İlaç kullanmayan ve komorbı̇dı̇tesı̇z çocukluk çağı obsesı̇f kompulsı̇f bozukluğunda serum enflamatuar parametrelerı̇nı̇n değerlendı̇rı̇lmesı̇

Öz

Amaç: Obsesif ve kompulsif bozukluğun etiyopatogenezinde inflamatuar süreçlerin olası rolüne ilişkin veriler giderek artmaktadır. Bu verilere dayanarak yaptığımız bu çalışmada, obsesif kompulsif bozukluğu olan çocuk ve ergenlerde serum inflamatuar parametrelerini değerlendirmeyi, sonuçları sağlıklı kontrollerle karşılaştırmayı ve bu parametreler ile bozukluğun şiddeti arasındaki ilişkiyi değerlendirmeyi amaçladık. Yöntem: DSM-V tanı kriterlerine göre komorbid bozukluğu olmaksızın obsesif kompulsif bozukluk tanısı alan çocuk ve ergenlerde beyaz kan hücresi sayısı, ferritin, c-reaktif protein (CRP), prokalsitonin, interlökin 1 (IL-1), interlökin 2 (IL-2), interlökin 6 (IL-6), interlökin 8 (IL-8), interlökin 10 (IL-10) ve tümör nekroz faktörü-alfa (TNF- α) düzeyleri incelenmiş ve sonuçlar sağlıklı çocuk ve ergenlerden elde edilen sonuçlarla karşılaştırılmıştır. Ayrıca, çalışmaya dahil edilen tüm bireylere Yale-Brown Obsesif Kompulsif Bozukluk Ölçeği uygulanmış ve saptanan inflamatuvar parametre düzeyleri ile çalışma grubunun semptom şiddeti arasındaki ilişki değerlendirilmiştir. Bulgular: Gruplar arasında sosyodemografik farklılık bulunmadı. Diğer parametreler açısından gruplar arasında anlamlı bir fark bulunmazken, IL-10 düzeyleri hasta grubunda anlamlı olarak daha yüksekti. Semptom şiddeti ile herhangi bir parametre arasında ilişki bulunmadı. Ferritin seviyeleri gruplar arasında farklılık göstermezken, demir eksikliğini gösteren düşük ferritin seviyelerinin tespit edilme oranı hasta grubunda daha yüksekti ve bu fark istatistiksel olarak anlamlıydı. Ayrıca, OKB hastalarının ferritin düzeyleri ile kompulsiyon skorları arasında negatif bir korelasyon bulunmuştur. Sonuç: Bu çalışmanın sonuçları, OKB etyolojisinde olası inflamasyon durumunu saptamak için beyaz kan hücresi sayımı, CRP ve prokalsitonin düzeylerinin kullanılabilirliğini desteklememektedir. Bu çalışma, serum sitokin seviyelerindeki değişikliklerin etiyolojik değerlendirme için önemli olabileceğini ortaya koyacak daha ileri çalışmalara duyulan ihtiyacı yinelemiştir. Öte yandan, literatürde OKB hastalarında demir eksikliğinin sağlıklı bireylere göre daha fazla görülebileceğini ve bu durumun OKB'nin şiddetini artırabileceğini gösteren ilk çalışmadır. Dolayısıyla, demir eksikliği OKB'nin semptom şiddetini etkileyebilir, bu alanda daha fazla çalışmaya ihtiyaç vardır.

Anahtar Kelimeler

• obsesif-kompulsif bozukluk
• çocuk ve ergen
• ferritin
• prokalsitonin
• inflamasyon

Evaluataion of serum inflammatory parameters in drug naive comorbidity free childhood obsessive compulsive disorder

Öz

Aim: There is growing data on the possible role of inflammatory processes in the etiopathogenesis of obsessive and compulsive disorder (OCD). In this study based on these data, we aimed to evaluate serum inflammatory parameters in children and adolescents with the OCD, compare results with healthy controls, and evaluate the relationship between these parameters and the severity of the disorder. Method: The number of white blood cell counts, ferritin, c-reactive protein (CRP), procalcitonin, interleukin 1(IL-1), interleukin 2 (IL-2), interleukin 6 (IL-6), interleukin 8 (IL-8), interleukin 10 (IL-10) and tumor necrosis factor-alpha (TNF- α) levels were studied in children and adolescents with the OCD without comorbid disorder and the results were compared with the results from the healthy children and adolescents. Also, the relationship between levels of inflammatory parameters and the symptom severity of OCD was evaluated. Results: No sociodemographic differences were found between groups. While no significant difference was found between the groups in terms of other parameters, IL-10 levels were significantly higher in the patient group. No relation was found between symptom severity and any parameters. While ferritin levels did not show any difference between the groups, the rate of detection of low ferritin levels that show iron deficiency was higher in the patient group and this difference was statistically significant. Furthermore, a negative correlation was found between ferritin levels and compulsion scores of OCD patients. Conclusion: The results of this study do not support the availability of white blood cell count, CRP, and procalcitonin levels to detect possible inflammation status in the etiopathogenesis of OCD. This study reiterated the need for further studies to evoluate changes in serum cytokine levels may be important for the etiological evaluation. On the other hand, it is the first study in the literature showing that iron deficiency may be seen more in OCD patients than healthy individuals and this may increase the severity of OCD. Thus, iron deficiancy may effect the symptom severity of OCD, further studies are needed on this area.

Anahtar Kelimeler

• Obsessive-compulsive disorder
• child and adolescent
• ferritin
• procalcitonin
• inflammation

Kaynakça

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