SİSTEMİK SKLEROZDA PLAZMA HOMOSİSTEİN DÜZEYLERİ VE PULMONER BULGULARIN DEĞERLENDİRİLMESİ

Öz

Sistemik skleroz, deri ve iç organ fıbrozisi ve mikrovasküler hasar yanında imünolojik anormallikler ile karakterize, bir multisistem bağ dokusu hastalığıdır. Hastalığın klinik gidişatı ve organ tutulumu oldukça değişkendir. Akciğerlerde parankimal fibrozis ya da pulmoner hipertansiyon ile giden pulmoner tutulum sıklıkla karşımıza çıkar ve belirgin mortalite ve morbidite ile seyreder. Hiperhomosisteinemi, koroner, serebral ve periferik vasküler hastalıklar için modifiye edilebilir bağımsız bir risk faktörüdür. Biz de bu çalışmada, sistemik sklerozlu hastalarımızın genel özellikleri, akciğer tutulumları ile plazma homosistein düzeyleri ile homosisteinin akciğer tutulumu üzerine etkisini araştırdık. Bu çalışmaya sistemik skleroz tanısı ile Ankara Üniversitesi Tıp Fakültesi Klinik İmmünoloji ve Romatoloji Bilim Dalı’na başvuran 29 hasta ile 16 sağlıklı kontrol grubu alınmıştır. Toplam 29 hastanın 12’si (%41.6) sınırlı tutulumlu,17’si (%%58.6) diffüz tutulumlu idi. 29 hastanın 6’sında pulmoner tutulum saptanamazken, 14’ünde hafif-orta, 9’ unda ileri-son dönem pulmoner tutulum saptandı. Hastalarla kontrol grubunun plazma homosistein ve kan yağları ile kolesterol düzeyleri arasında anlamlı bir fark bulunamadı. Sistemik skleroz organ tutulumları, özellikle akciğer tutulumu ile giden, prognozu kötü olabilen bir romatizmal hastalıktır. Sistemik sklerozda hiperhomosisteinemi değişik mekanizmalarla hastalık gidişatını kötüleştiren bir faktör olabilir. Homosisteinin sistemik sklerozda akciğer tutulumu üzerine etkisini gösterecek prospektif geniş çaplı vaka kontrol çalışmalarına ihtiyaç vardır. Dr. Şükran ERTEN, Dr. Orhan KÜÇÜKŞAHİN, Dr. Ali ŞAHİN, Dr. Murat TURGAY

Anahtar Kelimeler

• Sistemik Skleroz
• Organ Tutulumu
• Hiperhomosisteinemi

PLASMA HOMOCYSTEIN LEVELS AND EVALUATION OF PULMONARY FUNCTIONS IN SYSTEMIC SCLEROSIS

Öz

Systemic sclerosis is a multisystem connective tissue disease, characterized by immunulogic abnormalities besides the skin and internal organ fibrosis. The progress and organ involvement of the disease varies. Pulmonary involvement presenting as parenchymal disease of the lungs or pulmonary hypertension is frequently seen and causes severe morbidity and mortality. Hyperhomocysteinemia, is a independant modifiable risk factor for coronary, cerebral and peripheral vascular diseases. In the presenting study, we evaluated the general findings, lung involvement and plasma homocystein levels of systemic sclerosis patients. This study included 29 patients attending to Ankara University Faculty of Medicine Department of Clinic Immunology and Rheumatology and 16 healthy control cases. Of 29 patients, 12 patients had limited and 17 patients have diffuse form of the disease. Of 29 patients, 6 patients had no pulmonary involvement, 14 patients had mild to moderate and 9 patients had severe or end-stage pulmonary involvement. There was no significant differences between plasma homocystein and cholesterol and triglyceride levels. Systemic sclerosis is a multisystem disease that may affect the organs especially the lung with a worse prognosis. Hyperhomocysteinemia may worsen the disease prognosis with different mechanisms. Prospective case control studies with large sample size are needed to show the effect of homocysteine on lung involvement in systemic sclerosis.

Anahtar Kelimeler

• systemic sclerosis
• organ involvement
• hyperhomocysteinemia

Kaynakça

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