Çocuklarda Akut Skrotumun Ayırıcı Tanısında Tiyol-Disülfid ve İskemi Modifiye Albüminin Rolü

Abstract

Amaç: Akut skrotumun en sık nedenleri arasında yer alan testis torsiyonu, gerçek bir cerrahi acildir. Ancak ileri görüntüleme teknikleri ve laboratuvar tetkiklerine rağmen akut skrotuma neden olan diğer patolojilerden ayırt edilmesi zordur. Bu nedenle, tanıyı doğrulamak için daha spesifik laboratuvar testlerine ihtiyaç vardır. Çalışmada, tiyol-disülfid ve iskemi modifiye albümin (İMA) düzeylerini ölçerek çocuklarda akut skrotumun ayırıcı tanısında bir laboratuvar testinin kullanılabilirliğini araştırmayı amaçladık.

Gereç ve Yöntem: 30’u akut skrotumlu ve 30 sünnet için başvuran sağlıklı erkek çocuk olamk üzere 60 erkek çocuk çalışmaya dahil edildi. Native tiyol (SH), total tiyol (SH+SS), dinamik disülfid (SS), SS/ SH+SS yüzde oranı, albümin ve IMA seviyeleri ölçüldü. Hastaların ameliyat öncesi ve ameliyat sonrası ilk gün kan testi sonuçları karşılaştırıldı.

Bulgular: Akut skrotum grubunda SH (p=0,025), SH+SS (p=0,032), SS (p=0,045), albümin (p0.05).

Sonuç: Tiyol-disülfid dengesi ve IMA düzeylerinin değerlendirilmesi sonucu oksidatif stres lehine değişikliklerin saptanması akut skrotumun ayırıcı tanısında yardımcı olabilir, ancak bu sonuçlar testis torsiyonunu epididimo-orşit tanısından ayırmaya yardımcı olamaz.

Keywords

• Akut skrotum
• çocuklar
• IMA
• tiyol-disülfid

The role of thiol-disulfide and ischemia-modified albumin in the differential diagnosis of acute scrotum in children

Abstract

Aim: Testicular torsion which is the most common cause of acute scrotum, is a real surgical emergency. However, despite imaging techniques and laboratory studies used in the differential diagnosis of pathologies causing acute scrotum, the diagnosis is difficult. Therefore, there is a need for laboratory parameters that confirm the diagnosis of testicular torsion.In our study, we aimed to investigate the usability as a laboratory parameter in the differential diagnosis of acute scrotum causing inflammation in children via thiol-disulfide and ischemia-modified albumin(IMA) levels. Methods: Of 60 children, 30 boys with acute scrotum and 30 healthy boys who were admitted for circumcision were included. The levels of native thiol(-SH), total thiol (SH + SS), dynamic disulfide(SS), dynamic disulfide(SS)/total thiol(SH + SS) % rate, albumin and IMA were measured. Patients’ pre-operative and postoperative first day blood samples’ laboratory findings were also compared. Results: Native thiol(p = 0.025), total thiol(p = 0.032), dynamic disulfide(p = 0.045), albumin(p <0.001) and IMA(p <0.001) levels of the acute scrotum group were significantly higher than controls. IMA levels of epididymo-orchitis subgroup of acute scrotum were found higher than the testicular torsion subgroup. Pre and post-operative laboratory findings of the acute scrotum group were similar (for all variables p>.05). Conclusion: The evaluation of thiol/disulfide homeostasis and IMA levels, and detection of changes in favor of oxidative stress might help in the differential diagnosis of the acute scrotum, but it cannot help to differentiate the testicular torsion from an epididymo-orchitis diagnosis.

Keywords

• Acute scrotum
• Children
• IMA
• Thiol/disulfide

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