0131n ara\u015ft\u0131r\u0131lmas\u0131 gereklidir. Fibromiyalji s\u0131kl\u0131kla iltihapl\u0131 romatizmal hastalara e\u015flik eden bir tablo olabilir. Arka plandaki iltihapl\u0131 romatizma bulunup tedavi edilmedik\u00e7e fibromiyalji tablosu da iyile\u015fmez. Yine bel f\u0131t\u0131\u011f\u0131 tan\u0131s\u0131 ald\u0131\u011f\u0131, fizik ve ila\u00e7 tedavisi ald\u0131\u011f\u0131, hatta ameliyat oldu\u011fu halde bel s\u0131rt a\u011fr\u0131lar\u0131 ge\u00e7meyen hastalar\u0131n bel f\u0131t\u0131\u011f\u0131 d\u0131\u015f\u0131nda iltihapl\u0131 omurga romatizmas\u0131n\u0131 (Spondil Artro Pati- SpA) d\u00fc\u015f\u00fcnmeleri gerekir. \u0130ltihapl\u0131 romatizmal hastal\u0131klardan yayg\u0131n a\u011fr\u0131 yapan en s\u0131k iki hastal\u0131k spondilartropatiler (SpA; omurga romatizmas\u0131) ve ba\u011f (kollagen) dokusu hastal\u0131klar\u0131d\u0131r. Yine Polimyalji romatika da pek tan\u0131namayan sedimantasyon ve CRP\u2019nin y\u00fcksek\u00e7e oldu\u011fu \u00fc\u00e7\u00fcnc\u00fc s\u0131kl\u0131ktaki romatizmal bir hastal\u0131kt\u0131r. Bir di\u011fer yayg\u0131n a\u011fr\u0131 yapan hastal\u0131k ise D vitamini d\u00fc\u015f\u00fckl\u00fc\u011f\u00fc ile giden Osteomalazi\u2019dir. Ancak t\u00fcm iltihapl\u0131 romatizmal hastal\u0131klar\u0131n da yayg\u0131n a\u011fr\u0131 yapabilece\u011fi bilinmelidir” \u015feklinde konu\u015ftu.<\/p>\n
“Klinik tan\u0131 koymak uzmanl\u0131k ve tecr\u00fcbe ister”<\/p>\n
VM Medical Park Kocaeli Hastanesi Romatoloji Uzm. Dr. Orhan Eren, “FMF (Akdeniz ate\u015fi) hastalar\u0131nda ila\u00e7 (kol\u015fisin) verildi\u011finde hastan\u0131n ataklar\u0131n\u0131n ge\u00e7mesiyle FMF tan\u0131s\u0131 kesinle\u015fir. Atak s\u0131ras\u0131nda muayene edilemeyen FMF hastal\u0131\u011f\u0131ndan hastan\u0131n \u00f6yk\u00fcs\u00fcne dayanarak \u015f\u00fcphelenildi\u011finde ilac\u0131 g\u00fcnl\u00fck olarak devaml\u0131 verilir ve atak tekrarlamazsa tedaviden te\u015fhise gidilmi\u015f olur. G\u00fcn\u00fcm\u00fczde kan\u0131ta dayal\u0131 modern t\u0131p kurallar\u0131 ge\u00e7erli olsa da, sadece hastan\u0131n ifade veya muayene bulgular\u0131na g\u00f6re klinik tan\u0131 koymak uzmanl\u0131k ve tecr\u00fcbe ister. \u0130ltihapl\u0131 romatizmal hastal\u0131klardan en s\u0131k yayg\u0131n a\u011fr\u0131 yapan yukar\u0131da sayd\u0131\u011f\u0131m\u0131z \u00fc\u00e7 hastal\u0131kta hastalardaki yayg\u0131n a\u011fr\u0131 gece ve sabah uyand\u0131\u011f\u0131 saatlerde \u00e7ok daha fazlad\u0131r, hareketle saatler i\u00e7inde azal\u0131r. Sabah a\u011fr\u0131lar\u0131n\u0131n daha \u00e7ok olmas\u0131n\u0131n d\u0131\u015f\u0131nda sabahlar\u0131 eklem, bel kal\u00e7a s\u0131rt kol bacak gibi b\u00f6lgelerde eklemlerde hareket k\u0131s\u0131tl\u0131l\u0131\u011f\u0131 da belirgindir. G\u00fcn i\u00e7inde birka\u00e7 saat sonra bu hareket k\u0131s\u0131tl\u0131l\u0131\u011f\u0131 kaybolur” ifadelerini kulland\u0131.<\/p>\n
“\u0130ltihapl\u0131 omurga romatizmas\u0131n\u0131n te\u015fhisi zor olabilir”<\/p>\n
Uzm. Dr. Orhan Eren, iltihapl\u0131 omurga romatizmas\u0131nda (SpA) ise a\u011fr\u0131 ve hareket k\u0131s\u0131tl\u0131\u011f\u0131n\u0131n (sabah tutuklu\u011fu, kat\u0131la\u015fma, robotla\u015fma) bel kal\u00e7a ve s\u0131rt b\u00f6lgesinde daha belirgin oldu\u011funa dikkat \u00e7ekerek \u201cSpA hastal\u0131\u011f\u0131nda hastal\u0131\u011f\u0131n merkez \u00fcss\u00fc le\u011fen kemi\u011fi eklemi olmas\u0131na ra\u011fmen, kol ve bacak eklemleri de etkilenebilir. Daha da \u00f6nemlisi SpA hastal\u0131\u011f\u0131, kaslar\u0131n kemi\u011fe ba\u011fland\u0131\u011f\u0131 b\u00f6lgelerde de iltihap yapar. \u0130skelet sistemimizi kas ve kemiklerin olu\u015fturdu\u011funu d\u00fc\u015f\u00fcnd\u00fc\u011f\u00fcm\u00fczde SpA\u2019l\u0131 hastalarda yayg\u0131n a\u011fr\u0131 olaca\u011f\u0131n\u0131 d\u00fc\u015f\u00fcnmemiz gerekir. SpA\u2019l\u0131 hasta da bel a\u011fr\u0131lar\u0131n\u0131 daha \u00f6nce MR ile tan\u0131 ald\u0131\u011f\u0131 bel f\u0131t\u0131\u011f\u0131na veya yayg\u0131n kas a\u011fr\u0131s\u0131 yapan fibromiyalji hastal\u0131\u011f\u0131na ba\u011flasa da, e\u011fer e\u015flik eden ana hastal\u0131\u011f\u0131n SpA oldu\u011fu tespit edilemezse, hastane hastane, doktor doktor gezmeye devam eder\u201d diye konu\u015ftu.<\/p>\n
“Kortizon yerinde ve uygun kullan\u0131lmal\u0131”<\/p>\n
Uzm. Dr. Orhan Eren, “Bir\u00e7ok iltihapl\u0131 romatizmal hastal\u0131kta oldu\u011fu gibi kortizon tedavisi iltihab\u0131n alevini s\u00f6nd\u00fcrerek CRP, sedimantasyon tahlillerini normale getirerek hastan\u0131n h\u0131zla iyile\u015fmesini sa\u011flamak, hastal\u0131\u011f\u0131 kontrol alt\u0131na almak i\u00e7in \u00e7ok gerekli elzem bir ila\u00e7t\u0131r ancak uzun d\u00f6nem tedavide kortizon olmayan ila\u00e7larla hastal\u0131\u011f\u0131n kontrol alt\u0131na al\u0131narak m\u00fcmk\u00fcnse kortizon tedavisinin kesilmesi uygun olacakt\u0131r. \u0130ltihapl\u0131 romatizmal hastal\u0131klar \u00e7o\u011fu kez diyabet, hipertansiyon gibi kronik hastal\u0131klard\u0131r. Anti romatizmal ila\u00e7lar\u0131n etkinli\u011fi ba\u015flad\u0131ktan sonra hemen \u00e7o\u011fu hastal\u0131kta kortizon tedavisinin kademeli olarak kesilmesi planlan\u0131r ancak bazen ya\u015fam boyu kortizon kullanmam\u0131z gereken hastalar olabilmektedir. Bu hastalarda osteoporoza kar\u015f\u0131 D vitamini, kalsiyum deste\u011fi ve osteopeni varsa bile ostoporoz gibi tedavi ederek \u00f6nlem al\u0131yoruz” dedi.<\/p>\n","protected":false},"excerpt":{"rendered":"
VM MED\u0130CAL PARK KOCAEL\u0130 HASTANES\u0130 ROMATOLOJ\u0130 UZM. DR. ORHAN EREN, YAYGIN A\u011eRI YAPAN HASTALIKLAR KONUSUNDA B\u0130LG\u0130LEND\u0130RD\u0130.<\/p>\n","protected":false},"author":1,"featured_media":215836,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[1073,19375,1866,1440,54571,54570],"class_list":["post-215835","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","tag-ozel","tag-agriyor","tag-butun","tag-dikkat","tag-diyenler","tag-vucudum"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/www.tvturk.com\/wp-content\/uploads\/2019\/10\/ozel-butun-vucudum-agriyor-diyenler-dikkat_1928425.jpg?fit=1000%2C813","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/paKIfm-U9d","_links":{"self":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/215835","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/comments?post=215835"}],"version-history":[{"count":0,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/215835\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media\/215836"}],"wp:attachment":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media?parent=215835"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/categories?post=215835"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/tags?post=215835"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}