Sistemik skleroz ile ilişkili interstisyel akciğer hastalığında siklofosfamid tedavisi öncesi ve sonrası ortalama trombosit hacminin değerlendirilmesi

Yıl 2020, Cilt: 4 Sayı: 8, 682 - 684, 01.08.2020

Nurhan Atilla , Gözde Yıldırım Çetin

https://doi.org/10.28982/josam.736242

Öz

Amaç: Sistemik sklerozlu (SSc) hastalarda yapılan çalışmalar ortalama trombosit hacminin (MPV) SSc ileri evresi ile ilişkili olduğunu göstermiştir. Bununla birlikte, sistemik skleroza sekonder interstisyel akciğer hastalığında (SSc-İAH), siklofosfamid (CP) tedavisinin MPV değeri üzerindeki etkisi bilinmemektedir. Bu çalışmada SSc-İAH'de, CP tedavisine MPV yanıtını araştırmayı amaçladık.
Yöntemler: Bu retrospektif kesitsel çalışmaya CP tedavisinden fayda görmüş 38 SSc-İAH hastası dahil edildi. Tedavi öncesi MPV değerleri ile tedavi sırasında üçüncü, altıncı ve dokuzuncu ayların MPV değerleri karşılaştırıldı.
Bulgular: Dokuz yıllık bir süre içinde hastanemiz romatoloji kliniğinde 82 hastaya SSc tanısı kondu. Hastaların 43’ünde SSc-İAH vardı ve bunların hepsinde 9 ay süre ile CP tedavisi uygulandı. CP'den klinik yarar gören 38 hastanın, 32’si (%84) kadın ve 6’sı (%16) erkek idi. SSc-İAH hastalarında CP tedavisi sonrası MPV düzeyleri (9,44 fL), CP tedavisi öncesine (7,89 fL) göre belirgin yüksek tespit edildi (P=0,001).
Sonuç: Siklofosfamid tedavisi, SSc-İAH'de MPV'de bir artışa neden olmaktadır. Negatif akut faz reaktanı olarak MPV'nin koroner ve periferik arter hastalığı için bağımsız bir risk faktörü olarak kabul edildiği bilinmektedir. Siklofosfamid alan hastalar bu tür hastalıklar için özellikle takip edilmelidir.

Anahtar Kelimeler

Siklofosfamid, Ortalama trombosit volümü, Sistemik skleroz

Evaluation of mean platelet volume before and after cyclophosphamide treatment in systemic sclerosis associated interstitial lung disease

Öz

Aim: Studies carried out in patients with systemic sclerosis (SSc) have shown that mean platelet volume (MPV) is associated with more advanced stage of SSc. However, the effect of cyclophosphamide (CP) on MPV in systemic sclerosis-associated interstitial lung disease (SSc-ILD) is less clear. In this study, we aimed to investigate the MPV response to CP treatment in SSc-ILD.
Methods: Thirty-eight SSc-ILD patients who responded positively to CP were included in this retrospective cohort study. MPV values before the treatment were compared with third, sixth, and ninth months’ values during treatment.
Results: Over the nine-year period, 82 patients were diagnosed with SSc in the rheumatology clinic of our hospital. Forty-three of them had SSc-ILD and all were administered CP treatment for 9 months. Thirty-eight clinically benefited from CP, among which 32 were females (84%) and 6 (16%) were males. The MPV levels in SSc-ILD patients after CP (9.44 fL) were significantly higher than those before CP (7.89 fL) (P=0.001).
Conclusion: Cyclophosphamide treatment causes an increase in MPV in SSc-ILD. MPV, a negative acute phase reactant, is considered an independent risk factor for coronary and peripheral artery diseases. Patients receiving CP should be followed more closely for such diseases.

Anahtar Kelimeler

Cyclophosphamide, Mean platelet volume, Systemic Sclerosis

Kaynakça

• 1. Cappelli S, Bellando Randone S, Camiciottoli G, De Paulis A, Guiducci S, Matucci-Cerinic M. Interstitial lung disease in systemic sclerosis: where do we stand? Eur Respir Rev. 2015;24(137):411-9.
• 2. Gear AR, Camerini D. Platelet chemokines and chemokine receptors: Linking hemostasis, inflammation, and host defense. Microcirculation. 2003;10:335–50.
• 3. Weyrich AS, Lindemann S, Zimmerman GA. The evolving role of platelets in inflammation. Thromand Hematol. 2003;1:1897-905.
• 4. Friedhoff LT, Seibold JR, Kim HC, Simester KS. Serotonin induced platelet aggregation in systemic sclerosis. Clin and Exp Rheu. 1984;2:119-23.
• 5. Postlethwaite AE, Chiang TM. Platelet contributions to the pathogenesis of systemic sclerosis. Cur Opin in Rhe. 2007;19:574-9.
• 6. Giraud B, Hebert G, Deroussent A, Veal GJ, Vassal G, Paci A.Oxazaphosphorines: new therapeutic strategies for an old class of drugs. Expert Opin Drug Metab Toxicol. 2010;6(8):919-38.
• 7. Eren R, Doğu MH, Koç A, Altındal Ş, Yokuş O, Suyanı E. The association of mean platelet volume and platecrit and bone marrow fibrosis in patients with essential thrombocythemia: A cohort study. J Surg Med. 2019;3(2):176-9.
• 8. İnanır M. An investigation of platelet parameters in smoking patients with coronary slow flow detected during coronary angiography. J Surg Med. 2020;4(4):281-4.
• 9. Abanoz M. Predictive value of plateletcrit in the diagnosis of lower extremity deep vein thrombosis. J Surg Med. 2020;4(2):148-51.
• 10. Bıyık İ, Aslan MM, Keskin F. Association between platelet indices and missed abortion. J Surg Med. 2019;3(8):549-52.
• 11. Aksoy S, Kilickap S, Hayran M, Harputluoglu H, Koca E, Dede DS. Platelet size has diagnostic predictive value for bone marrow metastasis in patients with solid tumors. Int J Lab Hematol. 2008;30:214-9.
• 12. Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean platelet volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators of Inflammation. 2019;2019:14.
• 13. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17:47-58.
• 14. Balbaloglu O, Korkmaz M, Yolcu S, Karaaslan F, Beceren NG. Evaluation of mean platelet volume (MPV) levels in patients with synovitis associated with knee osteoarthritis. Platelets. 2014;25(2):81-5.
• 15. 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;75:291-4.
• 16. Gasparyan AY, Sandoo A, Stavropoulos-Kalinoglou A, Kitas GD. Mean platelet volume in patients with rheumatoid arthritis: The effect of anti-TNF-α treatment. Rheumatology International. 2010;30:1125-9.
• 17. Sahin A, Yetisgin A, Sahin M, Durmaz Y, Cengiz AK. Can Mean Platelet Volume be a Surrogate Marker of Inflammation in Rheumatic Diseases? West Indian Med J. 2015;65:165-9.
• 18. Soydinc S, Turkbeyler IH, Pehlivan Y, Soylu G, Goktepe MF, Bilici M et al. Mean Platelet Volume Seems To Be a Valuable Marker in Patients with Systemic Sclerosis Inflammation. 2014;37(1):100-6.