Çocukluk çağında sık görülen komplikasyonsuz viral infeksiyonlarda akut faz reaktanlarının yeri

Amaç: Bu çalışmada viral infeksiyonların seyrinde akut faz reaktanlarının düzeylerinde anlamlı yükselme olup olmadığı saptanarak komplikasyonsuz viral infeksiyonlarda akut faz reaktanlarının tanısal değerlerini belirlemek amaçlanmıştır. Yöntem: Hastanemiz çocuk polikliniğinde 2000-2001 yılları arasında kabakulak, suçiçeği, kızamık tanısı alan 23 kız, 19 erkek toplam 42 hasta çalışmaya alındı. Hastalık tanısı klinik bulgulara dayanılarak konuldu, virus izolasyonu yapılmadı. Veriler, anlamlı yükselme olup olmaması ve korelasyon açısından değerlendirildi. Bulgular: Çalışma grubundaki 42 hastanın 22'si (% 52.4) kabakulak, 16'sı (% 38.1) suçiçeği, 4'ü (% 9.5) kızamık tanısı aldı. Hastalık grupları arasında yaş açısından farklılık yoktu. Çalışma grubunun tümünde ölçülen reaktanlardan yalnızca eritrosit sedimentasyon hızı (ESH) ve C3'te anlamlı yükselme saptandı. Akut faz reaktanlarının kendi aralarında anlamlı korelasyon kurulamadı. Sonuç: Komplikasyonsuz viral infeksiyonlarda ESH ve C3 daha belirgin olmak üzere CRP ve a2 globulin düzeylerinde de hafif artış görülebileceği saptanmıştır. Viral ve bakteriyel infeksiyon ayırımında akut faz reaktanlarının ölçümü tek başına tanısal değer taşımayıp tanı mutlaka klinik ile de desteklenmelidir.

Anahtar Kelimeler:

Virüs hastalıkları, Akut faz proteinleri, Varyans analizi, C-reaktif protein, Çocuk

Diagnostic accuracy of acute phase reactants in uncomplicated viral infections in children

Aim: To determine whether there are significant elevations in the levels of acute phase reactants during the course of viral the infections and thereby to verify the diagnostic accuracy of these proteins in uncomplicated viral infections. Methods: 42 patients (23 female, 19 male) who were diagnosed as mumps, varicella and measles in our outpatient clinic between 2000-2001 were included in the study. The diagnosis is made only on the basis of clinical findings, virus isolation was not of the masle. The results were evaluated in terms of significance elevations and correlations. Results: The number of patients with the diagnosis of mumps, varicella and, measles were 22 (52.4 %), 16 (38.1 %) and 4 (9.5 %), respectively. With respect to age there was no difference between the groups. Only erythrocyte sedimentation rate (ESR) and C3 were found to be significantly elevated when compared with the cut-off values in the study group. No correlation was found between the reactants. Conclusion: In uncomplicated viral infections, significant elevations of ESR and C3 and a slight elevation of CRP and a2 globulin might be seen. Measurement of acute phase reactants only, has no diagnostic accuracy in discriminating between bacterial and viral infections necessitating clinical confirmation.

Keywords:

Virus Diseases, Acute-Phase Proteins, Analysis of Variance, C-Reactive Protein, Child,

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