Çocukluk Çağı Tüberkülozunu Toplum Kaynaklı Pnömoniden Ayırmada Yeni Parametreler Arayışı - Mümkün mü?

Öz

Giriş: Nötrofil-lenfosit oranı (NLO) ve monosit-lenfosit oranı (MLO), bakteriyemi, hastalık aktivitesi, nüks oranı, sürveyans ve prognozu değerlendirmek için birçok hastalıkta kullanılan yararlı inflamasyon biyobelirteçleridir. Amaç: Bu çalışmanın amacı akciğer tüberkülozu olan çocukların TKP'den ayırıcı tanısında NLO ve MLO' nı değerlendirmektir. Gereç ve Yöntemler: Haziran 2016 ile Aralık 2018 tarihleri ​​arasında Çocuk Enfeksiyon Hastalıkları Servisi'nde akciğer tüberkülozu olan 50 çocuğun hastane kayıtlarını incelenerek NLO ve MLO değerleri 50 TKP ve 50 sağlıklı çocuk ile karşılaştırıldı. Ayrıca; tüberküloz ve TKP grubu arasında eritrosit sedimantasyon hızı (ESR) ve C-reaktif protein değerleri (CRP) karşılaştırıldı. Bulgular: 3 grup karşılaştırıldığında, 3 grup arasında NLO ve MLO değerleri arasında anlamlı fark vardı. İkili karşılaştırmalarda, sağlıklı kontrollere karşı tüberküloz ve TKP ile sağlıklı kontroller arasında NLO ve MLO değerleri arasında anlamlı fark vardı. Ancak tüberküloz ve TKP grupları arasında NLO, MLO değerleri arasında anlamlı bir fark yoktu. Sonuç: Bu çalışma, çocukluk çağı tüberküloz ayırıcı tanısında NLO ve MLO'nı değerlendiren ilk çalışmadır. NLO ve MLO değerleri, hem akciğer tüberkülozu hem de TKP'de ayrı ayrı iyi birer inflamasyon biyobelirteci olmasına rağmen, çocuklarda tüberkülozu TKP'den ayırmada beklendiği kadar yararlı değildir.

Anahtar Kelimeler

• tüberküloz
• toplum kaynaklı pnömoni
• çocuk
• notrofil lenfosit oranı
• monosit lenfosit oranı

Seeking New Parameters In Differentiating Child Tuberculosis From Community Acquired Pneumonia- Is It Possible?”

Öz

Abstract Background: The neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio(MLR) are useful biomarkers of inflammation used in many diseases to evaluate bacteremia, disease activity, recurrence rate, surveillance and prognosis. Objective: Aim of this study was to evaluate NLR and MLR in the differential diagnosis of children with pulmonary tuberculosis disease from CAP. Materials and Methods: I reviewed hospital-records of 50 children with pulmonary tuberculosis disease in the Pediatric Infectious Disease Ward between June 2016 and December 2018, and compared; NLR and MLR with 50 CAP and 50 healthy children. Also; erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) were compared between the tuberculosis and CAP group. Results: When 3 groups were compared there was significant difference among NLR and MLR values between 3 groups. In pairwise-comparisons, there was significant difference among NLR and MLR values between tuberculosis versus healthy controls, and CAP versus healthy controls. However, there was no significant difference among NLR, MLR values between tuberculosis versus CAP groups. Conclusion: This study is unique that evluates NLR and MLR in tuberculosis differentiation. Although NLR and MLR values are useful biomarkers of inflammation in both pulmonary tuberculosis and CAP seperately, they’re not as useful as expected in differentiating tuberculosis from CAP in children.

Anahtar Kelimeler

• tuberculosis
• community acquired pneumonia
• child
• neutrophil to lymphocyte ratio
• monocyte to lymphocyte ratio

Kaynakça

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