Mean Platelet Volume and Neutrophil-to-Lymphocyte Ratio in Patients with Crimean–Congo Hemorrhagic Fever

Amaç: Kırım-Kongo Kanamalı Ateşi (KKKA), Kırım-Kongo Kanamalı Ateşi Virüsünün (KKKAV) neden olduğu kene kaynaklı zoonotik bir hastalıktır. Bu çalışmanın amacı subklinik inflamasyonun ve KKKA’nın basit belirteçleri olan kan nötrofil/lenfosit oranı (NLR) ve ortalama trombosit hacmi (MPV) arasındaki ilişkinin araştırılmasıydı. Yöntemler: Kayseri Eğitim ve Araştırma Hastanesi’ne 2009-2013 yılları arasında başvuran KKKA şüpheli 31 hasta retrospektif olarak değerlendirildi. Bu 31 hastadan 19’unun laboratuvar tanısı RT-PCR veya KKKAV’ye özgül IgM pozitifliği ile KKKA olarak doğrulandı. Hasta grupları arasında alanin aminotransferaz (ALT), aspartat aminotransferaz (AST), laktat dehidrogenaz (LDH), kreatinin fosfokinaz (CK), koagülasyon parametreleri, beyaz küre sayıları (WBC) ve trombosit sayıları 25 sağlıklı bireyle karşılaştırıldı. Bulgular: MPV, AST, ALT, LDH, CK ve koagülasyon parametreleri KKKA’lı hastalarda kontrollere göre anlamlı olarak daha yüksek bulunurken, WBC, nötrofil, lenfosit, hemoglobin, trombosit sayıları ve NLR anlamlı olarak daha düşüktü (p

Kırım-Kongo Kanamalı Ateşi Olan Hastalarda Ortalama Trombosit Hacmi ve Nötrofil/Lenfosit Oranı

Objectives: Crimean–Congo hemorrhagic fever (CCHF) is a tick-borne zoonotic infection caused by Crimean Congo hemorrhagic fever virus (CCHFV). The aim of the present study was to investigate the association between blood neutrophilto-lymphocyte ratio (NLR) and mean platelet volume (MPV) which are simple markers of subclinical inflammation and CCHF. We also investigated the relationship of these markers with coagulation parameters. Methods: Thirty-one suspected CCHF patients, who submitted to Training and Research Hospital, Kayseri, Turkey between 2009 and 2013, were evaluated retrospectively. Among thirty-one patients, nineteen were laboratory confirmed CCHF patients diagnosed by RT-PCR or CCHFV-specific IgM positivity. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatinine phosphokinase (CK), coagulation parameters, white blood cell counts (WBCs), and platelet counts of patient group were compared with twenty-five healthy individuals. Results: MPV, AST, ALT, LDH, CK and coagulation parameters were significantly higher in patients with CCHF than the controls, whereas WBCs, neutrophil, lymphocyte, hemoglobin, platelet counts and NLR were significantly lower (p

Kaynakça

1.Ergonul O. Crimean-Congo haemorrhagic fever. Lancet Infect Dis 2006; 6(4): 203-214.

2.Whitehouse CA. Crimean-Congo haemorrhagic fever. Antiviral Res 2004; 64(3): 145-160.

3.Tarantola A, Ergonul O, Tattevin P. (2007) Estimates and prevention of Crimean Congo hemorrhagic fever risks for health care workers. In: Ergonul O, Whitehouse CA, editors. Crimean Congo hemorrhagic fever: a global perspective. Dordrecht: Springer. 281-294.

4.Mardani M, Keshtkar-Jahromi M. Crimean-Congo hemorrhagic fever. Arch Iran Med 2007; 10(2): 204-214.

5.Villinger F, Rollin PE, Brar SS, Chikkala NF, Winter J, Sundstrom JB, et al. Markedly elevated levels of interferon (IFN)-gamma, IFN-alpha, interleukin (IL)-2, IL-10, and tumor necrosis factor-α associated with fatal Ebola virus infection. J Infect Dis 1999; 179: 188-191.

6.Baize S, Leroy EM, Georges AJ, Georges-Courbot MC, Capron M, Bedjabaga I, et al. Inflammatory responses in Ebola virus-infected patients. Clin Exp Immunol 2002; 128(1): 163-168.

7.Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 2002; 13(5-6): 301-306.

8.Bancroft, AJ, Abel EW, Mclaren M, Belch JJ. Mean platelet volume is a useful parameter: a reproducible routine method using a modified Coulter thrombocytometer. Platelets 2000; 11(7): 379-387.

9.Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des 2011; 17(1): 47-58.

10. Duffy BK, Gurm HS, Rajagopal V, Gupta R, Ellis SG, Bhatt DL. Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol 2006; 97(7): 993-996.

11. Halazun KJ, Hardy MA, Rana AA, Woodland DC 4th, Luyten EJ, Mahadev S, et al. Negative impact of neutrophillymphocyte ratio on outcome after liver transplantation for hepatocellular carcinoma. Ann Surg 2009; 250(1): 141-151.

12. Avanzas P, Quiles J, Lopez de Sa E, Sánchez A, Rubio R, García E, et al. Neutrophil count and infarct size in patients with acute myocardial infarction. Int J Cardiol 2004; 97(1): 155-156.

13. Ommen SR, Hodge DO, Rodeheffer RJ, McGregor CG, Thomson SP, Gibbons RJ. Predictive power of the relative lymphocyte concentration in patients with advanced heart failure. Circulation 1998; 97(1): 19-22.

14. Leblebicioglu H. Crimean-Congo haemorrhagic fever in Eurasia. Int J Antimicrob Agents. 2010;36:43-46.

15. Turkish Ministry of Health. Kırım Kongo Kanamalı atesi: 2002-2009 yılları vaka sayıları. Ankara, Turkey: Ministry of Health; 2011. Available at: http://www.saglik.gov.tr/KKKA/belge/1-6590/kirim-kongokanamali-atesi-vaka-ve-olumlerinin-yillara-.html.(accessed March 11, 2011).

16. Uyar Y, Carhan A, Albayrak N, Altaş AB. Evaluation of PCR and ELISA-IgM results in the laboratory diagnosis of Crimean-Congo haemorrhagic fever cases in 2008 in Turkey. Mikrobiyol Bul 2010; 44(1): 57-64.

17. Karti SS, Odabasi Z, Korten V, Yilmaz M, Sonmez M, Caylan R, et al. Crimean-Congo hemorrhagic fever in Turkey. Emerg Infect Dis 2004; 10(8): 1379-1384.

18. Fisman DN. Hemophagocytic syndromes and infection. Emerg Infect Dis 2000; 6(6): 601-608.

19. Zubcevic N, Mesihovic R, Zubcevic S. Usefulness of laboratory data in estimation of Crohn's disease activity. Med Arh 2010; 64(1): 33-36.

20. Yuksel O, Helvaci K, Basar O, Köklü S, Caner S, Helvaci N, et al. An overlooked indicator of disease activity in ulcerative colitis: mean platelet volume. Platelets. 2009; 20(4): 277-281.

21. 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(3): 291- 294.

22. Ekiz F, Yuksel O, Kocak E, Yılmaz B, Altınbaş A, Çoban S, Yüksel I, et al. Mean platelet volume as a fibrosis marker in patients with chronic hepatitis B. J Clin Lab Anal 2011; 25(3): 162-165.

23. Beyazit Y, Sayilir A, Torun S, Suvak B, Yesil Y, Purnak T, et al. Mean platelet volume as an indicator of disease severity in patients with acute pancreatitis. Clin Res Hepatol Gastroenterol 2012; 36(2): 162-168.

24. Numbenjapon T, Mahapo N, Pornvipavee R, Srıswasdı C, Mongkonsritragoon W, Leelasiri A, et al. A prospective evaluation of normal mean platelet volume in discriminating hyperdestructive thrombocytopenia from hypoproductive thrombocytopenia. Int J Lab Hematol 2008; 30(5): 408-414.

25. Kaito K, Otsubo H, Usui N, Yoshida M, Tanno J, Kurihara E, et al. Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. Br J Haemat 2005; 128(5): 698-702.

26. Bowles KM, Cooke LJ, Richards EM, Baglin TP. Platelet size has diagnostic predictive value in patients with thrombocytopenia. Clin Lab Haemat 2005; 27(6): 370-373.

27. Ekiz F, Gürbüz Y, Basar Ö, Aytekin G, Ekiz Ö, Sentürk ÇŞ, et al. Mean platelet volume in the diagnosis and prognosis of Crimean-Congo hemorrhagic fever. Clin Appl Thromb Hemost 2013; 19(4): 441-444.

28. Ergonul O, Tuncbilek S, Baykam N, Celikbas A, Dokuzoguz B. Evaluation of Serum Levels of Interleukin (IL)–6, IL-10, and Tumor Necrosis Factor-α in Patients with Crimean-Congo Hemorrhagic Fever. J Infect Dis 2006; 193(7): 941-944.

29. Kaser A, Brandacher G, Steurer W, Kaser S, Offner FA, Zoller H, et al. Interleukin-6 stimulates thrombopoiesis through thrombopoietin: role in inflammatory thrombocytosis. Blood 2001; 98(9): 2720-2755.

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