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Sweet Syndrome due to G-CSF Use in Children with Acute Lymphoblastic Leukemia; Case Report [J Dr Behcet Uz Child Hosp]
J Dr Behcet Uz Child Hosp. 2019; 9(3): 263-267 | DOI: 10.5222/buchd.2019.71354  

Sweet Syndrome due to G-CSF Use in Children with Acute Lymphoblastic Leukemia; Case Report

Ayşen Türedi Yıldırım1, Hüseyin Gülen1, Yeşim Yiğit1, Peyker Temiz2
1Manisa Celal Bayar University Medical Faculty Hospital, Department of Pediatric Hematology, Manisa
2Manisa Celal Bayar University Faculty of Medicine, Department of Pathology, Manisa

Introduction: Sweet syndrome is characterized by fever, arthralgia, neutrophilic leukocytosis and painful erythematous plaques, which occur mostly on the face and upper extremities. It is a rare skin disease characterized by dense neutrophilic infiltration in the dermis at the lesion sites, usually seen between 30-50 years of age.
Case: A nine-years-old girl with a diagnosis of acute lymphoblastic leukemia was admitted to the hospital with high fever cause. Empirical broad spectrum antibiotic and granulocyte colony stimulating factor (G-CSF) treatments were initiated for febrile neutropenia. Although antifungal therapy was added to the treatment, fever height could not be controlled. On the 14th day of G-CSF treatment, red, painful rashes were seen on the legs. The result of the skin biopsy was compatible with Sweet syndrome. G-CSF treatment was discontinued and intravenous steroids were started. The fever was controlled and the rash was lost.
Conclusion: Sweet syndrome should be kept in mind when erythematous rashes develop in patients with febrile neutropenia who have been using G-CSF for a long time and who have not been able to control their fever despite appropriate antibiotics and antifungals.

Keywords: Acut lymphoblastic leukemia, Sweet syndrome, G-CSF, febrile neutropenia


Akut Lenfoblastik Lösemili Çocuk Hastada G-CSF Kullanımına Bağlı Sweet Sendromu; Olgu Sunumu

Ayşen Türedi Yıldırım1, Hüseyin Gülen1, Yeşim Yiğit1, Peyker Temiz2
1Manisa Celal Bayar Üniversitesi Tıp Fakültesi Hastanesi, Çocuk Hematoloji Bilim Dalı, Manisa
2Manisa Celal Bayar Üniversitesi Tıp Fakültesi Hastanesi, Patoloji Anabilim Dalı, Manisa

Giriş: Sweet Sendromu ateş, artralji, nötrofilik lökositoz ve daha çok yüzde ve üst ekstremitelerde ortaya çıkan ağrılı eritamatöz plaklar ve bu lezyon bölgelerinde dermiste yoğun nötrofilik infiltrasyon ile karakterize nadir görülen bir deri hastalığıdır.
Olgu: Akut lenfoblatik lösemi tanısıyla tedavisi devam eden dokuz yaşında kız hasta yüksek ateş nedeni ile yatırıldı. Febril nötropeniye yönelik ampirik geniş spektrumlu antibiyotik ve granülosit koloni uyarıcı faktör (G-CSF) tedavileri başlandı. İzleminde antifungal tedavi eklenmesine rağmen ateş yüksekliği kontrol altına alınamadı. G-CSF tedavisinin 14. gününde bacaklarda ortaya çıkan kırmızı, ağrılı döküntülerin biopsisi sonucu Sweet sendromu ile uyumlu geldi. G-CSF tedavisi kesilerek intravenöz steroid başlanan olguda ateş kontrol altına alındı ve döküntüler kayboldu.
Yorum: Uzun süre G-CSF kullanan ve uygun antibiyotik ve antifungallere rağmen ateşi konrol altına alınamayan febril nötropenili hastalarda, eritematöz döküntüler geliştiğinde, sweet sendromu akılda bulundurulmalıdır.

Anahtar Kelimeler: Akut lenfoblastik lösemi, Sweet sendromu, G-CSF, febril nötropeni


Ayşen Türedi Yıldırım, Hüseyin Gülen, Yeşim Yiğit, Peyker Temiz. Sweet Syndrome due to G-CSF Use in Children with Acute Lymphoblastic Leukemia; Case Report. J Dr Behcet Uz Child Hosp. 2019; 9(3): 263-267

Corresponding Author: Ayşen Türedi Yıldırım, Türkiye


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