Yasemin OGUL, Veysel Atilla AYYILDIZ, Mustafa GÜZEL, Orhan AKPINAR, Hikmet ORHAN

Brusellozda Kas İskelet Tutulumunda Manyetik Rezonans Görüntüleme ve İnflamatuar Belirteçlerin Tanıya Katkısı

Amaç: Brusellozda kas iskelet sistemi tutulumu çok önemlidir. Bu çalışmada, manyetik rezonans görüntüleme (MRG) bulgularının ve hematolojik parametrelerin kas-iskelet sistemi brusellozu tanısında prediktif değer olarak değerlendirilmesi amaçlandı. Metod: Bu prospektif vaka-kontrol çalışması Haziran 2011 ile Kasım 2019 tarihleri arasında bir üniversite hastanesinde yapıldı. Kas-iskelet tutulumu olmayan bruselloz tanısı doğrulanmış 99 hasta ve kas-iskelet tutulumu olan kırk üç bruselloz hastası incelendi. Her iki grubun hematolojik, biyokimyasal parametreleri ve radyolojik görüntüleme bulguları kaydedildi. Bu parametreler istatistiksel olarak iki grup arasında karşılaştırıldı. Bulgular: Hastaların (tutulum olmayan grup) ve kas-iskelet tutulum gruplarının ortalama yaşı sırasıyla 44.04 ± 23.11 ve 37.92 ± 24.80 yıldı (P = 0.062). C-reaktif protein (CRP) ve alkalin fosfataz (ALP) düzeyleri kas-iskelet tutulumu grubunda anlamlı olarak daha yüksekti (P < 0.05). Lenfosit miktarının düşüklüğü bu grupta istatistiksel olarak anlamlıydı. Alıcı işletim özelliği (ROC) analizine göre, duyarlılık ve özgüllük ALP için sırasıyla %70 ve %65, CRP için %77 ve %58, lenfopeni için %83 ve %45 idi. Diğer hematolojik ve biyokimyasal parametreler açısından iki grup arasında istatistiksel olarak anlamlı fark yoktu. Spondilodiskit (%34.8) kas iskelet sistemi tutulumu olan hastalarda en sık MRG bulgusuydu. Sonuç: Çalışma sonuçlarımız, kas-iskelet sistemi brusellozunun ön tanısında CRP, ALP ve lenfopeninin değerli belirteçler olarak kullanılabileceğini göstermektedir.

Anahtar Kelimeler:

Bruselloz, Manyetik Rezonans Görüntüleme, Spondilodiskit, Bulaşıcı Hastalıklar

Contribution to Diagnosis of Magnetic Resonance Imaging and Inflammatory Markers in Musculoskeletal Involvement of Brucellosis

Objective: Musculoskeletal involvement in brucellosis is very important. This study aimed to evaluate the magnetic resonance imaging (MRI) findings and hematological parameters as a predictive value for the diagnosis of musculoskeletal brucellosis. Methods: This prospective case-control study was conducted between June 2011 and November 2019 in a university hospital. Ninety-nine patients with the confirmed diagnosis of brucellosis without musculoskeletal involvement and forty-three brucellosis patients with musculoskeletal involvement were examined. The hematological, biochemical parameters, and radiological imaging findings of both groups were recorded. These parameters were statistically compared between the two groups. Results: The mean age of the patients (non-involvement group) and musculoskeletal involvement groups was 44.04 ± 23.11 and 37.92 ± 24.80 years, respectively (P = 0.062). C-reactive protein (CRP) and alkaline phosphatase (ALP) levels were significantly higher in the musculoskeletal involvement group (P < 0.05). The lower lymphocyte level was statistically significant in this group. Based on the receiver operating characteristic (ROC) analysis, the sensitivity and specificity were 70% and 65% for ALP, 77% and 58% for CRP, 83% and 45% for lymphopenia, respectively. There was no statistically significant difference between the two groups in terms of the other hematological and biochemical parameters. Spondylodiscitis (34.8%) was the most common MRI finding in patients with musculoskeletal involvement. Conclusions: Our study results show that CRP, ALP, and lymphopenia can be used as valuable markers in the preliminary diagnosis of musculoskeletal brucellosis.

Keywords:

Brucellosis Musculoskeletal Involvement, MRI, Spondylodiscitis, Infectious Diseases,

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ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez