Sedat ÖKTEM, Tavukçu Fatma ERGİN, Gülnur TOKUÇ

Bakteriyel menenjitli çocuklarda beyin omurilik sıvısında ferritin düzeyi

Amaç: Beyin omurilik sıvısında (BOS) ferritin düzeyinin bakteriyel menenjit tanısında ve tedaviye yanıtın değerlendirilmesinde bir kriter olarak olup olmayacağını belirlemek. Gereç ve Yöntem: Ocak 2001-Temmuz 2003 tarihleri arasında 16'sı kontrol ve 20'si bakteriyel menenjit olmak üzere 36 vaka prospektif olarak değerlendirildi. Kontrol vakalarından bir kez, bakteriyel menenjitli hastalardan ise, tedavi öncesi ve sonrası olmak üzere 2 kez BOS incelemesi yapıldı. Veriler SPSS 10.0 istatistik programı ile değerlendirildi. Bulgular: Bakteriyel menenjitli vakaların tedavi öncesi BOS ferritin düzeyleri ile kontrol vakaları arasında istatistiksel olarak anlamlı fark saptandı. Ayrıca menenjitli vakalarda tedavi öncesi ve tedavi sonrası BOS ferritin düzeyleri arasında da ileri derecede anlamlı fark saptandı. Bakteriyel menenjitli vakaların tedavi öncesi BOS protein düzeyi ve polimorf nüveli lökosit sayısı ile BOS ferritin düzeyi arasında pozitif, BOS şeker düzeyi ile ferritin arasında negatif korelasyon vardı. Sonuç: BOS ferritin düzeyinin bakteriyel menenjit tanısı ve tedavi yanıtının değerlendirilmesinde kullanılabilecek bir parametre olduğu düşünülmektedir.

Anahtar Kelimeler:

Menenjit, bakteriyel, Beyin omurilik sıvısı, Çocuk, Ferritin, Tanı teknik ve işlemleri

Cerebrospinal fluid ferritin levels in children with bacterial meningitis

Aim: To determine if cerebrospinal fluid (CSF) ferritin level can be a criteria for the diagnosis and response to the therapy of bacterial meningitis. Material and Methods: Between January 2001-July 2003 36 cases (20 bacterial meningitis, and 16 control group) were evaluated prospectively. Cerebrospinal fluid examination was performed for once in control group and twice in study group. The data was evaluated with SPSS 10.0 statistic programme. Results: The difference between CSF ferritin level of the control group and the cases with bacterial meningitis before treatment was found to be statistically significant. The difference between CSF ferritin levels of study group before and after therapy was also found to be statistically highly significant. A positive correlation was found between CSF protein, CSF leukocyte count and ferritin levels and negative correlation was found between CSF glucose and ferritin level before treatment. Conclusion: Cerebrospinal fluid ferritin level can be a diagnostic parameter in cases of bacterial meningitis and in the evaluation of the response to therapy.

Keywords:

Meningitis, Bacterial, Cerebrospinal Fluid, Child, Ferritin, Diagnostic Techniques and Procedures,

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