Ömür TARAK, EBUBEKİR ŞENATEŞ, FERHAT ARSLAN, Reşat ÖZARAS

Hastaneye yatırılan hastalarda poliserozit etyolojisi: 40 hastanın değerlendirilmesi

Giriş ve Amaç: Poliserozit birden fazla seröz zarın inflamasyonuna verilen addır. Poliserozite değişik hastalıklar neden olabilmektedir. Biz bu çalışmada hastaneye yatırılan ve poliserozit saptanan olgularımızı ayrıntılı olarak incelemeyi amaçladık. Gereç ve Yöntem: Cerrahpaşa Tıp Fakültesi, İç Hastalıkları Anabilim Dalı'nda 1 Ocak 2001 ve 31 Aralık 2004 tarihleri arasında yatırılarak tetkik edilen toplam 12,485 hastanın dosyası ayrıntılı şekilde incelendi. Poliserozit saptanan 40 olgu demografik, klinik ve etyolojik açıdan ele alındı. Bulgular: Toplam 12,485 hastanın 40'ı (%0.3) poliserozit tanısı almıştı (22 kadın, 18 hasta). Bu hastalarda poliserozitin en sık nedeni 15 hasta (%37.5) ile maligniteler idi (4 hastada Non-Hodgkin Lenfoma, 2'sinde over kanseri, 2'sinde sarkom, birer hastada ise akciğer, meme, mide, serviks ve endometrium kanseri, Burkitt lenfoması, primeri bilinmeyen karaciğere metastaz yapmış adenokanser ve Hepatit B ve Hepatit C zemininde gelişen hepatosellüler kanser). İkinci en sık neden ise 9 hasta ile (%22.5) kollajen bağ dokusu hastalıkları idi (7 hastada Behçet hastalığı ve 2 hastada sistemik lupus eritematozus). Diğer poliserozit nedenleri ise sıklık sırasıyla tüberküloz (8 hasta, %20), idyopatik (3 hasta, %7.5) ve diğer nedenler (2 hastada portal ven trombozu, 2 hastada kronik böbrek yetmezliği ve hipotiroidi zemininde peritonit, 1 hastada konjestif kalp yetmezliği ve peritonit) idi. En sık başvuru semptomu halsizlik, en sık fizik muayene bulgusu ise ödem idi. Sonuç: Çalışmamızda poliserozitin en sık nedeni maligniteler idi. Diğer nedenler ise sıklık sırasıyla bağ dokusu hastalıkları, enfeksiyonlar ve idyopatik nedenler idi. Poliserozitli bir hasta ile karşılaşıldığında bu bulgular ışığında değerlendirmenin yararlı olacağını düşünmekteyiz.

Anahtar Kelimeler:

Poliserozit, malignite, kollajen hastalıklar, enfeksiyon

Etiology of polyserositis in hospitalized patients: Evaluation of 40 patients

Background and aims: Polyserositis is defined as inflammation of more than one serous membrane. In this retrospective study, we aimed to investigate the patients diagnosed with polyserositis who were hospitalized. Materials and Methods: Between 1 January 2001 and 31 December 2004, 12,485 patients were hospitalized in the Internal Medicine Services of Istanbul University, Cerrahpasa Medical Faculty. Forty patients with polyserositis were determined, and these patients were carefully examined with respect to demographic, clinical and etiologic characteristics. Results: Totally, 40 (22 female, 18 male) of 12,485 patients were diagnosed with polyserositis (0.3%). The most frequent etiology of polyserositis was malignancy (15 patients) (4 patients were diagnosed with non-Hodgkin lymphoma, 2 with ovarian cancer, 2 with sarcoma, and 1 patient each with lung, breast, gastric, cervical, endometrial cancer, Burkitt's lymphoma, metastatic adenocarcinoma to the liver of unknown primary origin and hepatocellular cancer developed from liver cirrhosis due to chronic hepatitis B and C). The second most frequent cause of polyserositis was collagen vascular disease, determined in 9 patients (22.5%) (7 with Behçet's disease, 2 with systemic lupus erythematosus). The other etiologies of polyserositis in order of frequency were tuberculosis (8 patients), idiopathic (3 patients) and other (2 with portal venous thrombosis, 2 with peritonitis with background of chronic renal failure and hypothyroid and 1 with peritonitis with background of congestive heart failure). The most frequent presenting symptom was malaise and the most frequent finding was edema. Conclusions: The most frequent etiology of polyserositis in our study was malignancy. The other causes were collagen vascular diseases, infections and idiopathic causes. We suggest that it will be useful to evaluate patients with polyserositis in light of these data.

Keywords:

Polyserositis, malignancy, collagen vascular diseases, infection,

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