Esra TERZİ DEMİRSOY, Ceyda ASLAN, Ayfer GEDÜK

İzole Trombositopenili Hastaların Demografik ve Klinik Özellikleri

GİRİŞ ve AMAÇ: Trombosit sayısının 150.000/ mm³ altı trombositopeni olarak tanımlanmaktadır. İzole trombositopeni ise diğer serilerin (eritrosit ve lökosit) normal olup sadece trombosit değerinin düşüklüğü ile karakterizedir. Bu çalışmada izole trombositopeni nedeniyle hematoloji kliniğine başvuran hastaların etyolojik tanısı, klinik özellikleri ve kan parametrelerini değerlendirmeyi amaçladık. YÖNTEM ve GEREÇLER: Ekim 2016 - Ocak 2018 tarihleri arasında kliniğimizde trombositopeni nedeniyle takip edilen hastaların dosyaları geriye dönük olarak tarandı. İzole trombositopeni saptanan 301 hasta çalışmaya dahil edildi. Patofizyolojik etyolojiye göre izole trombositopeni sınıflandırıldı. Primer immun trombositopeni (ITP) ile izole trombositopeniye yol açan diğer hastalıkların tam kan sayımı değerleri karşılaştırıldı. BULGULAR: Hastaların 202'si kadın ve 99'u erkekti. 173 hastada artmış trombosit tüketimi, 45 hastada yalancı trombositopeni, 27 hastada trombosit sekestrasyonu( hipersplenizm), 3 hastada ise azalmış trombosit üretimine neden olan hastalıklar saptandı. 54 hastada trombosit değeri 100.000- 150.000 / mm³ arasında idi ve bu durumu açıklayacak herhangi bir patoloji yoktu. Primer ITP izole trombositopenili hastalarda en sık saptanan hastalıktı (%35,8) ve bu hastalarda trombosit sayısı diğer izole trombositopeniye yol açan hastalıklara göre anlamlı olarak daha düşüktü TARTIŞMA ve SONUÇ: Çalışmamızda izole trombositopeninin en sık nedeni primer ITP, ikinci en sık neden yalancı trombositopeniydi. Diğer nedenler olarak ilaç ve enfeksiyon ilişkili, gestasyonel trombositopeni, kollajen vasküler hastalıklar ve hipersplenizm bulundu. Trombositopeni bir laboratuar bulgusudur ve çeşitli hastalıklarla ilişkili olabilir. İzole trombositopeniyi tanımlayabilen spesifik bir test yoktur. İlk önce periferik yayma ile gerçek ve yalancı trombositopeni ayrımı yapılmalıdır. Sonra da kapsamlı anamnez, fizik muayene ve diğer laboratuar testleri ile tanıya ulaşılmalıdır.

Demographic and Clinical Features of Patients with Isolated Thrombocytopenia

INTRODUCTION: Thrombocytopenia is defined as platelet count below 150.000/mm³. Isolated thrombocytopenia is characterized by low platelet count without any other abnormality of erythrocyte and leucocyte.This study aims to evaluate the etiological diagnosis, clinical features and blood parameters of patients who admitted to the hematology clinic due to isolated thrombocytopenia. METHODS: The datas of patients who were diagnosed and followed up in our clinic between October 2016 and January 2018 for thrombocytopenia were screened retrospectively. 301 patients with isolated thrombocytopenia were included.İsolated thrombocytopenia was classified according to pathophysiological etiology. RESULTS: Of the patients, 202 were female and 99 were male. We observed that decreased platelet causes were due to platelet consumption in 173 patients, pseudo-thrombocytopenia (PTCP) in 45 patients, platelet sequestration in 27 patients, and decreased platelet production in 3 patients. The platelet count was between 100 and 150,000/mm³ in 54 patients and there was no pathology to explain this condition. Primary ITP was the most common disorder (35,8%) and the level of platelet was significantly lower in these patients than in other isolated thrombocytopenia. DISCUSSION AND CONCLUSION: In our study, the two most common causes of isolated thrombocytopenia were primary ITP and pseudothrombocytopenia.We showed that other causes were drug and infection-related, gestational thrombocytopenia, collagen vascular diseases and hypersplenism. Thrombocytopenia is a laboratory finding and may be related to various disorders.There are no specific tests that can identify thrombocytopenia. True and false thrombocytopenia should be differentiated by peripheral smear.Then, the cause of isolated thrombocytopenia should be determined by comprehensive history, physical examination and laboratory tests.

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