AKNE VULGARİS HASTALARINDA İSOTRETİNOİN TEDAVİSİNİN SERUM ÜRİK ASİT VE ORTALAMA TROMBOSİT HACMİ (MPV) ÜZERİNE OLAN ETKİLERİNİN ARAŞTIRILMASI

Year 2021, Volume: 28 Issue: 3, 397 - 402, 13.09.2021

Havva Hilal Ayvaz , Selma Korkmaz , İjlal Erturan , Mehmet Yıldırım , Emrah Atay

https://doi.org/10.17343/sdutfd.791681

Abstract

Amaç
Sistemik oral isotretinoin, orta-şiddetli akne vulgaris ve
tedaviye dirençli hafif akne vulgaris tedavisinde yıllardır
kullanılan etkin bir tedavidir. İsotretinoin tedavisinin
birçok yan etkisi bildirilmiş olup, gün geçtikçe yeni yan
etkileri de ortaya çıkmaktadır. Bu çalışmada, isotretinoin
tedavisinin birçok hastalıkla ilişkili değerlendirilebilen
belirteçler olan serum ürik asit ve MPV düzeylerinde
değişime neden olup olmadığının araştırılması
amaçlandı.
Gereç ve Yöntem
Hastanemiz Dermatoloji Polikliniğine başvuran, en
az üç ay önce isotretinoin tedavisi başlanmış olan ve
kontrollerini aksatmayan, hafif-orta veya şiddetli akne
vulgaris tanısı almış 78 hasta çalışmaya alındı. Standart
olarak yaklaşık 0,5 mg/kg/gün dozda isotretinoin
tedavisi başlanan hastaların tedavi öncesi ve tedavinin
3. ayındaki hemogram parametreleri, lipit düzeyleri,
monosit/HDL oranı ve MPV ile ürik asit düzeyleri
incelendi.
Bulgular
Hastaların tedavi öncesi ve tedavinin 3. ayında bakılan
hemogram parametreleri, MPV ve ürik asit düzeyleri
arasında herhangi bir anlamlı değişiklik saptanmamışken
(p>0,05); lipit düzeyleri arasında (trigliserit, total
kolesterol, LDL) anlamlı farklılıklar mevcuttu (p<0,05).
Hastalar, global akne skorlamasına göre hafif-orta ve
şiddetli aknesi olanlar şeklinde gruplandırıldığında tedavi
öncesi ve tedavinin 3. ayında bakılan MPV ile ürik
asit düzeyleri arasında da herhangi bir anlamlı değişiklik
saptanmadı (sırasıyla p=0.43, p=0.23; p=0.31,
p=0.14).
Sonuç
Literatürde ürik asit ve MPV’nin ateroskleroz dahil birçok
inflamatuvar durumla ilişkili olabileceğini gösteren
çalışmalar mevcuttur. İsotretinoin tedavisinin de kardiyovasküler
sistem ve kemik iliği üzerine etkileri açısından
çelişkili sonuçların bildirildiği araştırmalar ve olgu
sunumları bulunmaktadır. İsotretinoin tedavisinin MPV
üzerine veya ürik asit seviyeleri üzerine olan etkilerinin
ayrı ayrı yapılmış çalışmaları mevcut olup, bu çalışmalar
çelişen sonuçlara sahiptirler. Literatürde, daha
önceden her iki parametrenin aynı anda değerlendirildiği
bir çalışma bulunmamaktadır. Bu çalışmamızda,
sistemik isotretinoin tedavisinin, ateroskleroz dahil
birçok inflamatuvar durumla ilişkili olabileceği gösterilmiş
olan parametrelerden MPV ve serum ürik asit
üzerine ve hematolojik diğer parametreler üzerine bir
etkisi olmadığını saptadık. Akne vulgaris tedavisinde
kullanılan isotretinoin tedavisinin, altta yatan herhangi
bir kardiyovasküler sistem veya hematolojik hastalığı
olmayan kişilerde güvenli bir şekilde kullanılabileceğini
düşünmekteyiz.

Keywords

Akne, İsotretinoin, ürik asit, ortalama trombosit hacmi

Supporting Institution

Yok

EVALUATION OF THE EFFECTS OF ISOTRETINOIN TREATMENT ON SERUM URIC ACID AND MEAN PLATELET VOLUME IN PATIENTS WITH ACNE VULGARIS

Abstract

Objective
Oral isotretinoin is an effective treatment used for years
in the treatment of acne vulgaris. Many side effects
of it have been reported, and new ones appear day
by day. In this study, it was aimed to investigate whether
isotretinoin causes changes in serum uric acid and
MPV levels, which are markers that can be evaluated
in many diseases.
Material and Methods
78 patients who were admitted to Dermatology Outpatient
Clinic of our hospital and were diagnosed with
mild to moderate or severe acne vulgaris and to whom
isotretinoin treatment was started at least three months
ago, were included in this study. Hemogram parameters,
lipid levels, monocyte / HDL ratio, MPV and
uric acid levels were examined before treatment and
at the third month of treatment in patients who started
isotretinoin at a dose of approximately 0.5 mg / kg /
day as a standard.
Results
While there was no significant change between the hemogram
parameters, MPV and uric acid levels of the
patients before and in the third month of treatment (p>
0.005); there were significant differences between lipid
levels (triglyceride, total cholesterol, LDL) (p <0.005).
When the patients were grouped as mild-moderate
and severe acne according to the global acne scoring,
no significant difference was found between the MPV
and uric acid levels measured before the treatment
and in the third month of treatment (p=0.43, p=0.23,
p=0.31, p=0.14, respectively).
Conclusion
There are studies showing that uric acid and MPV
may be associated with atherosclerosis in the literature.
There are contradictory studies and case reports
in terms of the effects of isotretinoin treatment
on cardiovascular system, also on MPV or uric acid
levels. There had been no previous study evaluating
both parameters. In this study, we found that systemic
isotretinoin treatment did not affect hematological parameters,
MPV and serum uric acid parameters, which
were shown to be associated with many inflammatory
conditions including atherosclerosis. We think that
isotretinoin treatment used in the treatment of acne
vulgaris can be used safely in individuals without any
underlying cardiovascular system or hematological disease.

Keywords

Acne, isotretinoin, uric acid, MPV

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