Kırmızı Hücre Dağılım Genişliğinin, İnflamatuar Barsak Hastalığı Aktivitesinin Değerlendirmesinde Rolü

Amaç: İnflamatuar barsak hastalığının (IBH) aktivite ve remisyon dönemlerinin değerlendirilmesinde, kırmızı hücre dağılım genişliğinin (RDW) faydalı olup olmadığını belirlemeyi amaçladık. Yöntemler: Bu retrospektif çalışmaya 98 ülseratif kolit (ÜK) ve 34 Crohn hastasından oluşan 132 İBH hastası dahil edildi. Hastaların serum C-reaktif protein (CRP) seviyesi, eritrosit sedimentasyon hızı (ESR), lökosit ve trombosit sayıları ve hemoglobin (Hb) konsantrasyonları, hastalık aktivite ve remisyon dönemlerinde ayrı ayrı değerlendirildi. ÜK ve Crohn hastalığı için hastalık aktivitesi sırasıyla Mayo skoru ve Crohn Hastalığı Aktivite İndeksi (CDAİ) ile belirlendi. Bulgular: Çalışmaya dahil edilen hastalarda medyan yaş (çeyrekler arası aralık) 37,5 (29-50), hastalık süresi 29,4±44,3 ay olarak saptanmıştır. Hastaların RDW, ESR, CRP değerleri, lökosit ve trombosit sayıları remisyon dönemleri ile karşılaştırıldığında, aktif dönemlerinde anlamlı olarak yüksekken (p

Role of Red Cell Distribution Width in Evaluation of Inflammatory Bowel Disease Activity

Objective: We aimed to determine whether red cell distribution width (RDW) is useful in evaluating the activity and remission periods of inflammatory bowel disease (IBD). Methods: One hundred thirty-two IBD patients, consisting of 98 ulcerative colitis (UC) patients and 34 Crohn’s patients, were included in this retrospective study. Serum C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), leukocyte and platelet counts and hemoglobin (Hb) concentrations were evaluated separately during disease activity and remission periods. Disease activity for UC and Crohn’s disease was determined by Mayo score and Crohn’s Disease Activity Index (CDAI), respectively. Results: The median age (interquartile range) was 37.5 (29-50) and the duration of the disease was 29.4±44.3 months in the patients included in the study. RDW, ESR, CRP values, leukocyte and thrombocyte counts were significantly active periods compared to remission periods (p

Kaynakça

1. Guan Q. A Comprehensive Review and update on the pathogenesis of inflammatory bowel disease. J Immunol Res 2019; 7247238.

2. Kulnigg S, Gasche C. Systematic review: managing anaemia in Crohn’s disease. Aliment Pharmacol Ther 2006; 24: 1507-23.

3. Vermeire S, Van Assche G, Rutgeerts P. Laboratory markers in IBD: useful, magic, or unnecessary toys? Gut 2006; 55: 426-31.

4. Cabrera-Abreu J, Davies P, Matek Z, Murphy MS. Performance of blood tests in diagnosis of inflammatory bowel disease in a specialist clinic. Arch Dis Child 2004; 89: 69-71.

5. Cakal B, Akoz AG, Ustundag Y, Yalinkilic M, Ulker A, Ankarali H. Red cell distribution width for assessment of activity of inflammatory bowel disease. Dig Dis Sci 2009; 54: 842-7.

6. Song CS, Park Il D, Yoon MY, Seok HS, Park JH, Kim HJ, et al. Association between red cell distribution width and disease activity in patients with inflammatory bowel disease. Digest Dis Sci 2011; 57: 1033-8.

7. Arhan M, Önal KI, Taş A, Kurt M, Kalkan İH, Özin Y, et al. The role of red cell distribution width as a marker in inflammatory bowel disease. Turk J Med Sci 2011; 41: 227-34.

8. Evans TC, Jehle D. The red blood cell distribution width. J Emerg Med. 1991; 9(Suppl 1): 71-4.

9. Sategna GC, Scaglione N, Martini S. Red cell distribution width as a marker of coeliac disease: a prospective study. Eur J Gastroenterol Hepatol 2002; 14: 177-81.

10. Spell DW, Jones DV Jr, Harper WF, Bessman JD. The value of a complete blood count in predicting cancer of the colon. Cancer Detect Prev 2004; 28: 37-42.

11. Goyal H, Lippi G, Gjymishka A, John B, Chhabra R, May E. Prognostic significance of red blood cell distribution width in gastrointestinal disorders. World J Gastroenterol 2017; 23: 4879-91.

12. Lippi G, Mattiuzzi C, Cervellin G. Learning more and spending less with neglected laboratory parameters: the paradigmatic case of red blood cell distribution width. Acta Biomed 2017; 87: 323-8.

13. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJV, Pfeffer MA, et al. Red cell distribution width as a novel prognostic marker in heart failure data from the CHARM program and the Duke databank. J Am Coll Cardiol 2007; 50: 41-7.

14. Patel KV, Ferrucci L, Ershler WB, Longo DL, Guralnik JM. Red cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med 2009; 169: 515-23.

15. Agarwal S. Red cell distribution width, inflammatory markers and cardiorespiratory fitness: Results from the National Health and Nutrition Examination Survey. Indian Heart J 2012; 64: 380-7.

16. Oliveira AM, Cardoso FS, Rodrigues CG, Santos L, Martins A, de Deus JR, et al. Can red cell distribution width be used as a marker of crohn’s disease activity? GE Port J Gastroenterol 2016; 23: 6-12.

17. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GS, et al. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med 2009; 133: 628-32.

18. Ayan NN, Savaş Z, Bireroğlu N, Keleş A, Aksoy N, Serin NÖ. Demir Eksikliği Anemisi Olan Kadınlarda Tedavi Öncesi ve Sonrası Trombosit Değerlerinin Karşılaştırılması. Jarem 2015; 5: 94-6.

19. Mahida YR, Wu K, Jewell DP. Enhanced production of interleukin 1-b by mononuclear cells isolated from mucosa with active ulcerative colitis of Crohn’s disease. Gut 1989; 30: 835-8.

20. MacDonald TT, Hutchings P, Choy MY, Murch S, Cooke A. Tumour necrosis factor-alpha and interferon-gamma production measured at the single cell level in normal and inflamed human intestine. Clin Exp Immunol 1990; 81: 301-5.

21. Strong SA, Pizarro TT, Klein JS, Cominelli F, Fiocchi C. Proinflammatory cytokines differentially modulate their own expression in human intestinal mucosal mesenchymal cells. Gastroenterology 1998; 114: 1244-56.

22. Schreiber S, Howaldt S, Schnoor M, Nikolaus S, Bauditz J, Gasché C, et al. Recombinant erythropoietin for the treatment of anemia in inflammatory bowel disease. N Engl J Med 1996; 334: 619-24.

23. Weiss G, Gasche C. Pathogenesis and treatment of anemia in inflammatory bowel disease. Haematologica 2010; 95: 175-8.

24. Antunes CV, Hallack Neto AE, Nascimento CR, Chebli LA, Moutinho ILD, do Valle Pinheiro B, et al. Anemia in inflammatory bowel disease outpatients: prevalence, risk factors, and etiology. Biomed Res Int 2015; 2015: 728925.

25. Clarke K, Sagunarthy R, Kansal S. RDW as an additional marker in inflammatory bowel disease/undifferentiated colitis. Dig Dis Sci 2008; 53: 2521-3.

26. Ipek S, Cekic C, Alper E, Coban E, Eliacik E, Arabul M, et al. Can red cell distribution width be a marker of disease activity in ulcerative colitis? Int J Clin Exp Med 2015; 8: 13848-53.

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