BURÇİN NALBANTOĞLU, Nuriye Ece MİNTAŞ, AYŞİN NALBANTOĞLU, MUSTAFA METİN DONMA, Nedim SAMANCI

MEAN PLATELET VOLUMES OF INFANTS WITH ACUTE BRONCHIOLITIS, IS THERE A CORRELATION BETWEEN THEM?

Aim: Acute bronchiolitis is the most common lower respiratory tract infection of children younger than 2 years of age. There aren't any standardized diagnostic criteria and severity assessment classifications for acute bronchiolitis available in literature. Mean platelet volume (MPV) has shown to be effected in inflammatory conditions and to our knowledge there's only one recent study in children with acute bronchiolitis that demonstrated an association between MPV change and acute brınchiolitis. Materials and Methods: In this retrospective study we enrolled 555 children diagnosed with Acute bronchiolitis and 516 healthy infants with a matching age and sex. Results: MPV levels were found significantly higher in patient group (8,2 ± 0,8 fL) than the control group (7,9 ± 0,8 fL). In terms of hospitalization need, no significant difference was detected between the MPV values of the hospitalized group and the outpatients (8,3±0,8 fL; 8,2±0.7 fL, respectively). Conclusions: In conclusion, our data show that MPV values are significantly elevated in acute bronchiolitis compared to healthy infants. However, MPV can't be used as a guidance in attack severity nor can it predict hospitalization and systemic steroid need.

Akut Bronşiolit Tanılı İnfantlarda Ortalama Platelet Hacmi, İkisi Arasında Bir Korelasyon Var Mı?

Amaç: Akut bronşiolit, 2 yaşından küçük çocuklarda en sık görülen alt solunum yolu enfeksiyonudur. Literatürde akut bronşiolit için standart tanı kriterleri ve şiddet değerlendirme sınıflamaları mevcut değildir. Ortalama platelet hacminin (MPV) lokal inflamasyondan etkilendiği gösterilmiştir ve akut bronşiolit ile MPV ilişkisini gösteren tek bir çalışma bulunmaktadır. Materyal ve Metot: Bu çalışmada MPV ile akut bronşiyolit arasındaki ilişkiyi belirlemeyi amaçladık, ayrıca hastalığın şiddetini değerlendirmede yararlı bir belirteç olup olmadığını araştırdık. Bu retrospektif çalışmada akut bronşiolitis tanısı alan 555 çocuğa ve eşleştirilmiş yaş ve cinsiyete sahip 516 sağlıklı bebek çalışma grubuna dahil edilmiştir. Bulgular: MPV düzeyleri hasta grubunda (8,2 ± 0,8 fL) kontrol grubuna (7,9 ± 0,8 fL) göre anlamlı olarak yüksek bulundu. Hastaneye yatış açısından hastaneye yatırılan grup ve poliklinik hastalarının MPV değerleri arasında anlamlı bir fark saptanmamıştır (sırası ile, 8,3 ± 0,8 fL; 8,2 ± 0,7 fL) Sonuç: Sonuç olarak, verilerimiz, akut bronşiolit varlığında MPV değerlerinin sağlıklı bebeklere göre anlamlı derecede yükseldiğini göstermektedir. Bununla birlikte, MPV atak şiddetinde bir rehber olarak kullanılamaz ve hastaneye yatışı ve sistemik steroid ihtiyacını tahmin edemez.

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Neyzi O, Ertuğrul T. Pediatri 4. Baskı. Nobel Tıp Kitabevi, 2010;1086.

Coates BM, Camarda LE, and Denise M. Goodman. Wheezing, Bronchitis and Bronchiolitis. In: Behrman RE, ed. Nelson Textbook of Pediatrics. 20th ed. Philadelphia: Elsevier Ltd, 2015;2044-8.

García-Salido A, Oñoro G, Melen GJ, Gómez-Piña V, Serrano-González A, Ramírez-Orellana M, et al. Serum sRAGE as a Potential Biomarker for Pediatric Bronchiolitis: A Pilot Study. Lung. 2015;193(1):19-23.

Oymar K, Skjerven HO, Mikalsen IB. Acute bronchiolitis in infants, a review. Scand J Trauma Resusc Emerg Med. 2014; 22: 23.

Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, et al. Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis. Pediatrics. 2014;134(5):1474-502.

Mehta R, Scheffler M, Tapia L, Aideyan L, Patel KD, Jewell AM, et al. Lactate dehydrogenase and caspase activity in nasopharyngeal secretions are predictors of bronchiolitis severity. Influenza Other Respi Viruses. 2014;617-25.

J. NP, K. ND. Platelets and the Vessel Wall. In: Orkin SH, Fisher DE, Ginsburg D, Look T, Lux SE, eds. Nathan and Oski’s Hematology and Oncology of Infancy and Childhood. 8th ed. Philadelphia: Elsevier Saunders, 2015; 951-61.

Barrett KE, Barman SM, Boitano S, Brooks HL. Immunity, Infection and Inflammation. In: Barrett KE, Barman SM, Boitano S, Brooks HL, eds. Ganong’s Review of Medical Physiology. 25th ed. Mc Graw Hill Education; 2016;66-83.

Rodgers GM, M.Lehman C. Disorders of Hemostasis and Coagulation. In: John GP, A. AD, Bertil G, F. LA, eds. Wintrobe’s Clinical Hematology. 13th ed. 45: Wolters Kluwer, Lippincott Williams & Wilkins; 2013:2419-2898.

Thompson CB, Jakubowski JA. The pathophysiology and clinical relevance of platelet heterogeneity. Blood. 1988;72(1):1-8.

Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: Methodological issues. Platelets. 2002;13:301-6.

Christof D. Thrombocytosis. In: Arceci RJ, Hann IM, Smith OP, Victor HA, eds. Pediatric Hematology. 3rd ed. Massachusetts: Blackwell Publishing Ltd.; 2006;548-51.

Morrell CN, Aggrey AA, Chapman LM, Modjeski KL. Emerging roles for platelets as immune and inflammatory cells. Blood. 2016;123(18):2759-68.

Golcuk Y, Golcuk B, Bilge A, Irik M, Dikmen O. Combination of mean platelet volume and the CURB-65 score better predicts 28-day mortality in patients with community-acquired pneumonia. Am J Emerg Med. 2015;33(5):648-52.

Tural Kara T, Yılmaz Özbek Ö, Tahire Köksal B. Evaluation of Platelet Activation During an Asthmatic Attack in Children. Turkish J Pediatr Dis. November 2015.

Tekin M, Toplu Y, Kahramaner Z, Erdemir A, Gulyuz A, Konca C, et al. The mean platelet volume levels in children with PFAPA syndrome. Int J Pediatr Otorhinolaryngol. 2014;78(5):850-3.

Lee IR, Shin J Il, Park SJ, Oh JY, Kim JH. Mean platelet volume in young children with urinary tract infection. Sci Rep. 2015;5:18072.

Tanju C, Ekrem G, Berksoy Emel A, Nur A. Mean platelet volume as a negative marker of inflammation in children with rotavirus gastroenteritis. Iran J Pediatr. 2014;24(5):617-22.

Karabulut M, Yilmaz E. Klinik Araştırma Akut Romatiz mal Ateş Tanılı Çocuklarda MPV ve PCT Parametrelerinin Değerlendirilmesi. Fırat Tıp Dergisi.2015;20(4):206-9.

Oncel MY, Ozdemir R, Yurttutan S, et al. Mean Platelet Volume in Neonatal Sepsis. J Clin Lab Anal. 2012;26(6):493-6.

Demir O. Simple Markers for Subclinical Inflammation in Patients with Familial Mediterranean Fever. Med Sci Monit. 2015;21:298-303.

Yousefichaijan P, Eghbali A, Rafiei M. Mean Platelet Volume as a Predictive Marker for Poor Prognosis of Acute Renal Failure in children. J Pediatr. 2015;2(4):137- 9

Liu R, Gao F, Huo J, Yi Q. Study on the relationship between mean platelet volume and platelet distribution width with coronary artery lesion in children with Kawasaki disease. Platelets. 2012;23(1):11-6.

Ergul AB, Altuner Torun Y, Uytun S, Aslaner H, Pac Kisaaslan A, Serbetci MC. Reduction in mean platelet volume in children with acute bronchiolitis. Türk Pediatr Arşivi. 2016;51(1):40-5.

Ricart S, Marcos MA, Sarda M, et al. Clinical risk factors are more relevant than respiratory viruses in predicting bronchiolitis severity. Pediatr Pulmonol. 2013;48(5):456- 63.

Bilavsky E, Yarden-Bilavsky H, Shouval DS, Fisch N, Garty BZ, Ashkenazi S, et al. Respiratory syncytial viruspositive bronchiolitis in hospitalized infants is associated with thrombocytosis. Isr Med Assoc J. 2010;12(1):39-41.

Bennett BL, Garofalo RP, Cron SG, Hosakote YM, Atmar RL, Macias CG, et al. Immunopathogenesis of respiratory syncytial virus bronchiolitis. J Infect Dis. 2007;195(10):1532–40.

Renshaw AA, Drago B, Toraya N, Gould EW. Respiratory syncytial virus infection is strongly correlated with decreased mean platelet volume. Int J Infect Dis. 2013;17(9):e678-e680.

Karadag-Oncel E, Ozsurekci Y, Kara A, Karahan S, Cengiz AB, Ceyhan M. The value of mean platelet volume in the determination of community acquired pneumonia in children. Ital J Pediatr. 2013;39(1):16.

Canpolat FE, Yurdakök M, Armangil D, Yiğit S. Mean platelet volume in neonatal respiratory distress syndrome. Pediatr Int. 2009;51(2):314-6.

Cho SY, Suh J-S, Cho B-S, et al. Mean platelet volume in pediatric chronic kidney diseases. Platelets. 2013;24(2):164-5.