Akut tonsillit hastalarında hızlı antijen tarama testi sonuçları ile laboratuvar bulgularının karşılaştırılması

Yıl 2018, Cilt: 10 Sayı: 2, 89 - 92, 01.06.2018

Ömer Hızlı , Cengiz Sivrikaya Hakan Ulusoy Zeynep Alev Sarısoy Ahmet Burçin Sarısoy Güven Yıldırım , Kürşat Murat Özcan

https://doi.org/10.21601/ortadogutipdergisi.376703

Öz

Amaç: Akut tonsillit hastalarında
etkeni saptamada hızlı antijen testinin öneminin ortaya konulması
amaçlanmıştır.

Gereç ve Yöntem: Polikliniğimize boğaz ağrısı ve
yüksek ateş şikâyetleriyle başvurup muayene sonucunda ‘akut tonsillofarenjit’
tanısı alan 36 hastaya poliklinik şartlarında hızlı antijen tarama testi
yapıldı, ardından tam kan sayımı, sedimantasyon hızı ve c-reaktif protein
düzeyleri tespit edildi. Hastalar hızlı antijen testi pozitifliğine göre iki
gruba ayrılarak iki grubun ortalama beyaz küre, c-reaktif protein, eritrosit
sedimantasyon hızı, nötrofil- lenfosit oranı ve platelet- lenfosit oranı
değerleri istatistiksel olarak karşılaştırdı.

Bulgular: Hızlı antijen tarama testi 18
hastada negatif iken 18 hastada pozitif bulundu. Hızlı antijen testi pozitif olanlarda ortalama beyaz küre, c-reaktif protein, eritrosit sedimantasyon
hızı, nötrofil- lenfosit oranı ve platelet- lenfosit oranı değerleri sırasıyla
11400± 4100/µlt, 6,1± 4,5 mg/dL, 25,1 ±18 mm/dk, 4,93 ± 2,72 ve 130,6 ±67,2 olarak
bulundu. Negatif olan grupta sırasıyla 11800± 3200/µlt, 7,2± 6 mg/dL, 15 ±8
mm/dk, 5,55 ±3,65 ve 135,3 ±37,2 olarak bulundu. İki grup arasında beyaz küre, c-reaktif
protein, eritrosit sedimantasyon hızı, nötrofil lenfosit oranı ve platelet
lenfosit oranı ortalamaları açısından anlamlı fark saptanmadı (p>0,05).

Sonuç: Hızlı antijen tarama testinin
pozitif veya negatif olması laboratuvar değerleri ile ilişkilendirilememiş
olup, inflamasyon göstergesi olan laboratuvar bulguları viral kaynaklı tonsillit
hastalarında da yükselebilmektedir. 

Anahtar Kelimeler

Hızlı antijen, tonsillit, antibiyotik, nötrofil-lenfosit oranı

Comparison of rapid antigen detecting test results with laboratory analysis results in patients with acute tonsillitis

Öz

Aim:
To reveal the importance of rapid antigen test in
detecting the agent in the patients with acute tonsillitis.

Material
and Method: We performed rapid antigen tests on 36 patients with
the complaints of sore throat and fever, who were diagnosed as ‘acute tonsillopharyngitis’
regarding the physical examination results. Then we noted the complete blood
count values with c- reactive protein levels and erythrocyte sedimentation
rates of all patients. We divided the patients into two groups according to the
rapid antigen test results and statistically compared the mean white blood
cell, c- reactive protein levels, erythrocyte sedimentation rates, neutrophil- lymphocyte
ratios and platelet- lymphocyte ratios of two groups.

Results:
Rapid antigen test was positive in 18 patients and
negative in 18 patients. The mean white blood cell, c- reactive protein,
erythrocyte sedimentation rate, neutrophil- lymphocyte ratio and platelet- lymphocyte
ratio levels were 11400± 4100/µlt, 6.1± 4.5 mg/dL, 25.1 ±18 mm/min, 4.93 ± 2.72
and 130.6 ±67.2 in positive test group and 11800± 3200/µlt, 7.2± 6 mg/dL, 15 ±8
mm/min, 5.55 ±3.65 and 135.3 ±37.2 in negative test group respectively. The
mean white blood cell, c- reactive protein levels, erythrocyte sedimentation
rates, neutrophil- lymphocyte ratios and platelet- lymphocyte ratios did not
significantly differ between the groups (p>0,05).

Conclusion:
Rapid antigen test results were not associated with
laboratory blood analysis results and inflammation markers may be elevated even
in viral infections.

 

Anahtar Kelimeler

Rapid antigen, tonsillitis, antibiotic, neutrophil-lymphocyte ratio

Kaynakça

• 1. Şahin GÖ, Akova M. Erişkinlerde Tonsillofarenjitler. In: Kaya S (ed) Tonsil. Ankara: Bilimsel Tıp Yayınevi; 2005: 152-165.
• 2. Bisno AL, Gerber MA, Gwaltney JM, Jr. et al. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Infectious Diseases Society of America. Clin Infect Dis 2002; 35: 113-125.
• 3. Cohen JF, Cohen R, Bidet P et al. Efficiency of a clinical prediction model for selective rapid testing in children with pharyngitis: A prospective, multicenter study. PLoS One 2017; 12: e0172871.
• 4. Shaikh N, Leonard E, Martin JM. Prevalence of streptococcal pharyngitis and streptococcal carriage in children: a meta-analysis. Pediatrics 2010; 126: e557-564.
• 5. Meyer A. Pediatric infectious diseases. In: Flint PW, Haughey BH, Lund VJ et al. (eds). Cummings otolaryngology head & neck surgery, 6th Edition. Philedelphia: Elsevier Saunders; 2015: 3045-3054.
• 6. Cohen JF, Cohen R, Bidet P et al. Rapid-antigen detection tests for group a streptococcal pharyngitis: revisiting false-positive results using polymerase chain reaction testing. J Pediatr 2013; 162: 1282-1284, 1284.e1281.
• 7. Atan D, Ikinciogullari A, Koseoglu S et al. New Predictive Parameters of Bell's Palsy: Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio. Balkan Med J 2015; 32: 167-170.
• 8. Kum RO, Ozcan M, Baklaci D et al. Elevated neutrophil-to-lymphocyte ratio in squamous cell carcinoma of larynx compared to benign and precancerous laryngeal lesions. Asian Pac J Cancer Prev 2014; 15: 7351-7355.
• 9. Sahin C, Varim C, Uyanik M. USE OF NEUTROPHILS TO LYMPHOCYTES RATIO AS AN INFLAMMATION MARKER IN PATIENTS WITH CHRONIC TONSILLITIS. Georgian Med News 2016; 62-65.
• 10. Bisno AL. Acute pharyngitis. N Engl J Med 2001; 344: 205-211.
• 11. Gerber MA, Baltimore RS, Eaton CB et al. Prevention of rheumatic fever and diagnosis and treatment of acute Streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation 2009; 119: 1541-1551.
• 12. McIsaac WJ, Kellner JD, Aufricht P et al. Empirical validation of guidelines for the management of pharyngitis in children and adults. JAMA 2004; 291: 1587-1595.
• 13. Shulman ST, Bisno AL, Clegg HW et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis 2012; 55: e86-102.