Mehmet BAYRAKTAR, Nihayet BAYRAKTAR, Yaşar BAYINDIR, Rıza DURMAZ

Brusellozlu hastalarda serum c-reaktif protein, demir ve ferritin düzeylerinin tanı ve izlemdeki değeri

Dünyada yaygın bir zoonotik hastalık olan bruselloz, ülkemizde de sık görülmektedir. Oldukça geniş bir klinik spektruma sahip olup, birtakım hematolojik bozukluklara da neden olmaktadır. En sık görülen hematolojik bozukluk ise, anemi ve nötropenidir. Serum ferritin düzeyindeki değişiklikler, nonspesifik doku hasarına, demir metabolizmasındaki ve/veya hematopbezdeki anormalliklere bağlı olarak meydana gelebilir. İnflamasyonun bir göstergesi olan artmış C-reaktif protein (CRP) düzeyleri ise, bruselloz olgularında tanıya yardımcı olarak kullanılabilmektedir. Serum CRP, demir ve ferritin düzeylerinin bruselloz tanı ve takibindeki önemini incelemek amacıyla, brusellozlu toplam 45 hasta ve 45 sağlıklı birey bu çalışmaya alınmıştır. Brusellozlu hastaların serumunda demir düzeyleri, kontrol grubuna göre istatistiksel olarak daha düşük (p

Anahtar Kelimeler:

C-reaktif protein, Ferritin, Tanı, Demir, Bruselloz

Evaluation of serum levels of c-reactive protein, iron and ferritin in diagnosis and monitoring of brucellosis

Brucellosis is an endemic zoonotic disease of a global distribution and is also commonly seen in our country. It has quite broad appearance with a certain number of haematologic disorders such as anemia and neutropenia. Changes in serum ferritin levels may be resulted in non-spesific tissue damage, abnormalities in iron metabolism and/or haematopoiesis. C-reactive protein (CRP) which is a marker of an inflammation may be helpful in diagnosis of brucellosis. To evaluate the importance of serum levels of CRP, iron and ferritin in monitoring and diagnosis of brucellosis, a total of 45 patients and 45 healthy controls were studied. Serum iron levels were statistically decreased in patients group (p< 0.001) whereas CRP and ferritin levels were significantly increased (p<0.001). The high serum CRP may indicate active Brucella infection while the low serum iron and highferritin levels may suggest chronic brucellosis. From these results it was concluded that serum levels of CRP, iron and ferritin may be good markers in diagnosis and follow up of brucellosis.

Keywords:

C-Reactive Protein, Ferritins, Diagnosis, Iron, Brucellosis,

PDF

___

1. Ahluwalia N: Diagnostic utility of serum transferring receptors measurement in assessing iron status, Nutrition Rev 1998;56:133-6.
2. Aktaş F, Şenol E, Yetkin A, Gürdoğan K, Ulutan F: Brusellozda klinik ve laboratuvar bulgularının hastalık stresi ile ilişkisi, Türk Mikrobiyol Cem Derg 1994;24:164-9.
3. Al-Eissa Y, Al-Nasser M: Hematological manifestations of childhood brucellosis, Infection 1993;21:23-6.
4. Bellaire BH, Elzer PH, Hagius S, Walker J, Baldwin CL, Roop RM 2nd.: Genetic organization and iron-responsive regulation of the Brucella abortus 2,3-dihydroxybenzoi c acid biosynthesis operon, a cluster of genes required for wild-type virulence in pregnant cattle, Infect Immun 2003;71:1794-8.
5. Danese I, Haine V, Delrue RM et al: The Ton system, an ABC transporter, and a universally conserved GTPase are involved in iron utilization by Brucella melitensis 16M, Infect Immun 2004;10:90-7.
6. Di Mario A, Sica S, Zini G, Salutari P, Leone G: Microangiopathic hemolytic anemia and severe thrombocytopenia in Brucella infection, Ann Hematol 1995;70:59-67.
7. Garcia P, Yrivarren JL, Argumans C, Crosby E, Carrillo C, Gotuzzo E: Evaluation of the bone marrow in patients with brucellosis. Clinicopathological correlation, Enferm Infect Microbiol Clin 1990; 8:19-22.
8. Gruner E, Bernasconi E, Galeazzi RL, Buhl D, Heinzle R, Nadal D: Brucellosis; an occupational hazard for medical laboratory personnel. Report of five cases, Infection 1994;22:33-7.
9. Hikawa A, Nomata Y, Suzuki T et al : Soluble transferrin receptor-transferrin complex in serum: measurement by latex agglutination nephelometric immunoassay, Clin Chim Acta 1996;254:159-72.
10. Li JJ, Wang HR, Huang CX, Xue JL, Li GS: Enhanced inflammatory response of blood monocytes to C-reactive protein in patients with unstable angina, Clin Chim Acta 2005;352:127-33.
11. Means RT Jr: Pathogenesis of the anemia of chronic disease: a cytokinemediated anemia, Stem Cells 1995;13:32-7.
12. Ozden M, Kalkan A, Demirdag K, Kilic SS, Denk A, Yuce P: Hepatocyte growth factor (HGF) in patients with acute brucellosis, Scand J Infect Dis 2004;36:109-13.
13. Reizenstein P: Iron, free radicals and cancer, Med Oncol Tumor Pharmacother 1991;8:229-32.