Dilek DOĞRUEL, Rabia Miray Kışla EKİNCİ, Sibel BALCI, Mustafa YILMAZ, Derya Ufuk ALTINTAŞ

Ailevi Akdeniz Ateşi Olan Çocuklarda Ortalama Trombosit Hacminin Klinik Önemi

Amaç: Ailevi Akdeniz Ateşi AAA , otozomal resesif geçiş gösteren inflamatuar bir hastalık olup seröz membranların tekrarlayan tutulumu ile karakterizedir. İnflamatuvar hastalıkların pek çoğunda ortalama trombosit hacminin OTH belirteç olarak kullanılabileceği gösterilmiştir. Bu çalışmada AAA’lı çocuklarda genetik mutasyon ile hastalığın ataklı ve ataksız dönemlerinde ortalama trombosit hacmindeki değişiklikleri inceledik. Hastalar ve Yöntemler: Çalışmaya Tel-Hashomer kriterlerine göre AAA tanısı almış 110 çocuk dahil edildi. Hastaların demografik özellikleri, genetik tarama sonuçları, tam kan sayımı parametreleri, OTH düzeyleri, eritrosit sedimantasyon hızı ESH , C-Reaktif protein CRP değerleri retrospektif olarak değerlendirildi. Hastaların verileri tedavi altında ataklı ve ataksız dönemlerine göre ayrı ayrı kaydedildi. Bulgular: Ortalama trombosit hacmi ataklı dönemde 8,55±1,51 fL iken ataksız dönemde 9,61±1,18 fL saptandı. Hastaların ataklı dönem OTH düzeylerinde, ataksız döneme göre istatistiksel olarak anlamlı düşüktü p=0.000 . Trombosit ve beyazküre sayıları, ESH ve CRP seviyeleri atak döneminde ataksız döneme göre istatistiksel olarak anlamlı yüksekti p=0.000 . Sonuç: Ortalama trombosit hacmi hastaların atak döneminde düşmektedir ve bu atakları saptama

Clinical Importance of Mean Platelet Volume In Children With Family Mediterranean Fever

Objectives: Familial Mediterranean Fever FMF is an autosomal recessive inflammatory disease characterised by recurrent involvement of serous membranes. It has been shown that the mean platelet volume MPV could be used as a marker in many inflammatory diseases. In this study, we investigated the genetic mutation in children with FMF and changes in MPV in attack and attack-free periods. Patients and Methods: The study included 110 children diagnosed with FMF based on the Tel-Hashomer Criteria. Demographic features, results of genetic analyses, complete blood count parameters, MPV levels, erythrocyte sedimentation rate ESR , C-reactive protein CRP results were evaluated retrospectively. Data of the patients were recorded separately based on the acute attack and attack-free periods under treatment. Results: The mean platelet volume was found to be 8,55±1,51 fL in the attack period and 9,61±1,18 fL in the attack-free period. The mean platelet volume was significantly lower in patients with an attack period compared to the patients at an attack-free period p=0.000 . The platelet and leukocyte count, ESR, CRP were statistically significantly higher in the attack period compared to the attack-free period p=0.000 . Conclusion: The mean platelet volume is decreased in patients with attack period and it may be a useful parameter in determining timing the attack. It is important that clinicians use this parameter when evaluating the hemogram result

Keywords:

Familial Mediterranean Fever, Inflammation, Mean Platelet Volume,

PDF

___

Abuhandan M, Kaya C, Güzelçiçek A. Ailevi Akdeniz ateşi tanısı alan 186 olgunun klinik semptom ve MEFV geni mutasyonlarının incelenmesi. Dicle Tıp Derg 2015;42:61–5. [CrossRef]

Çobankara V, Balkarlı A. Ailesel Akdeniz Ateşi. Pamukkale Tıp Derg 2011;:86–98.

Ahsen A, Ulu MS, Yuksel S, Demir K, Uysal M, Erdogan M, Acarturk G. As a new inflammatory marker for familial Mediterranean fever: neutrophil-to-lymphocyte ratio. Inflammation 2013;36:1357–62. [CrossRef]

Padeh S, Shinar Y, Pras E, Zemer D, Langevitz P, Pras M, Livneh A. Clinical and diagnostic value of genetic testing in 216 Israeli children with familial Mediterranean fever. J Rheumatol 2003;30:185–90.

Morrell CN, Aggrey AA, Chapman LM, Modjeski KL. Emerging roles for platelets as immune and inflammatory cells. Blood 2014;123:2759– 67. [CrossRef]

Martin JF, Shaw T, Heggie J, Penington DG. Measurement of the density of human platelets and its relationship to volume. Br J Haematol 1983;54:337–52. [CrossRef]

Bessman JD, Gilmer PR, Gardner FH. Use of mean platelet volume improves detection of platelet disorders. Blood Cells 1985;11:127–35.

Kisacik B, Tufan A, Kalyoncu U, Karadag O, Akdogan A, Ozturk MA, et al. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 2008;75:291–4. [CrossRef]

Makay B, Türkyılmaz Z, Ünsal E. Mean Platelet Volume in children with familial mediterranean fever. Clin Rheumatol 2009;28:975–8. [CrossRef]

Çoban E, Adanır H. Platelet activation in patients with Familial Mediterranean Fever. Platelets 2008;19:405–8. [CrossRef]

Baykal Y, Saglam K, Yılmaz, Taşlıpınar A, Akıncı SB, İnal A. Serum IL-2, IL6, IL-10, TNFα level in familial mediterranean fever patients. Clin Rheumatol 2003;22:99–101. [CrossRef]

Yüksel O, Helvacı K, Başar Ö, Köklü S, Caner S, Helvacı N, et al. An overlooked indicator of disease activity in ulcerative colitis: Mean platelet volume. Platelets 2009;20:277–81. [CrossRef]

Gasparyan AY, Sandoo A, Stavropoulos-Kalinoglou A, Kitas GD. Mean platelet volume in patients with rheumatoid arthritis: the effect of anti-TNF-alpha therapy. Rheumatol Int 2010;30:1125–9. [CrossRef]

Cazeneuve C, Sarkisian T, Pecheux C, Dervichian M, Nédelec B, Reinert P, et al. MEFV gene analysis in Armanian patients with Familial Mediterranean fever: Diagnostic value and unfavorable renal prognosis of M694V homozygous genoytpe --genetic and therapeutic implications. Am J Hum Genet 1999;65:88–97. [CrossRef]

Gershoni-Baruch R, Brik R, Lidar M, Shinawi M, Livneh A. Male sex coupled with arthicular manifestations cause a 4-fold increase in susceptibility to amyloidosis in patients with Familial Mediterranean Fever homozygous for the M694V-MEFV mutation. J Rheumatol 2003;30:308–12.