NİLÜFER GÖKNAR, Mehmet KÜÇÜKKOÇ, Ayşegül Doğan DEMİR, AYSEL VEHAPOĞLU TÜRKMEN, Faruk ÖKTEM

Çocukluk Çağı Nefrotik Sendromunda Ortalama Trombosit Hacminin Önemi

Amaç: Ortalama trombosit hacmi (MPV) ve trombosit sayısı pek çok kronik enflamatuar hastalıkta yüksek saptanmış ve prognoz ile ilişkili bulunmuştur. Bu çalışmada çocukluk çağı nefrotik sendromunda MPV' nin önemini ve steroide yanıt ile ilişkisini irdelemeyi amaçladık. Yöntemler: Çalışmaya nefrotik sendrom tanı kriterlerini dolduran 24'ü steroide dirençli 35'i steroide duyarlı olmak üzere toplam 59 çocuk alındı. Kontrol grubuna ise 34 sağlıklı çocuk alındı. Çalışma grubunun proteinüri, C-reaktif protein (CRP), serum kolesterol ve albumin seviyesi kaydedildi. Hem kontrol hem çalışma grubunun trombosit sayısı ve ortalama trombosit hacmi kaydedildi. Bulgular: MPV düzeyi nefrotik sendromlu olgularda (8,6 ± 1,39 fl), kontrole göre (7,09 ± 0,96 fl) daha yüksek saptandı (p

The Importance of Mean Platelet Volume in Children with Nephrotic Syndrome

Objective: The importance of mean platelet volume (MPV) in chronic inflammation was demonstrated in many diseases. We aimed to evaluate the role of MPV in nephrotic syndrome of childhood and relation with steroid response. Methods: We enrolled 59 children with nephrotic syndrome (24 steroid-resistance and 35 steroid-sensitive) and 34 healthy controls into the study. We evaluated total cholesterol, proteinuria, CRP, and albumin from study group and MPV and platelet count from both control and study group. Results: MPV level was higher in children with nephrotic syndrome when compared with control (8.6 ± 1.39 fl versus 7.09 ± 0.96 fl, p<0.001). Also platelet count was elevated in study group (406.092 ± 125.891 / µl versus 321.382 ± 78.666 / µl, p<0.001). MPV level and platelet count was similar in control and study subjects (p=0.798 and p=0.56).Conclusion: We demonstrated elevated MPV and platelet count in children with nephrotic syndrome. MPV is cheap, simple and important method to demonstrate platelet activation in nephrotic syndrome.

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1. Gbadegesin R, Smoyer WE. Nephrotic syndrome. In Geary DF, Schaefer F. Comprehensive Pediatric Nephrology. Philedelphia; 2008. p.205-216.
2. Büscher AK, Kranz B, Büscher R, et al. Immunosuppresion and renal outcome in congenital and pediatric steroid-resistant nephrotic syndrome. Clin Am Soc Nephrol 2010;5:2075-2084.
3. Bath PM, Butterworth RJ. Platelet size: Measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996;7:157-161.
4. Mertin JF, Trowbridge EA, Salmon G, Plumb J. The biological significance of platelet volume: Its relationship to bleeding time, platelet thromboxane B2 production and megakaryocyte nuclear DNA concentration. Thromb Res 1983;32:443-460.
5. Özkan EA, Khosroshahi HE, Serin Hİ, et al. The evaluation of carotid intima-media thickness and mean platelet volume values and correlation with cardiac functions in obese children. Int J Clin Exp Med. 2015; Dec 15;8:22557-22563
6. Zdrojewski Z, Raszeja-Specht A, Kustosz J, et al. Evaluation of factors influencing platelet aggregation in patients with chronic glomerulonephritis. Przegl Lek. 1996;53:434-438.
7. Tajarernmuang P, Phrommintikul A, Limsukon A, et al. The role of mean platelet volume as a predictor of mortality in critically ill patients: a systematic review and meta-analysis. Crit Care Res Pract 2016;2016:4370834.
8. Sclegel N. Thromboembolic risks and complications in nephrotic syndrome. Semin Thromb Hemost. 1997;23:271- 280.
9. Wasilewska AM, Zoch-Zwierz W, Tomaszewska B, Biernacka A. Platelet derived growth factor and platelet profiled in childhood nephrotic sydrome. Pediatric Nephrol 2005;20:36-41.
10. Kocyigit I, Yılmaz MI, Şimşek Y, et al. The role of platelet activation in determining response to therapy in patients with primary nephrotic syndrome. Platelets 2012; 24:474- 479.
11. Taraboletti G, Morigi M, Figliuzzi M, et al. Thrombospondin induced glomerular mesangial cell adhesion and migration. Lab Invest 1992; 67:566-571.
12. Barnes JL, Camussi G, Tetta C. Glomerular localization of platelet cationic proteins after immune complex-induced plateler activation. Lab Invest 1990;63:755-761.
13. Zdrojewski Z, Lizakowski S, Raszeja-Specht A. Skibowska A, Rutkowski B. Influence of spontaneous platelet aggregation on progression of glomerular disease. Nephron 2002;92:36-42.
14. Andrews RK, Berndt MC. Platelet physiology and thrombosis. Thromb Res 2004;114:447-453.
15. Kartal O, Kartal AT. MPV: a reliable method to determine the prognosis. Ren Fail 2015;27:184.
16. Gulleroglu K, Yazar B, Sakalli H, et al. Clinical importance of mean platelet volume in children with nephrotic syndrome. Ren Fail 2014;36:663-665.