Ig-A vasküliti (Henoch-Schönlein purpurası) Tanısı Alan Çocuklarda Trombosit İndekslerinin Klinik Önemi

Amaç: Ig-A vasküliti, çoğunlukla kendi kendini sınırlayan, cilt, eklem, gastrointestinal sistem ve böbrek tutulumu ile karakterize, çocukluk çağı sistemik vaskülitinin en yaygın şeklidir. Biz bu çalışmada, Ig-A vaskülitli hastaların demografik özelliklerini, klinik ve laboratuvar bulgularını ve bunların trombosit indeksleri ile ilişkisini araştırmayı amaçladık.Gereç ve Yöntem: Çocuk Acil kliniğine başvuran, Ig-A vasküliti tanısı almış hastaların kayıtları retrospektif olarak incelendi. Hastaların yaş, cinsiyet, başvuru şikayeti, klinik ve laboratuvar bulguları kayıt edildi. Sağlam çocuk polikliniğine başvuran yaş ve cinsiyet eşleştirmesi yapılmış 48 sağlıklı çocuk kontrol grubu olarak kabul edildi.Bulgular: Ig-A vasküliti tanısı alan 48 hastanın 33’ü (%68,8) cilt döküntüsü, 11’i (%22,9) eklem ağrısı ya da şişliği ve dördü (%8,3) karın ağrısı şikayeti ile başvurdu. Takiplerinde hastaların tamamında klasik Ig-A vasküliti döküntüsü ortaya çıktı. 38’inde (%79,2) eklem, 16’sında (%33,3) gastrointestinal sistem ve altısında (%12,5) böbrek tutulumu vardı. Böbrek tutulumu olan altı hastanın tamamının istatistiksel anlamlı olarak (p: 0,024) erkek olduğu tespit edildi. Laboratuvar bulguları karşılaştırıldığında kontrol grubuna göre trombosit sayısının hasta grubunda istatistiksel anlamlı olarak (p: 0,001) yüksek olduğu, ortalama trombosit hacminin ise hasta grubunda istatistiksel anlamlı olarak (p: 0,001) düşük olduğu tespit edildi. Yine C-reaktif protein ve eritrosit sedimentasyon hızının hasta grubunda kontrol grubuna oranla istatistiksel anlamlı olarak (p: 0,001) yüksek olduğu tespit edildi. Sonuç: Çalışmazda ortalama trombosit hacmi Ig-A vaskülitli hastalarda sağlam kontrollere oranla düşük tespit edildi. Ig-A vasküliti tanısı alan çocuklarda trombosit indekslerinin klinik öneminin anlaşılması için daha geniş ve çok merkezli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Ig-A vasküliti, çocuk, trombosit indeksleri

Clinical Importance of Platelet Indices in Children with Ig-A Vasculitis (Henoch-Schönlein Purpura)

Aim: Ig-A vasculitis (IgAV) is the most common form of systemic vasculitis in children, characterized by self-limiting skin, joint, gastrointestinal, and kidney involvement. In this study, we aimed to investigate clinical, demographic and laboratory characteristics of patients with IgAV, and evaluate their association with platelet indices.Materials and Methods: The records of patients who admitted to the pediatric emergency clinic and diagnosed as IgAV were reviewed retrospectively. Patients' age, gender, complaints, clinical and laboratory findings were recorded. 48 age- and sex-matched healthy children who had admitted to a healthy child polyclinic were included as the control group.Results: 48 patients were diagnosed as IgAV. 33 (68.8%) of the patients admitted with skin rash, 11 (22.9%) with joint pain or swelling, and four (8.3%) with abdominal pain. All of the patients developed classic IgAV rash during follow-up. Joint, gastrointestinal system and renal involvement was observed in 38 (79.2%), 16 (33.3%) and 6 (12.5%) of the patients, rspectively. All of the six patients with renal involvement were male, which was statistically significant (p: 0.024). When hemogram results were compared PLT levels were found to be significantly (p: 0.001) higher and MPV levels significantly lower (p: 0.001) in the patient group than the controls. The mean CRP and ESR levels were found to be significantly (p: 0.001) higher in the patient group. Conclusion: MPV levels were significantly lower in patients with IgAV. There is a need for wider and multicentered prospective studies to explain the clinical importance of platelet indices in patients with IgAV.

Keywords:

Ig-A vasculitis, child, platelet indices,

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