Kırım Kongo Kanamalı Ateşi Olan Hastalarda Hematolojik Değişikliklerin Araştırılması

Kırım Kongo kanamalı ateşi (KKKA) ateş, bulantı, kusma, miyalji, hematolojik değişiklikler ve çeşitli yerlerden kanama ile kendini gösteren viral hemorajik bir sendromdur. Bu çalışma, KKKA'lı hastalarda hematolojik değişiklikleri özetlemektedir. Bu çalışmada KKKA'lı hastaların demografik, klinik ve laboratuvar özellikleri geriye dönük olarak analiz edildi. Doğrulanmış KKKA'sı olan toplam 152 hasta araştırıldı. Hastaların 63'ü (%41,4)'ünde kanama görüldü. Hastalarda burun kanaması (%25,7), dişeti kanaması (%13,2), ekimoz (%11,8), melena (%10,5), hematemez (%7,9), hematüri (%7,2) ve vajinal kanama (%6,6) gibi hemorajik bulgular görüldü. 137 (%90,1) hastada trombositopeni gelişirken, KKKA hastalarında %31,6 trombosit sayısı 50000/mm3 ün altında idi. Hastaların %88,2'sinde lökopeni, %13,2'sinde anemi vardı. Hastaların %47,4 aPTT'sinde, %21,1'inde PT uzaması, %25,7’sinde INR artışı vardı. %17,8 hastada DİK gelişmişti. Kemik iliği aspirasyonu yapılan hastaların %35,9'unda hemofagositoz tespit edildi. On (%6,6) hasta öldü. Kanamalarla seyreden viral bir hastalık olan KKKA'li hastalarda trombositopeni, PT-aPTT uzaması, INR artışı, DİK gibi hematolojik bulgular görünür. Bu durumlara erken müdahale gerekli olup, KKKA'li hastaların destek tedavisinde kullanılmak üzere kan ve kan ürünlerinin temini için gerekli hazırlıkların yapılması hayati öneme sahiptir.

Anahtar Kelimeler:

Hematolojik değişiklikler, Kanama, KKKA, Trombositopeni

Investigation of Hematological Changes in Patients with Crimean-Congo Hemorrhagic Fever

Crimean-Congo hemorrhagic fever (CCHF) is a viral hemorrhagic syndrome manifested by fever, nausea, vomiting, myalgia, hematological changes, and bleeding from various sites. This study summarizes the hematological changes in patients with CCHF. In this study, demographic, clinical and laboratory characteristics of patients with CCHF were analyzed retrospectively. A total of 152 patients with confirmed CCHF were studied. Bleeding was observed in 63 (41.4%) of the patients. Hemorrhagic findings such as epistaxis (25.7%), gingival bleeding (13.2%), ecchymosis (11.8%), melena (10.5%), hematemesis (7.9%), hematuria (7.2%) and vaginal bleeding (6.6%) were observed in the patients. While thrombocytopenia developed in 137 (90.1%) patients, the platelet count was below 50000/mm3 in 31.6% of CCHF patients. 88.2% of the patients had leukopenia and 13.2% had anemia. 47.4% of the patients had aPTT, 21.1% had PT prolongation and 25.7% had an increase in INR. DIC developed in 17.8% of the patients. Hemophagocytosis was detected in 35.9% of patients who underwent bone marrow aspiration. Ten (6.6%) patients died. Hematological findings such as thrombocytopenia, PT-aPTT prolongation, increased INR, DIC appear in patients with CCHF, a viral disease that progresses with bleeding. Early intervention is required in these situations, and it is vital to make the necessary preparations for the supply of blood and blood products to be used in the supportive treatment of patients with CCHF.

Keywords:

Hematological changes, Bleeding, CCHF, Thrombocytopenia,

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