EOZİNOFİLİ SAPTANAN ÇOCUK VAKALARDA ETİYOLOJİK FAKTÖRLERİN DEĞERLENDİRİLMESİ

Öz

Amaç: Eozinofili dokularda ve/veya kanda eozinofillerin artması olarak tanımlanır. Periferik kanda eozinofil sayısının artması alerjik, enfeksiyöz, otoimmün ve malign hastalıkların ayırıcı bir özelliği ya da eşlik eden bulgusu olabilir. Çalışmamızda eozinofilisi olan çocuk hastaların etiyolojik faktörler açısından taranması amaçlanmıştır. Gereç ve Yöntemler: Kırıkkale Üniversitesi Tıp Fakültesi Çocuk Alerji ve İmmünoloji Polikliniğine Şubat 2020-Kasım 2021 tarihleri arasında başvuran ve tam kan sayımında eozinofili saptanan 1 ay-18 yaş arasındaki tüm hastaların elektronik dosyaları geriye dönük olarak incelendi. Tam kan sayımı ölçümünde periferik kan mutlak eozinofil sayısı ≥500 hücre/μL olması eozinofili olarak kabul edildi. Hastaların demografik verileri, klinik bulguları ve tetkik sonuçları retrospektif olarak değerlendirildi. Bulgular: Çalışmaya dahil edilen 176 hastanın 104’ü (%59.1) erkek olup, ortanca yaş 4.1 (0.6-8.9) [ortanca (çeyrekler arası aralık)] yıl idi. Hastaların 68’inde (%38.6) alerjik rinit, 51’inde (%28.9) atopik dermatit, 44’ünde (%25.0) astım ve 41’inde (%23.2) besin alerjisi vardı. Deri prik testi yapılan 113 hastanın 72’sinde (%63.7) alerjik duyarlanma saptandı. Alerjik duyarlanma saptanan hastalarda en sık polen (%43.0) ve besin duyarlılığı (%45.8) olduğu görüldü. Laboratuvar tetkiklerinde ortanca eozinofil sayısı 720/μL (580-1050), total IgE düzeyi 99.0 IU/mL (20.8-272) saptandı. Hastaların 25’inde (%14.2) en az bir immünglobülin düzeyinde düşüklük saptandı. Üç hastada (%1.7) paraziter hastalık mevcuttu. Sonuç: Alerjik hastalıklar eozinofilinin önemli nedeni olmakla birlikte paraziter hastalıklar, immün yetmezlikler gibi altta yatan birçok hastalıkta eozinofili görülebilir. Kapsamlı öykü ve klinik değerlendirme ayırıcı tanıda önemlidir.

Anahtar Kelimeler

• Alerjik hastalık
• çocuk
• eozinofili
• parazit
• periferik kan

Evaluation of Etiological Factors in Pediatric Cases with Eosinophilia

Öz

Objective: Eosinophilia is an increase in eosinophils in tissues and/or blood. Increased number of eosinophils in peripheral blood may be a differential feature or an accompanying finding of allergic, infectious, autoimmune, and malignant diseases. In our study, we aimed to screen pediatric patients with eosinophilia in terms of etiological factors. Material and Methods: The electronic files of all patients between the ages of 1 month and 18 years who were admitted to Kırıkkale University Faculty of Medicine, Pediatric Allergy and Immunology Outpatient Clinic between February 2020 and November 2021 and who were found to have eosinophilia in complete blood count were retrospectively analysed. A peripheral blood absolute eosinophil count of ≥500 cells/μL in the complete blood count measurement was considered eosinophilia. Demographic data, clinical findings and results of investigations were analysed retrospectively. Results: Of the 176 patients included in the study, 104 (59.1%) were male and the median age was 4.1 (0.6-8.9) [median (interquartile range)] years. Allergic rhinitis was present in 68 (38.6%), atopic dermatitis in 51 (28.9%), asthma in 44 (25.0%) and food allergy in 41 (23.2%) patients. Allergic sensitization was detected in 72 (63.7%) of 113 patients who underwent skin prick testing. The most common allergic sensitisation was pollen (43.0%) and food sensitisation (45.8%). The median eosinophil count was 720/μL (580-1050) and the total IgE level was 99.0 IU/mL (20.8-272). Low levels of at least one immunoglobulin were found in 25 patients (14.2%). Three patients (1.7%) had parasitic disease. Conclusion: Although allergic diseases are important causes of eosinophilia, eosinophilia can be seen in many underlying diseases such as parasitic diseases and immunodeficiencies. Comprehensive history and clinical evaluation are important in the differential diagnosis.

Anahtar Kelimeler

• Allergic disease
• child
• eosinophilia
• parasite
• peripheral blood

Kaynakça

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