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EKSTRAPULMONER TÜBERKÜLOZDA CİNSİYET FARKLILIĞI

Year 2010, Volume: 24 Issue: 3, 173 - 179, 01.12.2010

Abstract

Ekstrapulmoner tüberkülozun (EPT) klinik görünümlerinde cinsiyet farklılığını araştırmak amaçlanmıştır. Ocak 2000-Ocak 2004 tarihleri arasında dispanserimizde tedavi ve izlemi yapılan 137 EPT'li olgunun kayıtları retrospektif olarak incelendi. Olgularımızın 71 (%51.82)'i erkek 66 (%48.17)'sı kadın olup, erkeklerin yaş ortalaması 35.25± 16.02, kadınların yaş ortalaması 38.95±17.82 idi. Her iki cinste de en sık görülen EPT formları plevra ve lenf bezi tüberkülozu iken, plevra tüberkülozu erkeklerde (%67.60-%40.90, p=0.002), lenf bezi tüberkülozu kadınlarda (%31.81-%11.26, p=0.017) daha yüksek oranlarda saptandı. Akciğer tüberkülozu birlikteliği erkeklerde daha fazlaydı (%21.21-%8.45). Her iki cinste en sık izlenen semptomlar gece terlemesi, öksürük ve göğüs ağrısı idi. Erkeklerde göğüs ağrısı (p=0.046) ve balgam çıkarma (p=0.021), kadınlarda lenfadenopatiye bağlı ele gelen şişlik (p=0.003) yakınması daha fazlaydı. Temas öyküsü kadınlarda (%27.27- %21.12), daha fazla iken, tüberküloz geçirme öyküsü yalnız erkeklerde (%8.45) vardı. Kadınlarda ve erkeklerde, EPT'nin klinik görünümlerinde belirgin farklılıklar vardı. Her iki cinste de plevra tüberkülozu en sık EPT formu iken lenf bezi tüberkülozu kadınlarda erkeklere göre yaklaşık üç kat fazla saptandı.

References

  • 1. Lauzardo M, Askhin D. Phthisiology at the down of the century. A review of tuberculosis and prospects for its elimination. Chest 2000; 117: 1455-73.
  • 2. Yang Z, Kong Y, Wilson F, et al. Identification of risk factors for extrapulmonary tuberculosis. Clin Infect Dis 2004; 38: 199-205.
  • 3. American Thoracic Society. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med 2000; 161: 1376-95.
  • 4. Gender and Tuberculosis. World Health Organization 2003. Accepted from http:// www.who.int/gender/documents/en/TB. factsheet.pdf
  • 5. Frank G. Lung disease in women. Winter 2002; 6(1): 40-3.
  • 6. Martinez AN, Rhee JT, Small PM, Behr MA. Sex differences in the epidemiology of tuberculosis in San Francisco. Int J Tuberc lung Dis 2000; 4(1): 26-31.
  • 7. Salim Hamid MA, Declarcq E, Deun AV, Saki KAR. Gender differences in tuberculosis: a prevalence survey done in Bangladesh. Int J Tuberc lung Dis 2004; 8(8): 952-7.
  • 8. Özkara fi. K›l›çaslan Z, Öztürk F, Seymeno¤lu S ve ark. Bölge verileriyle Türkiye’de tüberküloz. Toraks Dergisi 2002; 3(2): 178-87.
  • 9. Akto¤u S, Yorganc›o ¤lu A, Ç›rak K, Dereli fi. Clinical spectrum of pulmonary and pleural tuberculosis: a report of 5480 cases. Eur Respir J 1996; 9: 2031-5.
  • 10. Balbay Ö, Ifl›khan V, Annakaya AN ve ark. Düzce T›p Fakültesi Dergisi 2004; 2: 5-14.
  • 11. Caracta CF. Gender differences in pulmonary disease. The Mount Sinai Journal of Medicine 2003; 70(4): 215-24.
  • 12. Holmes CB, Hausler H, Nunn P. A review of sex differences in the epidemiology of tuberculosis. In J Tuberc Lung Dis 1998; 2: 96- 104.
  • 13. Boore MJ, Harries AD, Godschalk P, et al. Gender differences in relation to sputum submission and smear positive pulmonary tubercolosis in Malawi. In J Tuberc Lung Dis 2000; 4(9): 882-4.
  • 14. Thorson A, Diwan VK. Gender inequatities in tuberculosis: aspects of infection, notificztion rates and compliance. Curr Opin Pulm Med 2001; 7(3): 165-9.
  • 15. Uplekar MW, Rangen S, Weiss MG, et al. Attention to gender issues in tuberculosis control. Tuber Lung Dis 2001; 5(3): 220-4.
  • 16. Hudelson P. Gender differentials in tuberculosis: the role of socio-economic and cultural factors. Tuber lung Dis 1996; 77(5): 391-400.
  • 17. Begum V, de Colombani P, Das Gupta S, et al. Tuberculosis and patient gender in Bangladesh: sex differences in diagnosis and treatment outcome. J Tuberc Lung Dis 2001; 5(7): 604-10.
  • 18. Gonzales OY, Adams G, Teeter LD, et al. Extrapulmonary manifestations in a large metropolitan area with a low incidence of tuberculosis. Int J Tuberc Lung Dis 2003; 7 (12): 1178-85.
  • 19. Hesselink DA, Yoo SM, Verhoeven GT, et al. A high prevalence of culture-positive extrapulmonary tuberculosis in a large Duth teaching hospital. Netherlands The Journal of Medicine 2003; 67(3): 65-70.
  • 20. Beek LAM, Werf MJ, Richter C, Borgdorff MW. Extrapulmonary tuberculosis by nat›onal›ty, the Netherlands, 1993-2001. Emerging Infectious Diseases 2006: 12(9): 1375-82.
  • 21. Saman Y, Krayem A, Haider M, et al Treatment outcome of tuberculosis among Saudi nationals: role of drug resistance and compliance. Clin Microbiol Infect 2003; 9: 289-94.
  • 22. Tatar D, Coflkunol ‹, Ayd›n M ve ark. ‹zmir Eflrefpafla Verem Savafl Dispanserinde 1995- 2000 y›llar› aras›nda izlenen ekstrapulmoner tüberküloz olgular›n›n retrospektif analizi. Akci¤er Arflivi 2001; 3: 107-12.
  • 23. Forssbohm M, Zwahlen M, Loddenkemper R,. Rieder HL. Demographic haracteristics of patients with extrapulmonary tuberculosis in Germany. Eur Respir J 2008; 31: 99-105.
  • 24. Rieder HL, Snider DE Jr, Cauthen GM. Extrapulmonary tuberculosis in the United States. Am Rev Respir Dis 1990; 41: 347– 51.
  • 25. Tam CM, Leung CC, Noertjojo K, Chan SL, Chan-Yeung M. Tuberculosis in Hong Kongpatient characteristics and treatment outcome. Hong Kong Med J 2003; 9: 83-90
  • 26. Özbay B, Uzun K. Extrapulmonary tuberculosis in high prevalence of tuberculosis and low prevalence of HIV. Clin Chest Med 2002; 23: 351-4.
  • 27. Peto HM, Pratt RH, Harrington TA, LoBua PA, Armstrong LR. Epidemiology of extrapulmonary tuberculosis in the United States, 1993-2006. Clin Infect Dis 2009 Nov 1; 49(9): 1350-7.
  • 28. Fiske TC, Griffin MR, rin H, Warkentin J, Lisa K, Arbogast PG, Sterling TR. Black race, sex, and extrapulmonary tuberculosis risk: an observational study. BMC infectious Diseases 2010; 10-23.

GENDER DIFFERENCES IN EXTRAPULMONARY TUBERCULOSIS

Year 2010, Volume: 24 Issue: 3, 173 - 179, 01.12.2010

Abstract

To e valuate gender differences in the clinical manifestations of extrapulmonary tuberculosis (EPT). Records of 137 cases with EPT reviewed retrospectively which were treated and followed up in our dispensary between January 2000- December 2003. 71 of our cases were male, 66 were female and the mean age was 35.25±16.02 in males and 38.95±17.82 in females. While the most common EPT forms were pleural and lymph node tuberculosis in both sexes, pleural tuberculosis was more in males (67.60%-40.90%, p=0.002), and lymph node tuberculosis was more in females (31.81%-11.26%, p=0.017). Accompanying lung tuberculosis was more in males (21.21%-8.45%). The most common symptoms in both sexes were night sweating, cough and chest pain. Chest pain (p=0.046) and sputum expectoration (p=0.021) were more in males, palpable lymphadenopathy(p=0.003) was more in females. While the history of contact was more in females, history of tuberculous disease was found only in males. There were significant clinical differences between females an d males. While the most common form of EPT was pleural tuberculosis in both genders, lymph node tuberculosis was found approximately three times more in females.

References

  • 1. Lauzardo M, Askhin D. Phthisiology at the down of the century. A review of tuberculosis and prospects for its elimination. Chest 2000; 117: 1455-73.
  • 2. Yang Z, Kong Y, Wilson F, et al. Identification of risk factors for extrapulmonary tuberculosis. Clin Infect Dis 2004; 38: 199-205.
  • 3. American Thoracic Society. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med 2000; 161: 1376-95.
  • 4. Gender and Tuberculosis. World Health Organization 2003. Accepted from http:// www.who.int/gender/documents/en/TB. factsheet.pdf
  • 5. Frank G. Lung disease in women. Winter 2002; 6(1): 40-3.
  • 6. Martinez AN, Rhee JT, Small PM, Behr MA. Sex differences in the epidemiology of tuberculosis in San Francisco. Int J Tuberc lung Dis 2000; 4(1): 26-31.
  • 7. Salim Hamid MA, Declarcq E, Deun AV, Saki KAR. Gender differences in tuberculosis: a prevalence survey done in Bangladesh. Int J Tuberc lung Dis 2004; 8(8): 952-7.
  • 8. Özkara fi. K›l›çaslan Z, Öztürk F, Seymeno¤lu S ve ark. Bölge verileriyle Türkiye’de tüberküloz. Toraks Dergisi 2002; 3(2): 178-87.
  • 9. Akto¤u S, Yorganc›o ¤lu A, Ç›rak K, Dereli fi. Clinical spectrum of pulmonary and pleural tuberculosis: a report of 5480 cases. Eur Respir J 1996; 9: 2031-5.
  • 10. Balbay Ö, Ifl›khan V, Annakaya AN ve ark. Düzce T›p Fakültesi Dergisi 2004; 2: 5-14.
  • 11. Caracta CF. Gender differences in pulmonary disease. The Mount Sinai Journal of Medicine 2003; 70(4): 215-24.
  • 12. Holmes CB, Hausler H, Nunn P. A review of sex differences in the epidemiology of tuberculosis. In J Tuberc Lung Dis 1998; 2: 96- 104.
  • 13. Boore MJ, Harries AD, Godschalk P, et al. Gender differences in relation to sputum submission and smear positive pulmonary tubercolosis in Malawi. In J Tuberc Lung Dis 2000; 4(9): 882-4.
  • 14. Thorson A, Diwan VK. Gender inequatities in tuberculosis: aspects of infection, notificztion rates and compliance. Curr Opin Pulm Med 2001; 7(3): 165-9.
  • 15. Uplekar MW, Rangen S, Weiss MG, et al. Attention to gender issues in tuberculosis control. Tuber Lung Dis 2001; 5(3): 220-4.
  • 16. Hudelson P. Gender differentials in tuberculosis: the role of socio-economic and cultural factors. Tuber lung Dis 1996; 77(5): 391-400.
  • 17. Begum V, de Colombani P, Das Gupta S, et al. Tuberculosis and patient gender in Bangladesh: sex differences in diagnosis and treatment outcome. J Tuberc Lung Dis 2001; 5(7): 604-10.
  • 18. Gonzales OY, Adams G, Teeter LD, et al. Extrapulmonary manifestations in a large metropolitan area with a low incidence of tuberculosis. Int J Tuberc Lung Dis 2003; 7 (12): 1178-85.
  • 19. Hesselink DA, Yoo SM, Verhoeven GT, et al. A high prevalence of culture-positive extrapulmonary tuberculosis in a large Duth teaching hospital. Netherlands The Journal of Medicine 2003; 67(3): 65-70.
  • 20. Beek LAM, Werf MJ, Richter C, Borgdorff MW. Extrapulmonary tuberculosis by nat›onal›ty, the Netherlands, 1993-2001. Emerging Infectious Diseases 2006: 12(9): 1375-82.
  • 21. Saman Y, Krayem A, Haider M, et al Treatment outcome of tuberculosis among Saudi nationals: role of drug resistance and compliance. Clin Microbiol Infect 2003; 9: 289-94.
  • 22. Tatar D, Coflkunol ‹, Ayd›n M ve ark. ‹zmir Eflrefpafla Verem Savafl Dispanserinde 1995- 2000 y›llar› aras›nda izlenen ekstrapulmoner tüberküloz olgular›n›n retrospektif analizi. Akci¤er Arflivi 2001; 3: 107-12.
  • 23. Forssbohm M, Zwahlen M, Loddenkemper R,. Rieder HL. Demographic haracteristics of patients with extrapulmonary tuberculosis in Germany. Eur Respir J 2008; 31: 99-105.
  • 24. Rieder HL, Snider DE Jr, Cauthen GM. Extrapulmonary tuberculosis in the United States. Am Rev Respir Dis 1990; 41: 347– 51.
  • 25. Tam CM, Leung CC, Noertjojo K, Chan SL, Chan-Yeung M. Tuberculosis in Hong Kongpatient characteristics and treatment outcome. Hong Kong Med J 2003; 9: 83-90
  • 26. Özbay B, Uzun K. Extrapulmonary tuberculosis in high prevalence of tuberculosis and low prevalence of HIV. Clin Chest Med 2002; 23: 351-4.
  • 27. Peto HM, Pratt RH, Harrington TA, LoBua PA, Armstrong LR. Epidemiology of extrapulmonary tuberculosis in the United States, 1993-2006. Clin Infect Dis 2009 Nov 1; 49(9): 1350-7.
  • 28. Fiske TC, Griffin MR, rin H, Warkentin J, Lisa K, Arbogast PG, Sterling TR. Black race, sex, and extrapulmonary tuberculosis risk: an observational study. BMC infectious Diseases 2010; 10-23.
There are 28 citations in total.

Details

Other ID JA53YN29BS
Journal Section Research Article
Authors

Dursun Tatar This is me

Serpil Alptekin This is me

Mert Aydın This is me

İpek Coşkunol This is me

Publication Date December 1, 2010
Published in Issue Year 2010 Volume: 24 Issue: 3

Cite

APA Tatar, D., Alptekin, S., Aydın, M., Coşkunol, İ. (2010). EKSTRAPULMONER TÜBERKÜLOZDA CİNSİYET FARKLILIĞI. İzmir Göğüs Hastanesi Dergisi, 24(3), 173-179.