Avascular necrosis of femoral head (AVNFH): Kasus yang jarang ditemui sebagai gejala fase kronik pada pasien chronic myelogenous leukemia dewasa dengan terapi nilotinib
DOI:
https://doi.org/10.36216/jpd.v7i2.202Keywords:
Avascular necrosis of femoral head, chronic myelogenous leukemia , nilotinibAbstract
Chronic myelogenous leukemia (CML) adalah kelainan klonal malignan dari stem cell hematopoetic yang ditandai dengan kelainan proliferasi dan akumulasi imatur granulosit. Avascular necrosis (AVN) sangat jarang ditemui pada pasien CML dimana sebuah systematic review melaporkan hanya terdapat 21 kasus dari tahun 1984 hingga 2021 dengan 17 kasus merupakan avascular necrosis of the femoral head (AVNFH) dan 3 kasus diantaranya dihubungkan dengan pemberian terapi tyrosine kinase inhibitors yaitu imatinib, desatinib serta nilotinib. Kami melaporkan pasien laki-laki berusia 51 tahun dengan keluhan nyeri sendi pinggul. Pasien didiagnosis menderita CML dari pemeriksan sumsum tulang dengan hasil hiperseluler dan pemeriksaan PCR yang mendeteksi adanya transkripsi BCR-ABL dalam bentuk fusi b2a2. Pasien mendapat terapi nilotinib 200 mg setiap 12 jam. Diagnosis avascular nekrosis ditegakkan dari gejala klinis dan pemeriksaan radiologi. Pasien direncanakan menjalani total hip replacement.
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