Tam Kan Sayımı Parametrelerinin Çocuklarda Graves Hastalığı’nın Medikal Tedavi ile Remisyonu için Prognostik Belirteç Olarak Değerlendirilmesi

Amaç: Graves hastalığı (GH), hipertiroidizme neden olan otoimmün bir hastalıktır. Lökosit, nötrofil, lenfosit, trombosit sayıları ve nötrofil-lenfosit oranı (NLO) ve sistemik immün-enflamasyon indeksinin (SII) GH remisyonu ile bir ilişkisi olup olmadığını bulmayı amaçladık. Gereç ve Yöntem: Çalışmaya GH olan otuz yedi çocuk dahil edildi. Hastaların antropometrik ölçümleri, fizik muayeneleri ve tıbbi öyküleri kaydedildi. Remisyonda olan (grup 1) ve remisyonda olmayan (grup 2) hastaların tanı anında ve medikal tedavi sonunda lökosit, nötrofil, lenfosit, trombosit sayıları, NLO ve SII değerleri karşılaştırıldı. Bulgular: Remisyondaki hasta oranı %54 idi. Çarpıntı varlığı grup 2’de grup 1’e göre daha yüksekti (p=0,026). Tanı anında lökosit ve nötrofil sayıları grup 1’de daha yüksekti (sırasıyla p=0,001 ve p=0,014). Çarpıntı olmaması remisyon oranını 6,0 (%95 CI: 1,1-33,1) kat artırırken, nötrofil sayısı arttıkça remisyon oranı 2,4 (%95 CI: 1,1-5,2) kat artmış olarak bulundu (p=0,041 ve p= sırasıyla 0.031). Grup 2’de medikal tedavi sonrası lökosit ve nötrofil sayılarında, NLO ve SII’de tanı anına göre artış saptandı (sırasıyla, p=0,049, p=0,008, p=0,002 ve p=0,001). Sonuç: Çocuklarda tanı anında çarpıntı olması ve nötrofil sayısının düşük olması, medikal tedavi sonrasında ise lökosit sayısı, nötrofil sayısı, NLO ve SII düzeylerinde artış olması GH’da medikal tedavi ile remisyona girmemeye ilişkin prognostik belirteçler olabilir

Anahtar Kelimeler:

Graves Hastaliği, Çocuklar, Remisyon, Prognostik Belirteçler, Nötrofil-Lenfosit Orani, Sistemik Immün-Enflamasyon Indeksi

Evaluation of the Complete Blood Count Parameters as Prognostic Markers for Remission of Graves’ Disease with Medical Therapy in Children

Objective: Graves’ Disease (GD) is an autoimmune disease that causes hyperthyroidism. This study intended to find out whether leukocyte, neutrophil, lymphocyte, platelet counts, and neutrophil-to-lymphocyte ratio (NLR) and systemic immun-inflammation index (SII) have an association with the remission of GD. Material and Methods: Thirty-seven children who have GD have been included in the study. Anthropometric measurements, physical examination and medical history of patients were recorded. Leukocyte, neutrophil, lymphocyte, platelet counts, NLR and SII at the time of diagnosis and at the end of medical therapy were compared between patients in remission (group 1) and patients not in remission (group 2). Results: The rate of patients in remission was 54%. The presence of palpitation was higher in group 2 than group 1 (p=0.026). At the time of diagnosis, the leukocyte and neutrophil counts were higher in group 1 (p=0.001 and p=0.014, respectively). While the absence of palpitation increased the rate of remission 6.0 (95% CI: 1.1-33.1) times, the rate of remission increased 2.4 (95% CI: 1.1-5.2) times as the neutrophil count increased (p=0.041 and p=0.031, respectively). In group 2, there was an increase in leukocyte and neutrophil counts, NLR and SII after medical therapy compared to the levels at the time of diagnosis (p=0.049, p=0.008, p=0.002 and p=0.001, respectively). Conclusion: Presence of palpitation and lower neutrophil count at the time of diagnosis and increase in leukocyte count, neutrophil count, NLR and SII levels after medical therapy could be prognostic markers for not achieving remission with medical therapy of GD in children.

Keywords:

Graves’ Disease, Children, Remission, Prognostic Markers, Neutrophil-To-Lymphocyte Ratio, Systemic Immun-Inflammation Index,

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