Fisun KARADAĞ, Onur YAZICI, Şule TAŞ GÜLEN, Emel CEYLAN, Mehmet POLATLI, Hatice Arzu Uçar

Sarkoidozda Pulmoner Parankimal ve Ekstrapulmoner Tulumu Belirlemede Serum Anjiyotensin Konverting Enzimin Rolü

ÖZGİRİŞ ve AMAÇ: Sarkoidoz günümüzde halen etiyolojisi bilinmeyen bir hastalıktır. Klinik tablo ve seyir hastalığın başlangıç yaşına, süresine, evresine ve yaygınlığına bağlı olarak değişmektedir. Klinik tabloyu ve seyri öngörebilecek biyomarkerların kullanılması hastalığın yönetiminde kolaylık sağlayacaktır. Çalışmamızda hematolojik ve biyokimyasal parametrelerle hastalığın evre ve yaygınlığı arasındaki ilişkiyi belirlemeyi amaçladık.YÖNTEM ve GEREÇLER: 2013-2018 yılları arasında kliniğimizde sarkoidoz tanısı konulan hastaların dosyaları retrospektif olarak incelendi. Hastaların demografik verileri, tanı sırasındaki klinik bulguları, evreleri, ekstrapulmoner tutulum olup olmadığı ve hemogram, eritrosit sedimentasyon hızı (ESR), C reaktif protein (CRP), serum kalsiyum (Ca) ve anjiotensin konverting enzim (ACE) düzeylerini içeren laboratuvar parametreleri kaydedildi. Hastalar akciğer parankim tutulumu ve ekstrapulmoner tutulumu olup olmamasına göre sınıflandırıldı. Akciğer parankim tutulumu olmayan evre 1 hastalar grup 1 ve akciğer parankim tutulumu olan evre 2 ve 3 hastalar grup 2 olarak sınıflandırıldı.BULGULAR: Belirlenen tarihler arasında 121 sarkoidoz hastasının verilerine ulaşıldı. Hastaların 30 (%24.8)’u erkek, 91 (%75.2)’i kadın ve yaş ortalaması 50.71±11.76 idi. Grup 1’de 59 (%48,8) ve grup 2’de 62 (%51,2) olgu vardı. Hastaların 71 (%58,9)’de sadece akciğer tutulumu varken 50 (%41.3)’sinde akciğer ve akciğer dışı organ tutulumu birlikte vardı. Akciğer dışı organ tutulumu en sık eritema nodozum (EN)’du (%15,7). Grup 2 olgularda serum ACE değeri grup 1’den daha yüksekti (p =0,027). Akciğer ve akciğer dışı tutulumu olan olgularda serum ACE düzeyi akciğer dışı tutulum olmayanlara göre daha yüksekti (p =0,045). Bakılan diğer laboratuvar parametreleri gruplar arasında farklı değildi

The Role of Serum Angiotensin Converting Enzyme for Predicting Pulmonary Parenchymal and Extrapulmonary Involvement of Sarcoidosis

ABSTRACTINTRODUCTION: The clinical characteristics and course of sarcoidosis vary according to the age of onset, duration, stage, and extent of the disease. Biomarkers that can predict clinical characteristics and course will provide convenience in disease management. We aimed to determine relationships of hematologic and biochemical parameters with the stage and extent of the disease.METHODS: The charts of sarcoidosis patients between 2013 and 2018 were retrospectively investigated. Demographic data, clinical findings at the time of diagnosis, stage, and extrapulmonary involvement were recorded together withcomplete blood count, erythrocyte sedimentation rate, serum C-reactive protein, calcium, and angiotensin converting enzyme (ACE) levels. Patients were classified according to the presence of pulmonary parenchymal and extrapulmonaryinvolvement. Stage-1 patients with no pulmonary parenchymal involvement were in Group 1, and stage-2 and stage-3 patients with pulmonary parenchymal involvement in Group 2.RESULTS: Of 121 sarcoidosis patients, 30 (24.8%) were male, 91 (75.2%) female. The average age was 50.71±11.76 years. 59 (48.8%) patients were in Group 1, and 62 (51.2%) in Group 2. Pulmonary involvement was present only in 71 (58.7%) patients. Extrapulmonary and pulmonary involvement was present in 50 (41.3%) patients. Most common extrapulmonary involvement was erythema nodosum (15.7%). Serum ACE level was higher in Group 2 than Group 1 (p=0.027) and in cases with pulmonary and extrapulmonary involvement both than those with pulmonary involvement only (p=0.045). No significant deviations were found between the groups regarding other laboratory parameters.

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