Bipolar Bozukluk ve Romatoid Artrit İlişkisi

Öz

Romatoid artrit, sinovit, sistemik inflamasyon, artrit ve vaskülit, anemi, mononörit, pulmoner fibrozis gibi eklem dışı sistem tutulumu ile karakterize olan zamanında ve yeterli tedavi edilmezse eklem destruksiyonuna, eklem hareketlerinin kısıtlanmasına, hastanın yaşam kalitesinin bozulmasına neden olabilecek kronik bir otoimmün hastalıktır. Romatoid artrit hastalarında eklem bulgularının yanı sıra klinik tabloya bilişsel işlev bozukluğu, davranış değişiklikleri ve duygudurum değişiklikleri gibi nöropsikiyatrik belirtiler de eşlik edebilir. Romatoid artrit hastalarında nöroinflamatuar sürecin, plazmadaki proinflamatuar sitokin düzeylerinde artışın, uzun süre kullanılan ilaçların yan etkilerinin, hastalıkla birlikte oluşan yeti yitiminin ve olası ortak gen bölgelerinin bu belirtilere neden olabileceği düşünülmektedir. Romatoid artrit hastalarında psikiyatrik semptom ve bozukluklarla ilgili giderek artan sayıda çalışmalar yayınlanmaktadır. Özellikle anksiyete bozuklukları ve major depresif bozukluk ile ilişkisine odaklanan birçok çalışma mevcuttur. Bipolar bozukluk etiyolojisinde immün fonksiyonlarda bozulmanın yer aldığına ilişkin giderek artan sayıda çalışma bulunmaktadır. Bipolar bozukluk hastalarının plazmalarında sitokin düzeylerinde değişiklikler görülmesi bu görüşü destekler niteliktedir. Çeşitli otoimmün hastalıklarla bipolar bozukluk arasındaki ilişki baraştırılmaya devam edilmektedir. Romatolojik hastalığı olan bireylerde, psikiyatrik eş tanılar açısından dikkatli olunması hastaların tedaviye uyumu ve klinik seyir açısından önemlidir.

Anahtar Kelimeler

• romatoid artrit
• inflamasyon
• psikonöroimmünoloji
• bipolar bozukluk

Relationship between Bipolar Disorder and Rheumatoid Arthritis

Abstract

Rheumatoid arthritis is a chronic autoimmune disease that is characterized by synovitis, systemic inflammation, arthritis and vasculitis, anemia, mononeuritis, pulmonary fibrosis, and can cause joint destruction, limitation of joint movements and impairment of the patient's quality of life if not treated in right time and adequate manner. In addition to joint symptoms, neuropsychiatric symptoms such as cognitive dysfunction, behavioral changes, and mood changes may accompany rheumatoid arthritis patients. It is thought that neuroinflammatory process in rheumatoid arthritis patients, increase in proinflammatory cytokine levels in plasma; side effects of drugs used for a long time, disability that occurs with the disease, and possible common gene regions may cause these symptoms. An increasing number of studies are being published on psychiatric symptoms and disorders in patients with rheumatoid arthritis. There are many studies focusing especially on its relationship with anxiety disorders and major depressive disorder. There are increasing numbers of studies showing that the impairment of immune functions is involved in the etiology of bipolar disorder. The changes in cytokine levels in the plasma of bipolar disorder patients supports this argument. The relationship between various autoimmune diseases and bipolar disorder continues to be examined. In people with rheumatological diseases, it is important to be careful in psychiatric comorbidities in terms of patient compliance and clinical course.

Keywords

• rheumatoid arthritis
• inflammation
• psychoneuroimmunology
• bipolar disorder

Kaynakça

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