Thalassemia Minor Presenting with Xiphodynia

Abstract

ÖzetKsifodini, ksifoid kemik veya ksifosternal bileşkeye bağlı olarak ortaya çıkan üst abdominal ağrı, göğüs ağrısı, boğaz, baş ve kola yayılabilen ağrı ile karakterize bir grup semptomu içeren nadir bir sendromu tarif eder. Otuzyedi yaşında kadın hasta göğüs sırt, orta kesimi ve kola yayılan keskin vebatıcı tarzda ağrı ve anemi ile başvurdu. Ağrı medikal tedaviye dirençli olup ksifoid kemik rezeksiyonu uygulandı.Histopatolojik olarak hastaya thalasemi minor tanısı kondu. Rezeksiyon sonrası ağrı kayboldu. Altıncı ay takibinde hasta asemptomatik ve hiç ağrısı yoktu. Ksifoid kemiğin cerrahi rezeksiyonu medical olarak dirençli ksifodinide tedavi edici olabilir. AbstractXiphodynia describes an uncommon syndrome with group of symptoms ranging from upper abdominal pain, chest pain, throat, head and arm symptoms referred from xiphosternal joint or the xiphoid process. A 37-year-old woman presented with a sharp and persistant pain complaint of chest, mid-dorsal region and arm and anemia. Pain was refractor to medication and xiphoid resection was performed. The patient was diagnosed as thalassemia minor histopathologically. After resection pain was disappeared. At the 6th month follow up patient was asymptomatic and no pain was detected. Surgical resection of xyphoid bone may be curable in medically refractor xiphodynia.

Episodic Abdominal and Chest Pain in a Young Adult

“…Patients with xiphodynia are usually treated with analgesics, an elastic rib belt, 3 topical heat and cold, and a course of ultrasound and laser, 4 but conservative physical therapies may not be effective. However, local injection with an anesthetic-steroid combination may provide symptomatic relief.…”

“…5 In the few reported patients for whom medical treatment has failed, xiphoidectomy provides resolution of symptoms. 2,4 Ambulatory esophageal pH and pressure monitoring, to rule out possible pathologic gastroesophageal reflux, should not be necessary with a proper physical examination. The decision to perform a xiphoidectomy in this case was supported by the persistence of symptoms after injections of cortisone and ketoprofen.…”