Romatoid artritli hastalarda kan eozinofil sayısının hastalık aktivitesi ve inflamatuvar belirteçlerle ilişkisi
Amaç: Bu çalışmanın amacı, romatoid artritli hastalarda eozinofili
sıklığının belirlenmesi, eozinofil sayısının hastalık aktivitesi ve
inflamatuvar belirteçlerle ilişkisinin değerlendirilmesidir. Gereç ve
Yöntem: Ocak 2016-Mart 2016 tarihleri arasında
Fiziksel Tıp ve Rehabilitasyon polikliniğine başvuran romatoid artrit tanılı
hastalar çalışmaya dahil edildi. Hastaların demografik ve klinik özelliklerine
ek olarak, laboratuvar verilerinden; periferik kandaki mikrolitre başına düşen
eozinofil sayısı, eozinofil yüzdesi, eritrosit sedimentasyon hızı (mm/s) ve
C-reaktif protein (mg/dL) düzeyleri kaydedildi. Mikrolitrede 500 ve üzerindeki
eozinofil değerleri “eozinofili” olarak kabul edildi. Hastalık aktivitesi
Hastalık Aktivite Skoru 28 (DAS28)-CRP ile belirlendi. Bulgular: Çalışmaya yaş ortalamaları 54,0±12,2 yıl olan 62 hasta (54 kadın, 8
erkek) dahil edildi. Eozinofil sayısı ve eozinofil yüzdesi için ortanca
(minimum-maksimum) değerleri sırasıyla 0,19 (0,01-0,8)/mikrolitre ve %2,45
(0,2-7,5) olarak hesaplandı. Çalışma grubunun %4,8’inde (n=3) eozinofili
mevcuttu. Eozinofil sayısı ile DAS28-CRP skoru, eritrosit sedimentasyon hızı ve
C-reaktif protein düzeyi arasında korelasyon saptanmadı.
Sonuç: Eozinofili romatoid artritte nadir gözlenen bir
durumdur. Romatoid artritli hastalarda, periferik kandaki eozinofil sayısının,
hastalık aktivitesi ve inflamatuvar belirteçlerle ilişkisi saptanmamıştır.
Relationship of blood eosinophil count to disease activity and inflammatory markers in patients with rheumatoid arthritis
Purpose: The aim of this study is to determine the frequency of eosinophilia
among rheumatoid arthritis patients, as well as to evaluate the relation of
eosinophil count to disease activity and inflammatory markers.
Material and
Methods: Patients with rheumatoid arthritis who had
admitted to the Physical Medicine and Rehabilitation out-patient clinic between
January2016-March 2016 were included in the study. The demographic and clinical
variables, along with the peripheral eosinophil count per microliter, eosinophil
percentage, erythrocyte sedimentation rate (mm/h) and C-reactive protein level
were recorded. Eosinophil count ≥ 500/microliter was regarded as eosinophilia.
The disease activity was determined via the Disease Activity Score 28
(DAS28)-CRP.
Results: Sixty-two rheumatoid arthritis patients (54 female, 8 male) with a
mean age of 54.0±12.2 years were included in the study. The median
(minimum-maximum) value for eosinophil count and eosinophil percentage were
0.19 (0.01-0.8)/microliter and 2.45%(0.2-7.5), respectively. Eosinophilia was
detected in 4.8% (n=3) of the patients. Eosinophil count showed no correlation
with DAS28-CRP score, erythrocyte sedimentation rate and C-reactive protein
level.
Conclusion: Eosinophilia is a rare occasion in rheumatoid arthritis.
Peripheral blood eosinophil count appears not to be correlated with the disease
activity or the inflammatory markers among patients with rheumatoid arthritis.
___
- 1. Roufosse F, Weller PF. Practical approach to the patient with hypereosinophilia. J Allergy Clin Immunol. 2010;126:39-44.
- 2. Mejia R, Nutman TB. Evaluation and differential diagnosis of marked, persistent eosinophilia. Semin Hematol. 2012;49:149-59.
- 3. Chiardola F, Schneeberger EE, Citera G, Rosemffet GM, Kuo L, Santillan G, Maldonado-Cocco JA. Prevalence and clinical significance of eosinophilia in patients with rheumatoid arthritis in Argentina. J Clin Rheumatol. 2008;14:211-3.
- 4. Hällgren R, Feltelius N, Svenson K, Venge P. Eosinophil involvement in rheumatoid arthritis as reflected by elevated serum levels of eosinophil cationic protein. Clin Exp Immunol 1985;59:539-46.
- 5. Mertens AV, De Clerck LS, Moens MM, Bridts CH, Stevens WJ. Study of eosinophil-endothelial
adhesion, production of oxygen radicals and release of eosinophil cationic protein by peripheral blood eosinophils of patients with rheumatoid arthritis. Clin Exp Allergy. 1993;23:868-73.
- 6. Savolainen HA, Leirisalo-Repo M. Eosinophilia as a side-effect of methotrexate in patients with chronic arthritis. Clin Rheumatol 2001;20:432-4.
- 7. Bruyn GA, Velthuysen E, Joosten P, Houtman PM. Pancytopenia related eosinophilia in rheumatoid arthritis: a specific methotrexate phenomenon? J Rheumatol. 1995;22:1373-6.
- 8. Rubin DT, Sohi S, Shilling R, White S. Pulmonary eosinophilia associated with infliximab treatment of Crohn’s disease. Ame J Gastroenterol. 2005;100:224-5.
- 9. Cancelliere N, Barranco P, Vidaurrázaga C, Benito DM, Quirce S. Subacute prurigo and eosinophilia in a patient with rheumatoid arthritis receiving infliximab and etanercept. J Investig Allergol Clin Immunol. 2011;21:248-9.
- 10. Poliak N, Orange JS, Pawel BR, Weiss PF. Eosinophilic fasciitis mimicking angioedema and treatment response to infliximab in a pediatric patient. Ann Allergy Asthma Immunol. 2011;106:444-5.
- 11. Morrisroe K, Wong M. Drug-induced hypereosinophilia related to tocilizumab therapy for rheumatoid arthritis. Rheumatology (Oxford). 2015;54:2113-4.
- 12. Kargili A, Bavbek N, Kaya A, Koşar A, Karaaslan Y. Eosinophilia in rheumatologic diseases: a prospective study of 1000 cases. Rheumatol Int. 2004;24:321-4.
- 13. Kaptanoglu E, Akkurt I, Sahin O, Hocaoglu S, Nacitarhan V, Elden H et al.. Prevalence of atopy in rheumatoid arthritis in Sivas, Turkey. A prospective clinical study. Rheumatol Int. 2004;24:267-71.
- 14. Guellec D, Milin M, Cornec D, Tobon GJ, Marhadour T, Jousse-Joulin S et al. Eosinophilia predicts poor clinical outcomes in recent-onset arthritis: results from the ESPOIR cohort. RMD Open 2015;1:e000070.