A novel approach in the diagnosis and follow-up of sarcoidosis

Aydın Balcı; Suphi Aydın

doi:10.28982/josam.811687

Araştırma Makalesi

Sarkoidozun tanı ve takibinde yeni bir yaklaşım

Yıl 2020, , 1077 - 1081, 01.11.2020

Aydın Balcı , Suphi Aydın

https://doi.org/10.28982/josam.811687

Öz

Amaç: Sarkoidoz, akciğerler ve mediastinal lenf nodları başta olmak üzere tüm organları tutabilen non-kazeifiye granülomların varlığı ile karakterize bir hastalıktır. Yıllardır yapılan araştırmalarda sarkoidoz için spesifik bir biyobelirteç gösterilememiştir. Çalışmamızda, sarkoidoz hastalarında nötrofil-lenfosit oranları (NLO), trombosit-lenfosit oranları (PLR), monosit-lenfosit oranları (MLR), eozinofil-lenfosit oranları (ELR), kan sayım parametreleri arasındaki ilişkiyi araştırmayı ve çıkan sonuçları değerlendirmeyi amaçladık.
Yöntem: Çalışmaya 97 sarkoidoz hastası, 53 kontrol olmak üzere toplam 150 kişi dahil edildi. Veriler geriye dönük olarak kaydedildi. Göğüs röntgeni bulguları yaş, cinsiyet, vücut kitle indeksi, modifiye tıbbi araştırma kavramı (Mmrc) dispne ölçeği ve solunum fonksiyon parametreleri dikkate alınarak analiz edildi. Sarkoidozlu hastalarda kan sayımı, NLR, PLR, MLR, eozinofil / bazofil oranı (EBR) değerlendirildi.
Bulgular: Sarkoidoz hastaları ile kontrol grubunun laboratuvar değerleri karşılaştırıldığında, sarkoidoz hastalarında hemoglobin (g/dl) değeri ve lenfosit sayısı (103 /UL) değerleri, kontrol grubuna göre anlamlı olarak düşük bulundu. Aksine, kırmızı kan hücresi dağılım genişliği standart sapması (RDW SD) (fl), nötrofil sayısı (103 /UL), monosit sayısı (103 /UL), bazofil sayısı (103 /UL), NLR, PLR, MLR değeri sarkoidoz hastalarınında kontrol grubuna göre anlamlı derecede yüksek bulundu. Trombosit (103 /UL), MPV ve EBR değerleri karşılaştırıldığında ise anlamlı bir fark gözlenmedi.
Sonuç: Bu çalışma bize, sarkoidoz hastalarında daha önce kullanılmayan MLR değerinin NLR değeri gibi sarkoidoz tanısında kullanılabilecek önemli bir biyobelirteç olabileceğini göstermiştir.

Anahtar Kelimeler

Sarkoidoz, Lenfadenopati, Monosit, Lenfosit, Akciğer

Kaynakça

1. Soto-Gomez N, Peters JI, Nambiar AM. Diagnosis and Management of Sarcoidosis. Am Fam Physician. 2016;93(10):840-8.
2. Hunninghake GW, Costabel U, Ando M, Baughtman R, Cordier JF, du Bois R et al. ATS/ERS/WASOG statement on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and other Granulomatous Disorders. Sarcoidosis, Vasc Diffus lung Dis Off J WASOG. 1999;16(2):149-73.
3. Baughman RP, Culver DA, Judson MA. A concise review of pulmonary sarcoidosis. Am J Respir Crit Care Med. 2011;183(5):573-81. doi: 10.1164/rccm.201006-0865CI
4. Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the E. Am J Respir Crit Care Med. 1999;160(2):736-55. doi: 10.1164/ajrccm.160.2.ats4-99
5. Jain R, Yadav D, Puranik N, Guleria R, Jin J-O. Sarcoidosis: Causes, Diagnosis, Clinical Features, and Treatments. J Clin Med. 2020;9(4). doi: 10.3390/jcm9041081
6. Sulica R, Teirstein AS, Kakarla S, Nemani N, Behnegar A, Padilla ML. Distinctive clinical, radiographic, and functional characteristics of patients with sarcoidosis-related pulmonary hypertension. Chest. 2005;128(3):1483-9. doi: 10.1378/chest.128.3.1483
7. Baughman RP, Lower EE, Drent M. Inhibitors of tumor necrosis factor (TNF) in sarcoidosis: who, what, and how to use them. Sarcoidosis, Vasc Diffus lung Dis Off J WASOG. 2008;25(2):76-89.
8. Ocal N, Dogan D, Ocal R, Tozkoparan E, Deniz O, Ucar E et al. Effects of radiological extent on neutrophil/lymphocyte ratio in pulmonary sarcoidosis. Eur Rev Med Pharmacol Sci. 2016;20(4):709-14.
9. Yalnız E, Karadeniz G, Üçsular FD, Erbay Polat G, Şahin GV. Predictive value of platelet-to-lymphocyte ratio in patients with sarcoidosis. Biomark Med. 2019;13(3):197-204. doi: 10.2217/bmm-2018-0252
10. Akboga MK, Canpolat U, Yuksel M, Yayla C, Yılmaz S, Turak O et al. Platelet to lymphocyte ratio as a novel indicator of inflammation is correlated with the severity of metabolic syndrome: A single center large-scale study. Platelets. 2016;27(2):178-83. doi: 10.3109/09537104.2015.1064518
11. Liu D, Jin J, Zhang L, Li L, Song J, Li W. The Neutrophil to Lymphocyte Ratio May Predict Benefit from Chemotherapy in Lung Cancer. Cell Physiol Biochem Int J Exp Cell Physiol Biochem Pharmacol. 2018;46(4):1595-605. doi: 10.1159/000489207
12. Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeanger JRH, Brenıtz EA et al. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med. 2001;164(10 Pt 1):1885-9. doi: 10.1164/ajrccm.164.10.2104046
13. Gupta D, Rao VM, Aggarwal AN, Garewal G, Jindal SK. Haematological abnormalities in patients of sarcoidosis. Indian J Chest Dis Allied Sci. 2002;44(4):233-6.
14. Silverstein E, Pertschuk LP, Friedland J. Immunofluorescent localization of angiotensin converting enzyme in epithelioid and giant cells of sarcoidosis granulomas. Proc Natl Acad Sci U S A. 1979;76(12):6646-8. doi: 10.1073/pnas.76.12.6646
15. Lieberman J, Nosal A, Schlessner A, Sastre-Foken A. Serum angiotensin-converting enzyme for diagnosis and therapeutic evaluation of sarcoidosis. Am Rev Respir Dis. 1979;120(2):329-35. doi: 10.1164/arrd.1979.120.2.329
16. Loke WSJ, Herbert C, Thomas PS. Sarcoidosis: Immunopathogenesis and Immunological Markers. Int J chronic Dis. 2013;2013:928601. doi: 10.1155/2013/928601

A novel approach in the diagnosis and follow-up of sarcoidosis

Yıl 2020, , 1077 - 1081, 01.11.2020

Aydın Balcı , Suphi Aydın

https://doi.org/10.28982/josam.811687

Öz

Aim: Sarcoidosis is characterized by the presence of non-caseous granulomas that can involve all organs, especially the lungs and mediastinal lymph nodes. No biomarker investigated in recent years appears to be specific for sarcoidosis. We aimed to investigate and evaluate the relationship between neutrophil-lymphocyte ratios (NLR), platelet-lymphocyte ratios (PLR), monocyte-lymphocyte ratios (MLR), eosinophil-lymphocyte ratios (ELR), and blood count parameters in sarcoidosis patients.
Methods: A total of 150 individuals comprising 97 sarcoidosis patients, and 53 controls, were included in the study. The data were recorded retrospectively. Chest X-ray findings were analyzed with regards to age, gender, body mass index, modified medical research concept (MMRC) dyspnea scale and respiratory function parameters. Blood count, NLR, PLR, MLR, eosinophil/basophil ratio (EBR) were evaluated in patients with sarcoidosis.
Results: Hemoglobin (g/dl) and lymphocyte count (103 /UL) values were significantly lower in sarcoidosis patients, while red blood cell distribution width standard deviation (RDW SD) (fl), neutrophil count (103 /UL), monocyte count (103 /UL), basophil count (103 /UL), NLR, PLR, MLR values were significantly higher compared to the control group. However, platelet (103 /UL), MPV and EBR values were similar.
Conclusion: Our study showed that MLR value, which was not previously used in sarcoidosis patients, is an important biomarker in the diagnosis of sarcoidosis, just as NLR.

Anahtar Kelimeler

Sarcoidosis, Lymphadenopathy, Monocyte, Lymphocyte, Lung

Kaynakça

1. Soto-Gomez N, Peters JI, Nambiar AM. Diagnosis and Management of Sarcoidosis. Am Fam Physician. 2016;93(10):840-8.
2. Hunninghake GW, Costabel U, Ando M, Baughtman R, Cordier JF, du Bois R et al. ATS/ERS/WASOG statement on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and other Granulomatous Disorders. Sarcoidosis, Vasc Diffus lung Dis Off J WASOG. 1999;16(2):149-73.
3. Baughman RP, Culver DA, Judson MA. A concise review of pulmonary sarcoidosis. Am J Respir Crit Care Med. 2011;183(5):573-81. doi: 10.1164/rccm.201006-0865CI
4. Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the E. Am J Respir Crit Care Med. 1999;160(2):736-55. doi: 10.1164/ajrccm.160.2.ats4-99
5. Jain R, Yadav D, Puranik N, Guleria R, Jin J-O. Sarcoidosis: Causes, Diagnosis, Clinical Features, and Treatments. J Clin Med. 2020;9(4). doi: 10.3390/jcm9041081
6. Sulica R, Teirstein AS, Kakarla S, Nemani N, Behnegar A, Padilla ML. Distinctive clinical, radiographic, and functional characteristics of patients with sarcoidosis-related pulmonary hypertension. Chest. 2005;128(3):1483-9. doi: 10.1378/chest.128.3.1483
7. Baughman RP, Lower EE, Drent M. Inhibitors of tumor necrosis factor (TNF) in sarcoidosis: who, what, and how to use them. Sarcoidosis, Vasc Diffus lung Dis Off J WASOG. 2008;25(2):76-89.
8. Ocal N, Dogan D, Ocal R, Tozkoparan E, Deniz O, Ucar E et al. Effects of radiological extent on neutrophil/lymphocyte ratio in pulmonary sarcoidosis. Eur Rev Med Pharmacol Sci. 2016;20(4):709-14.
9. Yalnız E, Karadeniz G, Üçsular FD, Erbay Polat G, Şahin GV. Predictive value of platelet-to-lymphocyte ratio in patients with sarcoidosis. Biomark Med. 2019;13(3):197-204. doi: 10.2217/bmm-2018-0252
10. Akboga MK, Canpolat U, Yuksel M, Yayla C, Yılmaz S, Turak O et al. Platelet to lymphocyte ratio as a novel indicator of inflammation is correlated with the severity of metabolic syndrome: A single center large-scale study. Platelets. 2016;27(2):178-83. doi: 10.3109/09537104.2015.1064518
11. Liu D, Jin J, Zhang L, Li L, Song J, Li W. The Neutrophil to Lymphocyte Ratio May Predict Benefit from Chemotherapy in Lung Cancer. Cell Physiol Biochem Int J Exp Cell Physiol Biochem Pharmacol. 2018;46(4):1595-605. doi: 10.1159/000489207
12. Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeanger JRH, Brenıtz EA et al. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med. 2001;164(10 Pt 1):1885-9. doi: 10.1164/ajrccm.164.10.2104046
13. Gupta D, Rao VM, Aggarwal AN, Garewal G, Jindal SK. Haematological abnormalities in patients of sarcoidosis. Indian J Chest Dis Allied Sci. 2002;44(4):233-6.
14. Silverstein E, Pertschuk LP, Friedland J. Immunofluorescent localization of angiotensin converting enzyme in epithelioid and giant cells of sarcoidosis granulomas. Proc Natl Acad Sci U S A. 1979;76(12):6646-8. doi: 10.1073/pnas.76.12.6646
15. Lieberman J, Nosal A, Schlessner A, Sastre-Foken A. Serum angiotensin-converting enzyme for diagnosis and therapeutic evaluation of sarcoidosis. Am Rev Respir Dis. 1979;120(2):329-35. doi: 10.1164/arrd.1979.120.2.329
16. Loke WSJ, Herbert C, Thomas PS. Sarcoidosis: Immunopathogenesis and Immunological Markers. Int J chronic Dis. 2013;2013:928601. doi: 10.1155/2013/928601

Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Cerrahi
Bölüm	Araştırma makalesi
Yazarlar	Aydın Balcı 0000-0002-6723-2418 Suphi Aydın 0000-0003-2102-0484
Yayımlanma Tarihi	1 Kasım 2020
Yayımlandığı Sayı	Yıl 2020

Kaynak Göster

APA	Balcı, A., & Aydın, S. (2020). A novel approach in the diagnosis and follow-up of sarcoidosis. Journal of Surgery and Medicine, 4(11), 1077-1081. https://doi.org/10.28982/josam.811687
AMA	Balcı A, Aydın S. A novel approach in the diagnosis and follow-up of sarcoidosis. J Surg Med. Kasım 2020;4(11):1077-1081. doi:10.28982/josam.811687
Chicago	Balcı, Aydın, ve Suphi Aydın. “A Novel Approach in the Diagnosis and Follow-up of Sarcoidosis”. Journal of Surgery and Medicine 4, sy. 11 (Kasım 2020): 1077-81. https://doi.org/10.28982/josam.811687.
EndNote	Balcı A, Aydın S (01 Kasım 2020) A novel approach in the diagnosis and follow-up of sarcoidosis. Journal of Surgery and Medicine 4 11 1077–1081.
IEEE	A. Balcı ve S. Aydın, “A novel approach in the diagnosis and follow-up of sarcoidosis”, J Surg Med, c. 4, sy. 11, ss. 1077–1081, 2020, doi: 10.28982/josam.811687.
ISNAD	Balcı, Aydın - Aydın, Suphi. “A Novel Approach in the Diagnosis and Follow-up of Sarcoidosis”. Journal of Surgery and Medicine 4/11 (Kasım 2020), 1077-1081. https://doi.org/10.28982/josam.811687.
JAMA	Balcı A, Aydın S. A novel approach in the diagnosis and follow-up of sarcoidosis. J Surg Med. 2020;4:1077–1081.
MLA	Balcı, Aydın ve Suphi Aydın. “A Novel Approach in the Diagnosis and Follow-up of Sarcoidosis”. Journal of Surgery and Medicine, c. 4, sy. 11, 2020, ss. 1077-81, doi:10.28982/josam.811687.
Vancouver	Balcı A, Aydın S. A novel approach in the diagnosis and follow-up of sarcoidosis. J Surg Med. 2020;4(11):1077-81.