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DOCK8 Eksikliği Sonucu Gelişen Çoklu Besin Alerjisi Olan Bir Olguda Kök Hücre Tedavisi Döneminde Karşılaşılan Nütrisyonel Sorunlar ve Uygulamalar

Yıl 2025, Cilt: 5 Sayı: 1, 46 - 54, 18.04.2025

Öz

DOCK8 eksikliği, yüksek morbidite ve mortaliteye sahip nadir görülen bir kombine immün yetmezlik hastalığıdır. Klinik özellikleri arasında atopi, besin alerjisi, tekrarlayan enfeksiyonlar, otoimmünite riski ve kanser bulunmaktadır. Bilinen tek tedavisi Hematopoetik Kök Hücre Naklidir (HKHN). DOCK8 eksikliğinde HKHN süreci yan etkileri ve komplikasyonları fazla olan bir tedavi sürecidir. Bu süreçte hastalar nütrisyonel açıdan nakilin ilk gününden son gününe kadar izlenmelidir. Hastanın aldığı tedaviye, karşılaşılan semptom ve komplikasyonlara uygun olacak şekilde tıbbi beslenme tedavisi yapılmalıdır. Bu olgu sunumunda DOCK8 eksikliği tanısı ile izlenen olgunun tedavisinde tıbbi beslenme tedavisinin uygulanması ve önemi tartışılmıştır.

Kaynakça

  • Kuloglu Z, Balci D, Haskologlu ZS, et al. Allogeneic hematopoietic stem cell and liver transplantation in a young girl with dedicator of cytokinesis 8 protein deficiency. Pediatr Transplant. 2019;23(7):e13545.
  • Biggs CM, Keles S, Chatila TA. DOCK8 deficiency: insights into pathophysiology, clinical features and management. Clinical Immunology. 2017;181:75-82.
  • Aydin SE, Kilic SS, Aytekin C, et al. DOCK8 deficiency: clinical and immunological phenotype and treatment options-a review of 136 patients. Journal of Clinical Immunology. 2015;35(2):189-98.
  • Muscaritoli M, Grieco G, Capria S, Paola Iori A, Rossi Fanelli F. Nutritional and metabolic support in patients undergoing bone marrow transplantation. The American Journal of Clinical Nutrition. 2002;75(2):183-90.
  • Bundak R, Neyzi O. Büyüme-gelişme ve bozuklukları. Neyzi O, Ertuğrul T (ed). Pediatri (3. baskı), Cilt 1, İstanbul: Nobel Tıp Kitabevleri, 2002, sf. 85-99.
  • Freifeld A. The neutropenic diet reviewed: Moving toward a safe food handling approach. Cancer. 2012;26(6).
  • Lupton JR, Brooks J, Butte N, Caballero B, Flatt J, Fried S. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. National Academy Press: Washington, DC, USA. 2002;5:589-768.
  • Skypala IJ, McKenzie R. Nutritional issues in food allergy. Clin Rev Allergy Immunol. 2019;57(2):166-78.
  • Happel CS, Stone KD, Freeman AF, et al. Food allergies can persist after myeloablative hematopoietic stem cell transplantation in dedicator of cytokinesis 8-deficient patients. J Allergy Clin Immunol. 2016;137(6):1895-8 e5.
  • Al-Herz W, Chu JI, van der Spek J, et al. Hematopoietic stem cell transplantation outcomes for 11 patients with dedicator of cytokinesis 8 deficiency. J Allergy Clin Immunol. 2016;138(3):852-9 e3.
  • Sova C, Feuling MB, Baumler M, et al. Systematic review of nutrient intake and growth in children with multiple IgE‐mediated food allergies. Nutrition in Clinical Practice. 2013;28(6):669-75.
  • Zeiger RS, Sampson HA, Bock SA, et al. Soy allergy in infants and children with IgE-associated cow’s milk allergy. The Journal of Pediatrics. 1999;134(5):614-22.
  • Christie L, Hine RJ, Parker JG, Burks W. Food allergies in children affect nutrient intake and growth. Journal of the American Dietetic Association. 2002;102(11):1648-51.
  • Cho H-N, Hong S, Lee S-H, Yum H-Y. Nutritional status according to sensitized food allergens in children with atopic dermatitis. Allergy, Asthma & Immunology Research. 2011;3(1):53-7.
  • Jacobsohn DA, Vogelsang GB. Acute graft versus host disease. Orphanet journal of rare diseases. 2007;2(1):35.
  • Campos DJ, Boguszewski CL, Funke VA, et al. Bone mineral density, vitamin D, and nutritional status of children submitted to hematopoietic stem cell transplantation. Nutrition. 2014;30(6):654-9.
  • Moody KM, Baker RA, Santizo RO, et al. A randomized trial of the effectiveness of the neutropenic diet versus food safety guidelines on infection rate in pediatric oncology patients. Pediatric Blood & Cancer. 2018;65(1):e26711.
  • Taggart C, Neumann N, Alonso PB, et al. Comparing a neutropenic diet to a food safety-based diet in pediatric patients undergoing Hematopoietic Stem Cell Transplantation. Biology of Blood and Marrow Transplantation. 2019;25(7):1382-6.
  • Sonbol MB, Firwana B, Diab M, Zarzour A, Witzig TE. The effect of a neutropenic diet on infection and mortality rates in cancer patients: a meta-analysis. Nutrition and Cancer. 2015;67(8):1232-40.
  • Zemrani B, Yap JK, Van Dort B, et al. Nutritional challenges in children with primary immunodeficiencies undergoing hematopoietic stem cell transplant. Clin Nutr. 2019.
  • Duncan CN, Vrooman L, Apfelbaum EM, Whitley K, Bechard L, Lehmann LE. 25-Hydroxy vitamin D deficiency following pediatric Hematopoietic Stem Cell Transplant. Biology of Blood and Marrow Transplantation. 2011;17(5):749-53.
  • Schulte CM, Beelen DW. Bone loss following hematopoietic stem cell transplantation: a long-term follow-up. Blood. 2004;103(10):3635-43.
  • Iovino L, Mazziotta F, Carulli G, et al. High-dose zinc oral supplementation after stem cell transplantation causes an increase of TRECs and CD4+ naïve lymphocytes and prevents TTV reactivation. Leukemia Research. 2018;70:20-4.
  • Hansson ME, Norlin A-C, Omazic B, et al. Vitamin D levels affect outcome in pediatric hematopoietic stem cell transplantation. Biology of Blood and Marrow Transplantation. 2014;20(10):1537-43.
  • Lounder DT, Khandelwal P, Dandoy CE, et al. Lower levels of vitamin A are associated with increased gastrointestinal graft-versus-host disease in children. Blood, The Journal of the American Society of Hematology. 2017;129(20):2801-7.
  • Cunningham-Rundles S, McNeeley DF, Moon A. Mechanisms of nutrient modulation of the immune response. Journal of Allergy and Clinical Immunology. 2005;115(6):1119-28.
  • Kauf E, Fuchs D, Winnefeld K, Hermann J, Zintl F. Blood selenium content after conditioning and during the course of bone marrow transplantation in children with malignant diseases. Medizinische Klinik (Munich, Germany: 1983). 1997;92:46-7.

Nutritional Problems and Aplications in Stem Cell Transplantation Period in A Case With Multiple Food Allergies as a Result of DOCK8 Deficiency

Yıl 2025, Cilt: 5 Sayı: 1, 46 - 54, 18.04.2025

Öz

DOCK8 deficiency is a rare combined immunodeficiency with high morbidity and mortality. Clinical features include atopy, food allergy, recurrent infections, risk of autoimmunity, and cancer. The only known treatment is Hematopoietic Stem Cell Transplant (HSCT). In DOCK8 deficiency, HSCT is a treatment process with many side effects and complications. In this process, patients should be monitored nutritionally from the first day of the transplant to the last day. Medical nutrition therapy should be performed in accordance with the treatment, symptoms and complications encountered. In this case report, the application and importance of medical nutrition therapy in the treatment of a case followed up with DOCK8 deficiency was discussed.

Kaynakça

  • Kuloglu Z, Balci D, Haskologlu ZS, et al. Allogeneic hematopoietic stem cell and liver transplantation in a young girl with dedicator of cytokinesis 8 protein deficiency. Pediatr Transplant. 2019;23(7):e13545.
  • Biggs CM, Keles S, Chatila TA. DOCK8 deficiency: insights into pathophysiology, clinical features and management. Clinical Immunology. 2017;181:75-82.
  • Aydin SE, Kilic SS, Aytekin C, et al. DOCK8 deficiency: clinical and immunological phenotype and treatment options-a review of 136 patients. Journal of Clinical Immunology. 2015;35(2):189-98.
  • Muscaritoli M, Grieco G, Capria S, Paola Iori A, Rossi Fanelli F. Nutritional and metabolic support in patients undergoing bone marrow transplantation. The American Journal of Clinical Nutrition. 2002;75(2):183-90.
  • Bundak R, Neyzi O. Büyüme-gelişme ve bozuklukları. Neyzi O, Ertuğrul T (ed). Pediatri (3. baskı), Cilt 1, İstanbul: Nobel Tıp Kitabevleri, 2002, sf. 85-99.
  • Freifeld A. The neutropenic diet reviewed: Moving toward a safe food handling approach. Cancer. 2012;26(6).
  • Lupton JR, Brooks J, Butte N, Caballero B, Flatt J, Fried S. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. National Academy Press: Washington, DC, USA. 2002;5:589-768.
  • Skypala IJ, McKenzie R. Nutritional issues in food allergy. Clin Rev Allergy Immunol. 2019;57(2):166-78.
  • Happel CS, Stone KD, Freeman AF, et al. Food allergies can persist after myeloablative hematopoietic stem cell transplantation in dedicator of cytokinesis 8-deficient patients. J Allergy Clin Immunol. 2016;137(6):1895-8 e5.
  • Al-Herz W, Chu JI, van der Spek J, et al. Hematopoietic stem cell transplantation outcomes for 11 patients with dedicator of cytokinesis 8 deficiency. J Allergy Clin Immunol. 2016;138(3):852-9 e3.
  • Sova C, Feuling MB, Baumler M, et al. Systematic review of nutrient intake and growth in children with multiple IgE‐mediated food allergies. Nutrition in Clinical Practice. 2013;28(6):669-75.
  • Zeiger RS, Sampson HA, Bock SA, et al. Soy allergy in infants and children with IgE-associated cow’s milk allergy. The Journal of Pediatrics. 1999;134(5):614-22.
  • Christie L, Hine RJ, Parker JG, Burks W. Food allergies in children affect nutrient intake and growth. Journal of the American Dietetic Association. 2002;102(11):1648-51.
  • Cho H-N, Hong S, Lee S-H, Yum H-Y. Nutritional status according to sensitized food allergens in children with atopic dermatitis. Allergy, Asthma & Immunology Research. 2011;3(1):53-7.
  • Jacobsohn DA, Vogelsang GB. Acute graft versus host disease. Orphanet journal of rare diseases. 2007;2(1):35.
  • Campos DJ, Boguszewski CL, Funke VA, et al. Bone mineral density, vitamin D, and nutritional status of children submitted to hematopoietic stem cell transplantation. Nutrition. 2014;30(6):654-9.
  • Moody KM, Baker RA, Santizo RO, et al. A randomized trial of the effectiveness of the neutropenic diet versus food safety guidelines on infection rate in pediatric oncology patients. Pediatric Blood & Cancer. 2018;65(1):e26711.
  • Taggart C, Neumann N, Alonso PB, et al. Comparing a neutropenic diet to a food safety-based diet in pediatric patients undergoing Hematopoietic Stem Cell Transplantation. Biology of Blood and Marrow Transplantation. 2019;25(7):1382-6.
  • Sonbol MB, Firwana B, Diab M, Zarzour A, Witzig TE. The effect of a neutropenic diet on infection and mortality rates in cancer patients: a meta-analysis. Nutrition and Cancer. 2015;67(8):1232-40.
  • Zemrani B, Yap JK, Van Dort B, et al. Nutritional challenges in children with primary immunodeficiencies undergoing hematopoietic stem cell transplant. Clin Nutr. 2019.
  • Duncan CN, Vrooman L, Apfelbaum EM, Whitley K, Bechard L, Lehmann LE. 25-Hydroxy vitamin D deficiency following pediatric Hematopoietic Stem Cell Transplant. Biology of Blood and Marrow Transplantation. 2011;17(5):749-53.
  • Schulte CM, Beelen DW. Bone loss following hematopoietic stem cell transplantation: a long-term follow-up. Blood. 2004;103(10):3635-43.
  • Iovino L, Mazziotta F, Carulli G, et al. High-dose zinc oral supplementation after stem cell transplantation causes an increase of TRECs and CD4+ naïve lymphocytes and prevents TTV reactivation. Leukemia Research. 2018;70:20-4.
  • Hansson ME, Norlin A-C, Omazic B, et al. Vitamin D levels affect outcome in pediatric hematopoietic stem cell transplantation. Biology of Blood and Marrow Transplantation. 2014;20(10):1537-43.
  • Lounder DT, Khandelwal P, Dandoy CE, et al. Lower levels of vitamin A are associated with increased gastrointestinal graft-versus-host disease in children. Blood, The Journal of the American Society of Hematology. 2017;129(20):2801-7.
  • Cunningham-Rundles S, McNeeley DF, Moon A. Mechanisms of nutrient modulation of the immune response. Journal of Allergy and Clinical Immunology. 2005;115(6):1119-28.
  • Kauf E, Fuchs D, Winnefeld K, Hermann J, Zintl F. Blood selenium content after conditioning and during the course of bone marrow transplantation in children with malignant diseases. Medizinische Klinik (Munich, Germany: 1983). 1997;92:46-7.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Beslenme
Bölüm Olgu Sunumları
Yazarlar

Furkan Yolcu 0000-0003-0341-1959

Hayriye Özer Işık 0000-0001-9617-3077

Gülhan Samur 0000-0003-0456-4623

Yayımlanma Tarihi 18 Nisan 2025
Gönderilme Tarihi 27 Şubat 2025
Kabul Tarihi 17 Mart 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 5 Sayı: 1

Kaynak Göster

APA Yolcu, F., Özer Işık, H., & Samur, G. (2025). DOCK8 Eksikliği Sonucu Gelişen Çoklu Besin Alerjisi Olan Bir Olguda Kök Hücre Tedavisi Döneminde Karşılaşılan Nütrisyonel Sorunlar ve Uygulamalar. Abant Sağlık Bilimleri Ve Teknolojileri Dergisi, 5(1), 46-54.
AMA Yolcu F, Özer Işık H, Samur G. DOCK8 Eksikliği Sonucu Gelişen Çoklu Besin Alerjisi Olan Bir Olguda Kök Hücre Tedavisi Döneminde Karşılaşılan Nütrisyonel Sorunlar ve Uygulamalar. SABİTED. Nisan 2025;5(1):46-54.
Chicago Yolcu, Furkan, Hayriye Özer Işık, ve Gülhan Samur. “DOCK8 Eksikliği Sonucu Gelişen Çoklu Besin Alerjisi Olan Bir Olguda Kök Hücre Tedavisi Döneminde Karşılaşılan Nütrisyonel Sorunlar Ve Uygulamalar”. Abant Sağlık Bilimleri Ve Teknolojileri Dergisi 5, sy. 1 (Nisan 2025): 46-54.
EndNote Yolcu F, Özer Işık H, Samur G (01 Nisan 2025) DOCK8 Eksikliği Sonucu Gelişen Çoklu Besin Alerjisi Olan Bir Olguda Kök Hücre Tedavisi Döneminde Karşılaşılan Nütrisyonel Sorunlar ve Uygulamalar. Abant Sağlık Bilimleri ve Teknolojileri Dergisi 5 1 46–54.
IEEE F. Yolcu, H. Özer Işık, ve G. Samur, “DOCK8 Eksikliği Sonucu Gelişen Çoklu Besin Alerjisi Olan Bir Olguda Kök Hücre Tedavisi Döneminde Karşılaşılan Nütrisyonel Sorunlar ve Uygulamalar”, SABİTED, c. 5, sy. 1, ss. 46–54, 2025.
ISNAD Yolcu, Furkan vd. “DOCK8 Eksikliği Sonucu Gelişen Çoklu Besin Alerjisi Olan Bir Olguda Kök Hücre Tedavisi Döneminde Karşılaşılan Nütrisyonel Sorunlar Ve Uygulamalar”. Abant Sağlık Bilimleri ve Teknolojileri Dergisi 5/1 (Nisan 2025), 46-54.
JAMA Yolcu F, Özer Işık H, Samur G. DOCK8 Eksikliği Sonucu Gelişen Çoklu Besin Alerjisi Olan Bir Olguda Kök Hücre Tedavisi Döneminde Karşılaşılan Nütrisyonel Sorunlar ve Uygulamalar. SABİTED. 2025;5:46–54.
MLA Yolcu, Furkan vd. “DOCK8 Eksikliği Sonucu Gelişen Çoklu Besin Alerjisi Olan Bir Olguda Kök Hücre Tedavisi Döneminde Karşılaşılan Nütrisyonel Sorunlar Ve Uygulamalar”. Abant Sağlık Bilimleri Ve Teknolojileri Dergisi, c. 5, sy. 1, 2025, ss. 46-54.
Vancouver Yolcu F, Özer Işık H, Samur G. DOCK8 Eksikliği Sonucu Gelişen Çoklu Besin Alerjisi Olan Bir Olguda Kök Hücre Tedavisi Döneminde Karşılaşılan Nütrisyonel Sorunlar ve Uygulamalar. SABİTED. 2025;5(1):46-54.