Sistemik skleroz ile ilişkili interstisyel akciğer hastalığında siklofosfamid tedavisi öncesi ve sonrası ortalama trombosit hacminin değerlendirilmesi

Amaç: Sistemik sklerozlu (SSc) hastalarda yapılan çalışmalar ortalama trombosit hacminin (MPV) SSc ileri evresi ile ilişkili olduğunu göstermiştir. Bununla birlikte, sistemik skleroza sekonder interstisyel akciğer hastalığında (SSc-İAH), siklofosfamid (CP) tedavisinin MPV değeri üzerindeki etkisi bilinmemektedir. Bu çalışmada SSc-İAH'de, CP tedavisine MPV yanıtını araştırmayı amaçladık. Yöntemler: Bu retrospektif kesitsel çalışmaya CP tedavisinden fayda görmüş 38 SSc-İAH hastası dahil edildi. Tedavi öncesi MPV değerleri ile tedavi sırasında üçüncü, altıncı ve dokuzuncu ayların MPV değerleri karşılaştırıldı. Bulgular: Dokuz yıllık bir süre içinde hastanemiz romatoloji kliniğinde 82 hastaya SSc tanısı kondu. Hastaların 43’ünde SSc-İAH vardı ve bunların hepsinde 9 ay süre ile CP tedavisi uygulandı. CP'den klinik yarar gören 38 hastanın, 32’si (%84) kadın ve 6’sı (%16) erkek idi. SSc-İAH hastalarında CP tedavisi sonrası MPV düzeyleri (9,44 fL), CP tedavisi öncesine (7,89 fL) göre belirgin yüksek tespit edildi (P=0,001). Sonuç: Siklofosfamid tedavisi, SSc-İAH'de MPV'de bir artışa neden olmaktadır. Negatif akut faz reaktanı olarak MPV'nin koroner ve periferik arter hastalığı için bağımsız bir risk faktörü olarak kabul edildiği bilinmektedir. Siklofosfamid alan hastalar bu tür hastalıklar için özellikle takip edilmelidir.

Anahtar Kelimeler:

Siklofosfamid, Ortalama trombosit volümü, Sistemik skleroz

Evaluation of mean platelet volume before and after cyclophosphamide treatment in systemic sclerosis associated interstitial lung disease

Aim: Studies carried out in patients with systemic sclerosis (SSc) have shown that mean platelet volume (MPV) is associated with more advanced stage of SSc. However, the effect of cyclophosphamide (CP) on MPV in systemic sclerosis-associated interstitial lung disease (SSc-ILD) is less clear. In this study, we aimed to investigate the MPV response to CP treatment in SSc-ILD. Methods: Thirty-eight SSc-ILD patients who responded positively to CP were included in this retrospective cohort study. MPV values before the treatment were compared with third, sixth, and ninth months’ values during treatment. Results: Over the nine-year period, 82 patients were diagnosed with SSc in the rheumatology clinic of our hospital. Forty-three of them had SSc-ILD and all were administered CP treatment for 9 months. Thirty-eight clinically benefited from CP, among which 32 were females (84%) and 6 (16%) were males. The MPV levels in SSc-ILD patients after CP (9.44 fL) were significantly higher than those before CP (7.89 fL) (P=0.001). Conclusion: Cyclophosphamide treatment causes an increase in MPV in SSc-ILD. MPV, a negative acute phase reactant, is considered an independent risk factor for coronary and peripheral artery diseases. Patients receiving CP should be followed more closely for such diseases.

Keywords:

Cyclophosphamide, Mean platelet volume, Systemic Sclerosis,

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