Osman YILMAZ, Selmin KARADEMİR, Önder DOKSÖZ, Burhan ÖCAL, Filiz ŞENOCAK, Ülker ERTAN, Utku Arman ÖRÜN, Vehbi DOĞAN, Özben CEYLAN, Senem ÖZGÜR, Mahmut KESKİN

Mitral Kapak Prolapsusu İle Otoimmünite Arasında İlişki Var Mı? Çocuk Olguların Değerlendirilmesi

Amaç: Mitral kapak prolapsusu (MVP) sık rastlanan bir kalp kapak hastalığıdır. Etyopatogenezinde genetik ve nöroendokrin faktörler yanısıra otoimmünitenin de rol aldığı düşünülmektedir. Çalışmamızda mitral valv prolapsuslu hastalarda otoimmün belirteçlerin taranarak, otoimmünitenin rolü incelenmek istenmiştir.Gereç ve yöntem: Mayıs 2009-Aralık 2009 tarihleri arasında Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi Pediatrik Kardiyoloji bölümünde MVP tanısı ile takip edilen 38 olgu hasta grubu ve 38 sağlıklı olgu kontrol grubu olarak çalışmaya alındı. Hasta ve kontrol grubunda akut faz reaktanları, biyokimyasal testler, serum immunoglobulin düzeyleri, kompleman 3 ve 4, antinükleer antikorlar, antikardiyolipin ve antifosfolipid antikorları, tiroid otoantikorları, romatoid faktör tetkikleri uygulandı. Elektrokardiyografi ( EKG) ve telekardiyografi çekildi, ekokardiyografik inceleme yapıldı.Bulgular: Hasta ve sağlıklı gruplar karşılaştırıldığında otoimmün belirteçler arasında istatistiksel olarak anlamlı fark bulunamadı (p>0.05). Hasta grubundaki 4 olguda ( 3 parsiyel, 1 selektif), kontrol grubundaki 2 olguda (2 parsiyel ) immünglobulin A (IgA) düzeyi düşük bulundu, ancak istatistiksel olarak anlamlı değildi (p>0,05).Sonuç: Çalışmamızda MVP ve otoimmün belirteçler arasında istatistiksel olarak anlamlı bir sonuç elde edilemedi. Ancak IgA eksikliğinin hasta grubunda kontrol grubuna göre daha fazla olduğunu gözledik. İstatistiksel olarak anlamlı olmasa da IgA eksikliği saptanan MVP’li çocuk hastaların ileri yaşlarda otoimmünite gelişebilme olasılığı yönünden izlenmesi gerektiği sonucuna varıldı.

Anahtar Kelimeler:

Mitral kapak prolapsusu, otoimmünite, IgA eksikliği, çocukluk çağı

DOES MITRAL VALVE PROLAPSE HAVE RELATION WITH AUTOIMMUNITY OR NOT? EVALUATION OF PEDIATRIC CASES

Aim: Mitral valve prolapse (MVP) is a common cardiac valvular disease. Besides genetic and neuroendocrine factors, autoimmunity is thought to play a role in its pathogenesis. In this study, we aimed to evaluate the role of autoimmunity in development of MVP through the screening of certain markers related with autoimmunity. Materials and methods: Between May 2009 and December 2009; a total of 38 patients followed with the diagnosis of MVP in the Pediatric Cardiology Department of Dr. Sami Ulus Maternity and Children’s Education and Research Hospital and a control group consisting of 38 healthy children were included in the study. Acute phase reactants, biochemical tests, levels of serum immunoglobulin, complement levels, antinuclear antibodies, antithyroid antibodies, rheumatoid factor, anticardiolipin, and antiphospholipid antibodies were all determined. Electrocardiography, telecardiography, and echocardiography were also performed in all cases. Results: In the comparison of two groups, no statistically significant difference was shown concerning autoimmunity markers (p>0.05). Four children in the patient group (3 with partial and one with selective Ig A deficiency) and 2 children in the control group (2 with partial Ig A deficiency) had low Ig A levels, whereas the difference between two groups were not statistically significant (p>0.05). Conclusion: In our study, no significant correlation was found between MVP and autoimmune markers. However, we observed that Ig A deficiency is more frequent in the patient group than in the control group. In spite of the statistically non-significant association between MVP and autoimmunity markers, we conclude that children with MVP having Ig A deficiency should be followed up for the development of autoimmune disoredrs in their future life

Keywords:

Mitral valve prolapse, autoimmunity, IgA deficiency, childhood,

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