Çocuk romatolojisi pratiğinde laboratuvar testlerinin kullanımı

Çocuklarda romatizmal hastalıklar ciddi komplikasyonlara ve büyüme-gelişme geriliğine yol açabilen önemli bir hastalıkgrubudur. Anti-nükleer antikorlar ve anti-ds DNA’nın sistemiklupus eritematozus için ve c-ANCA’nın Wegener hastalığıiçin tanısal kriter olması dışında, romatizmal hastalıklar içintanı koyduracak spesifik testler bulunmamaktadır. Çocuk romatolojisinde ayrıntılı bir hastalık öyküsü ve iyi bir fizik muayene ile çok yüksek oranda hastalık tanısı konabildiği vehastalıklar için tanı koydurucu veya ekarte ettirici özgül tekbir test veya “test paneli” bulunmadığı için, laboratuvar testlerini iyi bir klinik bilgi temelinde seçici olarak istemek gerekir. Bu konuda önemli bir nokta da testlerin sağlıklı bireylerde de belli oranlarda pozitif sonuç vermesidir. Bu derlemede çocuk romatolojisi pratiğinde kullanılan testlerin endikasyonları, hastalık tanısı ve izlemindeki önemleri tartışılmıştır.

The application of laboratory investigations in pediatric rheumatology practice

Rheumatologic diseases in children are an important group of disorders that may lead to severe complications and growth retardation. There are no specific diagnostic tests for rheumatologic diseases, except for anti-nuclear antibody and an- ti-dsDNA for systemic lupus erythematosus and c-ANCA for Wegener’s disease. Because of, taking a detailed patient’s medical history and performing a good physical examination most probably can provide a diagnosis, and there is nospecific test or “test panel” to diagnose or exclude rheumatologic disorders; it is imperative to choose laboratory tests selectively, based on a good clinical knowledge. Another important point is the existence of false positive test results innormal healthy population. In this review, the use laboratory investigations and their importance in diagnosis and follow up of disease in pediatric rheumatology practice has been discussed.

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