Araştırma Makalesi
BibTex RIS Kaynak Göster

Pediatrik Ailevi Akdeniz Ateşinde Basit Hemogram İndeksleri ile Hastalık Şiddet Skorları Arasındaki İlişkinin Değerlendirilmesi

Yıl 2022, Cilt: 24 Sayı: 1, 18 - 25, 30.04.2022
https://doi.org/10.18678/dtfd.1037824

Öz

Amaç: Son yıllarda, AAA hastalarında subklinik inflamasyonu göstermek için basit tam kan sayımı (TKS) parametrelerinin kullanılabileceği görülmüştür. Bu çalışmanın amacı, hastalık şiddeti skorlarına göre ayrılan AAA hasta grupları arasında TKS parametrelerinde farklılık olup olmadığını belirlemektir.
Gereç ve Yöntemler: Kliniğimizde 2016 ve 2019 yılları arasında takip edilen AAA hastalarının tıbbi kayıtları incelendi. Hastalar, Pras ve ark., Mor ve ark. ve AAA için uluslararası şiddet skorlama sistemi (International Severity Score for FMF, ISSF) hastalık şiddeti skorlama sistemlerine göre hafif, orta ve ağır hastalığı olanlar olmak üzere üç gruba ayrıldı. Hastaların eritrosit dağılım genişliği (red cell distribution width, RDW), trombosit, nötrofil, lenfosit, RDW-trombosit oranı (RDW-platelet ratio, RPR), trombosit-lenfosit oranı (platelet-lymphocyte ratio, PLR) ve nötrofil-lenfosit oranı (neutrophil-lymphocyte ratio, NLR) gruplar arasında karşılaştırıldı.
Bulgular: Pras ve ark.’nın skorlama sistemine göre, şiddetli hastalığı olan grupta lenfosit değerinin hafif ve orta derecede hastalığı olan gruplara göre anlamlı derecede yüksek olduğu bulundu (p=0,031). Mor ve ark.’nın skorlama sistemine göre PLR, şiddetli hastalığı olan grupta orta dereceli hastalıklara göre anlamlı olarak daha düşüktü (p=0,008). ISSF skorlamasına göre, TKS parametreleri açısından gruplar arasında fark yoktu.
Sonuç: Her üç skorlama sistemine göre de farklı sonuçlar elde edildi. ISSF, AAA hastalarında en yaygın ve kullanıma uygun sistem olduğundan, hastalık şiddeti ile RDW, RPR, NLR ve PLR arasında bir ilişki olmadığı sonucuna varabiliriz.

Kaynakça

  • Sönmez HE, Batu ED, Özen S. Familial Mediterranean fever: current perspectives. J Inflamm Res. 2016;9:13-20.
  • Daniels M, Shohat T, Brenner‐Ullman A, Shohat M. Familial Mediterranean fever: high gene frequency among the non‐Ashkenazic and Ashkenazic Jewish populations in Israel. Am J Med Genet. 1995;55(3):311-4.
  • Ozen S, Karaaslan Y, Ozdemir O, Saatci U, Bakkaloglu A, Koroglu E, et al. Prevalence of juvenile chronic arthritis and familial Mediterranean fever in Turkey: a field study. J Rheumatol. 1998;25(12):2445-9.
  • Schnappauf O, Chae JJ, Kastner DL, Aksentijevich I. The pyrin inflammasome in health and disease. Front Immunol. 2019;10:1745.
  • Maggio MC, Corsello G. FMF is not always “fever”: from clinical presentation to “treat to target”. Ital J Pediatr. 2020;46(1):7.
  • Sarı İ, Birlik M, Kasifoğlu T. Familial Mediterranean fever: an updated review. Eur J Rheumatol. 2014;1(1):21-33.
  • Kucuk A, Gezer IA, Ucar R, Karahan AY. Familial Mediterranean fever. Acta Medica (Hradec Kralove). 2014;57(3):97-104.
  • Bilginer Y, Akpolat T, Ozen S. Renal amyloidosis in children. Pediatr Nephrol. 2011;26(8):1215-27.
  • Livneh A, Langevitz P, Zemer D, Zaks N, Kees S, Lidar T, et al. Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum. 1997;40(10):1879-85.
  • Yeşil A, Şenateş E, Bayoğlu IV, Erdem ED, Demirtunç R, Övünç AO. Red cell distribution width: a novel marker of activity in inflammatory bowel disease. Gut Liver. 2011;5(4):460-7.
  • Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17(1):47-58.
  • Kisacik B, Tufan A, Kalyoncu U, Karadag O, Akdogan A, Ozturk MA, et al. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine. 2008;75(3):291-4.
  • Yazici S, Yazici M, Erer B, Erer B, Çalik Y, Bulur S, et al. The platelet functions in patients with ankylosing spondylitis: anti-TNF-α therapy decreases the mean platelet volume and platelet mass. Platelets. 2010;21(2):126-31.
  • Olumuyiwa-Akeredolu OO, Pretorius E. Platelet and red blood cell interactions and their role in rheumatoid arthritis. Rheumatol Int. 2015;35(12):1955-64.
  • Łukasik ZM, Makowski M, Makowska JS. From blood coagulation to innate and adaptive immunity: the role of platelets in the physiology and pathology of autoimmune disorders. Rheumatol Int. 2018;38(6):959-74.
  • Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009;133(4):628-32.
  • Wang L, Cai Q. [Value of red blood cell distribution width-to-platelet count ratio in predicting the prognosis of children with sepsis]. Zhongguo Dang Dai Er Ke Za Zhi. 2019;21(11):1079-83.
  • Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD. The platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases. Ann Lab Med. 2019;39(4):345-57.
  • Qiu L, Chen C, Li SJ, Wang C, Guo F, Peszel A, et al. Prognostic values of red blood cell distribution width, platelet count, and red cell distribution width-to-platelet ratio for severe burn injury. Sci Rep. 2017;7(1):13720.
  • Taefi A, Huang CC, Kolli K, Ebrahimi S, Patel M. Red cell distribution width to platelet ratio, a useful indicator of liver fibrosis in chronic hepatitis patients. Hepatol Int. 2015;9(3):454-60.
  • Cetinkaya E, Senol K, Saylam B, Tez M. Red cell distribution width to platelet ratio: new and promising prognostic marker in acute pancreatitis. World J Gastroenterol. 2014;20(39):14450-4.
  • Pras E, Livneh A, Balow JE Jr, Pras E, Kastner DL, Pras M, et al. Clinical differences between North African and Iraqi Jews with familial Mediterranean fever. Am J Med Genet. 1998;75(2):216-9.
  • Mor A, Shinar Y, Zaks N, Langevitz P, Chetrit A, Shtrasburg S, et al. Evaluation of disease severity in familial Mediterranean fever. Semin Arthritis Rheum. 2005;35(1):57-64.
  • Kalkan G, Demirkaya E, Acikel CH, Polat A, Peru H, Karaoglu A, et al.; FMF Arthritis Vasculitis and Orphan Disease Research in Paediatric Rheumatology (FAVOR). Evaluation of the current disease severity scores in paediatric FMF: is it necessary to develop a new one? Rheumatology (Oxford). 2012;51(4):743-8.
  • Demirkaya E, Acikel C, Hashkes P, Gattorno M, Gul A, Ozdogan H, et al.; FMF Arthritis Vasculitis and Orphan disease Research in pediatric rheumatology (FAVOR). Development and initial validation of international severity scoring system for familial Mediterranean fever (ISSF). Ann Rheum Dis. 2016;75(6):1051-6.
  • Yalçinkaya F, Ozen S, Ozçakar ZB, Aktay N, Cakar N, Düzova A, et al. A new set of criteria for the diagnosis of familial Mediterranean fever in childhood. Rheumatology (Oxford). 2009;48(4):395-8.
  • Lidar M, Scherrmann JM, Shinar Y, Chetrit A, Niel E, Gershoni-Baruch R, et al. Colchicine nonresponsiveness in familial Mediterranean fever: clinical, genetic, pharmacokinetic, and socioeconomic characterization. Semin Arthritis Rheum. 2004;33(4):273-82.
  • Yorulmaz A, Akbulut H, Taş SA, Tıraş M, Yahya İ, Peru H. Evaluation of hematological parameters in children with FMF. Clin Rheumatol. 2019;38(3):701-7.
  • Marzouk H, Mostafa N, Khalifa I, Badawi N, Mohamed Fathy Sabry NI. Red cell distribution width (RDW) as a marker of subclinical inflammation in children with familial Mediterranean fever. Curr Rheumatol Rev. 2020;16(4):298-303.
  • Özer S, Yılmaz R, Sönmezgöz E, Karaaslan E, Taşkın S, Bütün İ, et al. Simple markers for subclinical inflammation in patients with Familial Mediterranean Fever. Med Sci Monit. 2015;21:298-303.
  • Uslu AU, Deveci K, Korkmaz S, Aydin B, Senel S, Sancakdar E, et al. Is neutrophil/lymphocyte ratio associated with subclinical inflammation and amyloidosis in patients with familial Mediterranean fever? Biomed Res Int. 2013;2013:185317.
  • Uluca Ü, Demir F, Ece A, Şen V, Güneş A, Aktar F, et al. Assessment of epicardial adipose tissue thickness and the mean platelet volume in children with familial Mediterranean fever. Ital J Pediatr. 2015;41:15.
  • Jiang S, Liu J, Chen X, Zheng X, Ruan J, Ye A, et al. Platelet-lymphocyte ratio as a potential prognostic factor in gynecologic cancers: a meta-analysis. Arch Gynecol Obstet. 2019;300(4):829-39.
  • Hirahara T, Arigami T, Yanagita S, Matsushita D, Uchikado Y, Kita Y, et al. Combined neutrophil-lymphocyte ratio and platelet-lymphocyte ratio predicts chemotherapy response and prognosis in patients with advanced gastric cancer. BMC Cancer. 2019;19(1):672.
  • Goyal H, Lippi G, Gjymishka A, John B, Chhabra R, May E. Prognostic significance of red blood cell distribution width in gastrointestinal disorders. World J Gastroenterol. 2017;23(27):4879-91.
  • Zvetkova E, Fuchs D. Medical significance of simultaneous application of red blood cell distribution width (RDW) and neopterin as diagnostic/prognostic biomarkers in clinical practice. Pteridines. 2017;28(3-4):133-40.
  • Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2015;52(2):86-105.
  • Chen B, Ye B, Zhang J, Ying L, Chen Y. RDW to platelet ratio: a novel noninvasive index for predicting hepatic fibrosis and cirrhosis in chronic hepatitis B. PloS One. 2013;8(7):e68780.
  • Tecer D, Sezgin M, Kanık A, İncel NA, Çimen ÖB, Biçer A, et al. Can mean platelet volume and red blood cell distribution width show disease activity in rheumatoid arthritis? Biomark Med. 2016;10(9):967-74.
  • Xie S, Chen X. Red blood cell distribution width-to-platelet ratio as a disease activity-associated factor in systemic lupus erythematosus. Medicine (Baltimore). 2018;97(39):e12342.

Evaluation of the Relationship between Simple Hemogram Indexes and Disease Severity Scores in Pediatric Familial Mediterranean Fever

Yıl 2022, Cilt: 24 Sayı: 1, 18 - 25, 30.04.2022
https://doi.org/10.18678/dtfd.1037824

Öz

Aim: In recent years, it has been seen that simple complete blood count (CBC) parameters can be used to show subclinical inflammation in patients with familial Mediterranean fever (FMF). The aim of this study is to determine whether there is a difference in CBC parameters among FMF patient groups divided according to disease severity scores.
Material and Methods: FMF patients followed up in our clinic between 2016 and 2019, were reviewed for medical records. They were divided into three groups as those with mild, moderate, and severe diseases according to the disease severity scoring systems by Pras et al., Mor et al., and International Severity Score of FMF (ISSF). Red cell distribution width (RDW), platelet, neutrophil, lymphocyte, RDW-platelet ratio (RPR), platelet-lymphocyte ratio (PLR), and neutrophil-lymphocyte ratio (NLR) of the patients were compared among the groups.
Results: According to the scoring system of Pras et al., lymphocyte value was found significantly higher in the group with severe disease compared to the groups with mild and moderate diseases (p=0.031). PLR was significantly lower in the group with severe disease compared to moderate diseases according to the scoring system of Mor et al (p=0.008). According to ISSF, there was no difference among the groups in terms of CBC parameters.
Conclusion: Different results were obtained according to all three scoring systems. Since the ISSF is the most common and suitable system for use in FMF patients, we can conclude that there is no relationship between disease severity and RDW, RPR, NLR and PLR.

Kaynakça

  • Sönmez HE, Batu ED, Özen S. Familial Mediterranean fever: current perspectives. J Inflamm Res. 2016;9:13-20.
  • Daniels M, Shohat T, Brenner‐Ullman A, Shohat M. Familial Mediterranean fever: high gene frequency among the non‐Ashkenazic and Ashkenazic Jewish populations in Israel. Am J Med Genet. 1995;55(3):311-4.
  • Ozen S, Karaaslan Y, Ozdemir O, Saatci U, Bakkaloglu A, Koroglu E, et al. Prevalence of juvenile chronic arthritis and familial Mediterranean fever in Turkey: a field study. J Rheumatol. 1998;25(12):2445-9.
  • Schnappauf O, Chae JJ, Kastner DL, Aksentijevich I. The pyrin inflammasome in health and disease. Front Immunol. 2019;10:1745.
  • Maggio MC, Corsello G. FMF is not always “fever”: from clinical presentation to “treat to target”. Ital J Pediatr. 2020;46(1):7.
  • Sarı İ, Birlik M, Kasifoğlu T. Familial Mediterranean fever: an updated review. Eur J Rheumatol. 2014;1(1):21-33.
  • Kucuk A, Gezer IA, Ucar R, Karahan AY. Familial Mediterranean fever. Acta Medica (Hradec Kralove). 2014;57(3):97-104.
  • Bilginer Y, Akpolat T, Ozen S. Renal amyloidosis in children. Pediatr Nephrol. 2011;26(8):1215-27.
  • Livneh A, Langevitz P, Zemer D, Zaks N, Kees S, Lidar T, et al. Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum. 1997;40(10):1879-85.
  • Yeşil A, Şenateş E, Bayoğlu IV, Erdem ED, Demirtunç R, Övünç AO. Red cell distribution width: a novel marker of activity in inflammatory bowel disease. Gut Liver. 2011;5(4):460-7.
  • Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17(1):47-58.
  • Kisacik B, Tufan A, Kalyoncu U, Karadag O, Akdogan A, Ozturk MA, et al. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine. 2008;75(3):291-4.
  • Yazici S, Yazici M, Erer B, Erer B, Çalik Y, Bulur S, et al. The platelet functions in patients with ankylosing spondylitis: anti-TNF-α therapy decreases the mean platelet volume and platelet mass. Platelets. 2010;21(2):126-31.
  • Olumuyiwa-Akeredolu OO, Pretorius E. Platelet and red blood cell interactions and their role in rheumatoid arthritis. Rheumatol Int. 2015;35(12):1955-64.
  • Łukasik ZM, Makowski M, Makowska JS. From blood coagulation to innate and adaptive immunity: the role of platelets in the physiology and pathology of autoimmune disorders. Rheumatol Int. 2018;38(6):959-74.
  • Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009;133(4):628-32.
  • Wang L, Cai Q. [Value of red blood cell distribution width-to-platelet count ratio in predicting the prognosis of children with sepsis]. Zhongguo Dang Dai Er Ke Za Zhi. 2019;21(11):1079-83.
  • Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD. The platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases. Ann Lab Med. 2019;39(4):345-57.
  • Qiu L, Chen C, Li SJ, Wang C, Guo F, Peszel A, et al. Prognostic values of red blood cell distribution width, platelet count, and red cell distribution width-to-platelet ratio for severe burn injury. Sci Rep. 2017;7(1):13720.
  • Taefi A, Huang CC, Kolli K, Ebrahimi S, Patel M. Red cell distribution width to platelet ratio, a useful indicator of liver fibrosis in chronic hepatitis patients. Hepatol Int. 2015;9(3):454-60.
  • Cetinkaya E, Senol K, Saylam B, Tez M. Red cell distribution width to platelet ratio: new and promising prognostic marker in acute pancreatitis. World J Gastroenterol. 2014;20(39):14450-4.
  • Pras E, Livneh A, Balow JE Jr, Pras E, Kastner DL, Pras M, et al. Clinical differences between North African and Iraqi Jews with familial Mediterranean fever. Am J Med Genet. 1998;75(2):216-9.
  • Mor A, Shinar Y, Zaks N, Langevitz P, Chetrit A, Shtrasburg S, et al. Evaluation of disease severity in familial Mediterranean fever. Semin Arthritis Rheum. 2005;35(1):57-64.
  • Kalkan G, Demirkaya E, Acikel CH, Polat A, Peru H, Karaoglu A, et al.; FMF Arthritis Vasculitis and Orphan Disease Research in Paediatric Rheumatology (FAVOR). Evaluation of the current disease severity scores in paediatric FMF: is it necessary to develop a new one? Rheumatology (Oxford). 2012;51(4):743-8.
  • Demirkaya E, Acikel C, Hashkes P, Gattorno M, Gul A, Ozdogan H, et al.; FMF Arthritis Vasculitis and Orphan disease Research in pediatric rheumatology (FAVOR). Development and initial validation of international severity scoring system for familial Mediterranean fever (ISSF). Ann Rheum Dis. 2016;75(6):1051-6.
  • Yalçinkaya F, Ozen S, Ozçakar ZB, Aktay N, Cakar N, Düzova A, et al. A new set of criteria for the diagnosis of familial Mediterranean fever in childhood. Rheumatology (Oxford). 2009;48(4):395-8.
  • Lidar M, Scherrmann JM, Shinar Y, Chetrit A, Niel E, Gershoni-Baruch R, et al. Colchicine nonresponsiveness in familial Mediterranean fever: clinical, genetic, pharmacokinetic, and socioeconomic characterization. Semin Arthritis Rheum. 2004;33(4):273-82.
  • Yorulmaz A, Akbulut H, Taş SA, Tıraş M, Yahya İ, Peru H. Evaluation of hematological parameters in children with FMF. Clin Rheumatol. 2019;38(3):701-7.
  • Marzouk H, Mostafa N, Khalifa I, Badawi N, Mohamed Fathy Sabry NI. Red cell distribution width (RDW) as a marker of subclinical inflammation in children with familial Mediterranean fever. Curr Rheumatol Rev. 2020;16(4):298-303.
  • Özer S, Yılmaz R, Sönmezgöz E, Karaaslan E, Taşkın S, Bütün İ, et al. Simple markers for subclinical inflammation in patients with Familial Mediterranean Fever. Med Sci Monit. 2015;21:298-303.
  • Uslu AU, Deveci K, Korkmaz S, Aydin B, Senel S, Sancakdar E, et al. Is neutrophil/lymphocyte ratio associated with subclinical inflammation and amyloidosis in patients with familial Mediterranean fever? Biomed Res Int. 2013;2013:185317.
  • Uluca Ü, Demir F, Ece A, Şen V, Güneş A, Aktar F, et al. Assessment of epicardial adipose tissue thickness and the mean platelet volume in children with familial Mediterranean fever. Ital J Pediatr. 2015;41:15.
  • Jiang S, Liu J, Chen X, Zheng X, Ruan J, Ye A, et al. Platelet-lymphocyte ratio as a potential prognostic factor in gynecologic cancers: a meta-analysis. Arch Gynecol Obstet. 2019;300(4):829-39.
  • Hirahara T, Arigami T, Yanagita S, Matsushita D, Uchikado Y, Kita Y, et al. Combined neutrophil-lymphocyte ratio and platelet-lymphocyte ratio predicts chemotherapy response and prognosis in patients with advanced gastric cancer. BMC Cancer. 2019;19(1):672.
  • Goyal H, Lippi G, Gjymishka A, John B, Chhabra R, May E. Prognostic significance of red blood cell distribution width in gastrointestinal disorders. World J Gastroenterol. 2017;23(27):4879-91.
  • Zvetkova E, Fuchs D. Medical significance of simultaneous application of red blood cell distribution width (RDW) and neopterin as diagnostic/prognostic biomarkers in clinical practice. Pteridines. 2017;28(3-4):133-40.
  • Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2015;52(2):86-105.
  • Chen B, Ye B, Zhang J, Ying L, Chen Y. RDW to platelet ratio: a novel noninvasive index for predicting hepatic fibrosis and cirrhosis in chronic hepatitis B. PloS One. 2013;8(7):e68780.
  • Tecer D, Sezgin M, Kanık A, İncel NA, Çimen ÖB, Biçer A, et al. Can mean platelet volume and red blood cell distribution width show disease activity in rheumatoid arthritis? Biomark Med. 2016;10(9):967-74.
  • Xie S, Chen X. Red blood cell distribution width-to-platelet ratio as a disease activity-associated factor in systemic lupus erythematosus. Medicine (Baltimore). 2018;97(39):e12342.
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Vildan Güngörer 0000-0002-9838-2603

Şükrü  Arslan 0000-0001-5632-8273

Yayımlanma Tarihi 30 Nisan 2022
Gönderilme Tarihi 17 Aralık 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 24 Sayı: 1

Kaynak Göster

APA Güngörer, V., & Arslan, Ş. (2022). Evaluation of the Relationship between Simple Hemogram Indexes and Disease Severity Scores in Pediatric Familial Mediterranean Fever. Duzce Medical Journal, 24(1), 18-25. https://doi.org/10.18678/dtfd.1037824
AMA Güngörer V, Arslan Ş. Evaluation of the Relationship between Simple Hemogram Indexes and Disease Severity Scores in Pediatric Familial Mediterranean Fever. Duzce Med J. Nisan 2022;24(1):18-25. doi:10.18678/dtfd.1037824
Chicago Güngörer, Vildan, ve Şükrü Arslan. “Evaluation of the Relationship Between Simple Hemogram Indexes and Disease Severity Scores in Pediatric Familial Mediterranean Fever”. Duzce Medical Journal 24, sy. 1 (Nisan 2022): 18-25. https://doi.org/10.18678/dtfd.1037824.
EndNote Güngörer V, Arslan Ş (01 Nisan 2022) Evaluation of the Relationship between Simple Hemogram Indexes and Disease Severity Scores in Pediatric Familial Mediterranean Fever. Duzce Medical Journal 24 1 18–25.
IEEE V. Güngörer ve Ş. Arslan, “Evaluation of the Relationship between Simple Hemogram Indexes and Disease Severity Scores in Pediatric Familial Mediterranean Fever”, Duzce Med J, c. 24, sy. 1, ss. 18–25, 2022, doi: 10.18678/dtfd.1037824.
ISNAD Güngörer, Vildan - Arslan, Şükrü . “Evaluation of the Relationship Between Simple Hemogram Indexes and Disease Severity Scores in Pediatric Familial Mediterranean Fever”. Duzce Medical Journal 24/1 (Nisan 2022), 18-25. https://doi.org/10.18678/dtfd.1037824.
JAMA Güngörer V, Arslan Ş. Evaluation of the Relationship between Simple Hemogram Indexes and Disease Severity Scores in Pediatric Familial Mediterranean Fever. Duzce Med J. 2022;24:18–25.
MLA Güngörer, Vildan ve Şükrü Arslan. “Evaluation of the Relationship Between Simple Hemogram Indexes and Disease Severity Scores in Pediatric Familial Mediterranean Fever”. Duzce Medical Journal, c. 24, sy. 1, 2022, ss. 18-25, doi:10.18678/dtfd.1037824.
Vancouver Güngörer V, Arslan Ş. Evaluation of the Relationship between Simple Hemogram Indexes and Disease Severity Scores in Pediatric Familial Mediterranean Fever. Duzce Med J. 2022;24(1):18-25.
Creative Commons Lisansı
Düzce Tıp Fakültesi Dergisi Creative Commons Atıf-GayriTicari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.