Göðüs Hastanesi Dergisi. 2004; 18(1): 11-17

SARKOIDOZDA EVRELERE GÖRE KLÝNÝK VE LABORATUVAR PARAMETRELERDEKÝ DEÐÝÞÝKLÝKLER

Ahmet Emin ERBAYCU¹, M. Þevket DERELݹ, Ayþe ÖZSÖZ¹, Iþýl KARASU¹, Aydan ÇAKAN¹
Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý ve Tüberküloz Kliniði, Ýzmir

Sarkoidoz öncelikle akciðer ve lenfatik sistemleri etkileyen bir sistemik granülomatöz hastalýktýr. Çalýþmada; sarkoidozda evrelere göre klinik ve laboratuvar bulgulardaki farklýlýklarýn ortaya konmasý amaçlandý. Hastalýðýn evresi yaygýnlýðý semptomlar ve laboratuar bulgularý kaydedildi. Yetmiþ altý kadýn, 14 erkek toplam 90 sarkoidoz olgusunun biri evre~0, 29'u evre-1, 50'si evre-II, yedisi evre-III ve üçü evre-IV idi. Evrelere göre; serum anjiyotensin kon verting enzim (ACE), bron-koalveoler lavaj (BAL)'da lenfosit serum IgA, IgG, IgM, lökosit hemoglobin düzeyi eritrosit sedimentasyon hýzý, serum protein elektroforezinde beta, gamma, alfa-1, alfa-2 globulin, albumin düzeyi, serum kalsiyum (Ca) ve 24 saatlik idrarda Ca düzeyi farklýlýk göstermedi (p>0.05). Evre ilerledikçe karbon monoksit için difüzyon kapasitesi (DLCO), birinci saniyedeki zorlu ekspiratuvar voîüm (FEV-Î) ve zorlu vital kapasite (FVC)'nin azaldýðý belirlendi (sýrasýyla r: -0.487, r: -0.424 ve r: -0.362). BAL'da lenfosit düzeyi, serum ACE, spesifik difüzyon, FEV-1/FVC, serum Ca ve 24 saatlik idrarda Ca düzeyi evrelere göre korelasyon göstermedi. Serum ACE yüksekliði %43.9; serum Ca yüksekliði %17.5 ve 24 saatlik idrarda Ca yüksekliði %2.8 oranýnda saptandý. Tüberkülin testi pozitifliði %50 oranýnda idi. En sýk saptanan ekstrapulmoner tutulum eritema nodosum (%13.3) ve artrit/artralji (%1L2) ve en sýk pulmoner semptom öksürük (%61.1) idi. Sonuç olarak; sarkoidozda evrelere göre; serum ACE, BAL'da lenfosit serum IgA, IgG, IgM, lökosit, hemoglobin düzeyi eritrosit sedimentasyon hýzý, serum protein elektroforezi parametreleri serum Ca ve 24 saatlik idrarda Ca düzeyinin farklýlýk göstermediði evre ilerledikçe DLCO, FEV-1 ve FVC'nin azaldýðý tespit edilmiþtir.

Anahtar Kelimeler: Sarkoidoz, klinik bulgular, laboratuar bulgularý, evre

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THE CLINIC AND LABORATORY PARAMETRIC DIFFERENCES IN SARCOIDOSIS ACCORDING TO STAGES

Ahmet Emin ERBAYCU¹, M. Þevket DERELݹ, Ayþe ÖZSÖZ¹, Iþýl KARASU¹, Aydan ÇAKAN¹
Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý ve Tüberküloz Kliniði, Ýzmir

Sarcoidosis is a systemic granulomatous disorder effecting primarily lung and lymphatic system. In the study, it was aimed to reveal the differences of clinical and laboratory findings in stages of sarcoidosis. Stages, widespread of the disease, symptoms and laboratory findings were recorded. Of -76 woman, 14 man- totally 90 sarcoidosis patients, one was stage-0, 29 were stage-l, 50 were stage-II, seven were stage-Ill and three were stage-IV. According to the stages; serum angiotensin converting enzyme (ACE), lymphocyte in bronchoalveolar lavage fluid (BAL), serum IgA, IgG, IgM, leucocyte, haemoglobine level, erythrocyte sedimentation rate, percentage of beta, gamma, alpha-1, alpha-2 globulin, albumin in serum protein electrophoresis, serum calcium (Ca) and Ca in 24 hours urine did not differ (p>0.05). It was observed that as the stage gets higher, diffusion capacity for carbon monoxide (DLCO), first second forced expiratory volume (FEV-1) and forced vital capacity (FVC) gets lower (r: -0.487, r: -0.424 and r: -0.362, respectively). Lymphocyte count in BAL, serum ACE, specific diffusion, FEV-1/FVC, serum Ca and Ca in 24 hours urine did not correlate in stages of the disease. Serum ACE was higher in 43.9%, serum Ca was higher in 17.5% and Ca in 24 hours urine was higher in 2.8%. Tuberculine test positivity was 50%. The most frequent extrapulmonary involvement was erythema nodosum (13.3%) and arthritis/arthralgia (11.2%) and the most frequent pulmonary symptom was cough (61.1 %). In conclusion; it was revealed in stages of sarcoidosis that serum ACE, lymphocyte count in BAL, serum IgA, IgG, IgM, leucocyte, haemo-globine level, erythrocyte sedimentation rate, parameters of serum protein electrophoresis, serum Ca and Ca in 24 hours urine had not differed and as the stage got higher DLCO, FEV-1 and FVC got lower.

Keywords: Sarcoidosis, clinical findings, laboratory findings, stage

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ATIF KOPYALA