Viral Siğili Olan Hastalarda Kontrol Grubuna Kıyasla Daha Düşük Vitamin B12 Seviyeleri: Retrospektif Bir Çalışma

Abstract

Amaç: Viral siğil, yaygın olarak görülen benign enfeksiyöz bir dermatozdur. HPV'ye maruz kalan herkesin neden siğil geliştirmediği belirsizliğini korumaktadır. Vitamin ve mineral eksikliklerinin doğal ve kazanılmış bağışıklığı zayıflatabileceği ve daha fazla enfeksiyon kapma eğilimine yol açabileceği bilinmektedir. Bu çalışma, viral siğili olan hastalarda vitamin B12, folik asit ve ferritin düzeylerinin değerlendirilmesinin potansiyel faydasını değerlendirmeyi amaçlamıştır. Gereç ve Yöntemler: Bu geriye dönük çalışmaya, Ocak 2018 ve Aralık 2019 tarihleri arasında Karabük Üniversitesi Eğitim ve Araştırma Hastanesi dermatoloji polikliniğinde viral siğil tanısı almış olan 70 hasta dahil edildi. Kontrol grubu olarak cinsiyet ve yaş açısından viral siğil hastaları ile uyumlu olan 70 sağlıklı birey dahil edildi. Hastane otomasyon sisteminden her iki grubun serum vitamin B12, folik asit ve ferritin düzeyleri tespit edildi ve karşılaştırıldı. Bulgular: Serum vitamin B12 düzeyi, viral siğili olan hasta grubunda kontrol grubuna göre istatistiksel olarak anlamlı derecede daha düşük tespit edildi (p=0,046). Serum ferritin düzeyleri viral siğil grubunda daha düşük bulunmakla birlikte, bu fark istatistiksel olarak anlamlı değildi (p=0,677). Folat seviyeleri açısından, viral siğil ve kontrol grupları arasında istatistiksel olarak anlamlı bir farklılık tespit edilmemiştir (p=0,879). Sonuç: Serum vitamin B12 düzeyi düşük viral siğili olan hastalarda vitamin B12 replasman tedavisi düşünülebilir. Ayrıca viral siğil enfeksiyonu olan hastalarda vücutta demir depolama parametresi olan serum ferritin düzeyinin değerlendirilmesi önemlidir.

Keywords

• Siğil
• B12 vitamini
• folik asit
• ferritin
• viral siğil

Lower Levels of Vitamin B12 Among Patients with Viral Warts Compared with Control Subjects: A Retrospective Study

Abstract

Aim: Viral wart is a common benign infectious dermatosis. It remains unclear why not everyone exposed to HPV develops warts. It is known that vitamin and mineral deficiencies can affect impair natural and acquired immunity and lead to a tendency to get more infections. This study aimed to determine the potential utility of evaluating vitamin B12, folic acid, and ferritin levels in patients with viral warts. Material and Methods: In this retrospective study, 70 patients who were diagnosed with viral warts in the dermatology outpatient clinic of Karabük University Training and Research Hospital between January 2018 and December 2019 were included. 70 healthy individuals matched with viral wart patients in terms of gender and age were included as the control group. Serum vitamin B12, folic acid, and ferritin levels of both groups were detected and compared from the hospital automation system. Results: Vitamin B12 level was detected statistically significantly lower in the viral wart group as compared to the control group (p=0.046). Although serum ferritin levels were found lower in the viral wart group, this difference was not statistically significant (p=0.677). No statistically significant difference was detected between the viral wart and control groups in terms of folate levels (p=0.879). Conclusion: In patients with viral warts with low serum vitamin B12 levels, replacement therapy could be considered. Also, the evaluation of serum ferritin level, an iron storage parameter in the body, is important in patients with viral warts infection.

Keywords

• wart
• vitamin B12
• folic acid
• ferritin
• viral warts

References

1. Loo SK, Tang WY. Warts (non-genital). BMJ Clin Evid 2014;2014:1710.
2. Salah E. Impact of multiple extragenital warts on quality of life in immune-competent Egyptian adults: a comparative cross-sectional study. Clin Cosmet Investig Dermatol. 2018;11:289-95.
3. Abeck D, Tetsch L, Lüftl M, Biedermann T. Extragenital cutaneous warts - clinical presentation, diagnosis and treatment. J Dtsch Dermatol Ges. 2019;17(6):613-34.
4. Romain M, Sviri S, Linton DM, Stav I, van Heerden PV. The role of vitamin B12 in the critically ill--a review. Anaesth Intensive Care. 2016;44(4):447-52.
5. Oh R, Brown DL. Vitamin B12 deficiency. Am Fam Physician. 2003;67(5):979-86.
6. Alwarawrah Y, Kiernan K, MacIver NJ. Changes in nutritional status impact immune cell metabolism and function. Front Immunol. 2018;9:1055.
7. Gombart AF, Pierre A, Maggini S. A review of micronutrients and the immune system-working in harmony to reduce the risk of infection. Nutrients. 2020;12(1):236.
8. Wintergerst ES, Maggini S, Hornig DH. Contribution of selected vitamins and trace elements to immune function. Ann Nutr Metab. 2007;51(4):301-23.

9. Śliwińska A, Luty J, Aleksandrowicz-Wrona E, Małgorzewicz S. Iron status and dietary iron intake in vegetarians. Adv Clin Exp Med. 2018;27(10):1383-9.
10. Lynch S, Pfeiffer CM, Georgieff MK, Brittenham G, Fairweather-Tait S, Hurrell RF, et al. Biomarkers of Nutrition for Development (BOND)-Iron Review. J Nutr. 2018;148(suppl_1):1001S-67S.
11. Hassan TH, Badr MA, Karam NA, Zkaria M, El Saadany HF, Abdel Rahman DM, et al. Impact of iron deficiency anemia on the function of the immune system in children. Medicine (Baltimore). 2016;95(47):e5395.
12. Ganz T, Aronoff GR, Gaillard CAJM, Goodnough LT, Macdougall IC, Mayer G, et al. Iron administration, infection, and anemia management in CKD: untangling the effects of intravenous iron therapy on immunity and infection risk. Kidney Med. 2020;2(3):341-53.
13. Ebara S. Nutritional role of folate. Congenit Anom (Kyoto). 2017;57(5):138-41.
14. Socha DS, DeSouza SI, Flagg A, Sekeres M, Rogers HJ. Severe megaloblastic anemia: Vitamin deficiency and other causes. Cleve Clin J Med. 2020;87(3):153-64.
15. Partearroyo T, Úbeda N, Montero A, Achón M, Varela-Moreiras G. Vitamin B(12) and folic acid imbalance modifies NK cytotoxicity, lymphocytes B and lymphoprolipheration in aged rats. Nutrients. 2013;5(12):4836-48.
16. Calder PC, Carr AC, Gombart AF, Eggersdorfer M. Reply to "Comment on: optimal nutritional status for a well-functioning immune system is an important factor to protect against viral infections. Nutrients 2020,12,1181". Nutrients. 2020;12(8):2326.
17. Tamer F, Yuksel ME, Karabag Y. Pre-treatment vitamin B12, folate, ferritin, and vitamin D serum levels in patients with warts: a retrospective study. Croat Med J. 2020;61(1):28-32.
18. Demir A, Güder S. The effects of vitamin B12, vitamin D, ferritin level, neutrophil/monocyte ratio and some blood parameters on genital warts presence, the number of lesions, and recurrence rates. Andrologia. 2021;53(4):e14006.
19. Yenigul NN, Yazıcı Yılmaz F, Ayhan I. Can serum vitamin B12 and folate levels predict HPV penetration in patients with ascus? Nutr Cancer. 2021;73(4):602-8.
20. Lopes RDVC, Teixeira JA, Marchioni D, Villa LL, Giuliano AR, Luiza Baggio M, et al. Dietary intake of selected nutrients and persistence of HPV infection in men. Int J Cancer. 2017;141(4):757-65.
21. Sedjo RL, Inserra P, Abrahamsen M, Harris RB, Roe DJ, Baldwin S, et al. Human papillomavirus persistence and nutrients involved in the methylation pathway among a cohort of young women. Cancer Epidemiol Biomarkers Prev. 2002;11(4):353-9.
22. Silva NNT, Silva Santos AC, Carneiro CM, Lima AA. Association of serum folate and vitamin B12 with pre-neoplastic cervical lesions. Clin Nutr ESPEN. 2020;38:223-8.
23. Redwan EM, Uversky VN, El-Fakharany EM, Al-Mehdar H. Potential lactoferrin activity against pathogenic viruses. C R Biol. 2014;337(10):581-95.
24. Habib HM, Ibrahim S, Zaim A, Ibrahim WH. The role of iron in the pathogenesis of COVID-19 and possible treatment with lactoferrin and other iron chelators. Biomed Pharmacother. 2021;136:111228.
25. Antony AC. Evidence for potential underestimation of clinical folate deficiency in resource-limited countries using blood tests. Nutr Rev. 2017;75(8):600-15.
26. Shipton MJ, Thachil J. Vitamin B12 deficiency - A 21st century perspective. Clin Med (Lond). 2015;15(2):145-50.