Derya GÜÇLÜ, Ebru KARAGÜN, Elif Nisa UNLU, Mehtap OKTAY, Özge PASİN

Psöriazis ve Metotreksat Tedavisinin Karaciğer Sertliğine Etkisinin ARFI Görüntüleme ile Değerlendirilmesi

Amaç: Psöriazisin ve tedavisinde kullanılan metotreksatın karaciğer fibrozisine neden olup olmadığını araştırmak ve böylelikle metotreksatın tedavideki güvenilirliğini değerlendirmektir. Gereç ve Yöntem: Çalışmaya 44 olgu dahil edildi. Psöriasis tanılı olup metotreksat kullanan (grup 1, n=4) ve metotreksat kullanmayan (grup 2, n=13) hastalar ile sağlıklı kontrol grubunun (grup 3, n=17) Akustik Radyasyon Kuvveti İmpulsu (ARFI) tekniği ile yapılmış sonoelastografik incelemelerinde shear wave hız ortalamaları retrospektif olarak karşılaştırılmıştır. Bulgular: Ortalama shear wave hızları metotreksat kullanan hastalarda 2,57 ± 1,13 m/sn, metotreksat kullanmayan hasta grubunda 2,31 ± 1,16 m/sn, sağlıklı kontrol grubunda ise 1,56 ± 0,62 m/sn olarak hesaplanmış olup 3. grubun shear wave hız ortalaması 1 ve 2. gruptan anlamlı derecede düşük bulunurken (p=0,032; p=0,012), 1 ve 2. gruplar arasında anlamlı farklılık gözlenmemiştir (p=0,755). Sonuç: ARFI kuantifikasyon ile yapılan shear wave görüntüleme bulguları psöriasis hastalarında metotreksat tedavisinin karaciğer fibrozu ile ilişkili olmadığını ve psöriazis nedeniyle metotreksat kullanan hastalarda ortaya çıkan karaciğer doku sertliği artışının, metotreksattan ziyade, psöriazisin neden olduğu inflamatuar sürece sekonder olduğunu düşündürmüştür.

Anahtar Kelimeler:

ARFI, Metotreksat, Psöriazis, Shear Wave Elastograf

Assessment of the Effect of Psoriasis and Methotrexate Treatment on Liver Stiffness by ARFI Imaging

Objective: To investigate whether psoriasis and methotrexate used in its treatment cause liver fibrosis and eventually to evaluate the safety of methotrexate in treatment. Method: 44 cases were included in the study. Methotrexate-using (group 1, n=14) and methotrexate-not-using (group 2, n=13) psoriasis patients were compared retrospectively with a healthy control group (group 3, n=17) according to mean shear wave rates obtained from sonoelastographic examinations with ARFI technique. Results: Mean shear wave velocities were calculated as 2.57 ± 1.13 m/sec in the patients using methotrexate, 2.31 ± 1.16 m/sec in the patients who did not use methotrexate, and 1.56 ± 0.62 m/sec in the healthy control group. While the average shear wave velocity of the 3rd group was found to be significantly lower than that of the 1st and 2nd groups (p=0.032; p=0.012), no significant difference was observed between the 1st and 2nd groups (p=0.755). Conclusion: We think that the increase in liver tissue stiffness in patients using methotrexate for psoriasis is secondary to the inflammatory process caused by psoriasis itself rather than methotrexate, and methotrexate is safe for the liver in treatment.

Keywords:

ARFI, Methotrexate, Psoriasis, Shear wave elastography,

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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