Sarkoidoz'un Klinik Gidişatini Öngörmede Klinik Parametreler Ve Laboratuvar Değerlerinin Değerlendirilmesi - Tek Merkez Deneyimi

Yıl 2022, Cilt: 6 Sayı: 1, 34 - 41, 27.03.2022

Deniz Çelik , Sertan Bulut

https://doi.org/10.30565/medalanya.948632

Öz

Amaç: Sarkoidozun doğal seyri heterojendir. Bu hastalığın seyrini ve özelliklerini aylar/yıllar içinde öngörebilecek net bir belirteç yoktur. Başvuru sırasında bir tahmin parametresi belirlemek için hastalarımızın verilerini analiz etmeyi amaçladık.

Yöntem: 01/01/2015-31/12/2020 tarihleri arasında sarkoidoz tanısıyla takipte olan hastalar çalışma grubumuzu oluşturdu. Hastaların başvuru grafileri dahil Scadding evreleme sistemi ile evrelendi. Klinik-laboratuvar-radyolojik parametrelerin en az ikisinde düzelme veya bozulma sarkoidozda gerileme, stabil hastalık, progresyon veya relaps olduğunu gösterir.

Bulgular: Çalışmaya dahil ettiğimiz 4 vaka (%6,9) evre 0, 15 olgu (%25,86) evre 1, 39 olgu (%67,24) evre 2 olarak tanımlandı. Tanı yaşı ortalaması evre 0 + evre 1 grubunda 40,84±13,56, evre 2 grubunda 48,05±13,36 idi (p=0,06). Vakaların %74,1'i kadındı. Kadın/erkek oranı 2,86 olarak bulundu. 58 olgunun 57'sinde patolojik tanı vardı. Kullanılan yöntem Endobronşial ultrasonografi eşliğinde transbronşial iğne aspirasyonu idi (EBUS TBNA). Solunum fonksiyon testleri (SFT) ve karbonmonoksit difüzyon testi (DLCO) ileri evrelerdeki hastalarda anlamlı olarak daha düşük iken, bu testlerin sonuçları ile hastalığın klinik seyri arasında aynı istatistiksel anlamlılık saptanmadı. Çok değişkenli analiz sonucunda takip döneminde sadece başvuru anında göğüs ağrısının varlığının hastalığın progresyonunu etkilediği görüldü.

Sonuç: Sarkoidoz multisistemik bir hastalıktır ve hastalığın kötü prognozunu öngörmek için net bir bulgu yoktur. Başvurudaki göğüs ağrısı semptomunun değerli bir prediktif bulgu olduğunu ve takipteki progresyon için bir ipucu olarak kullanılabileceğini düşünüyoruz.

Anahtar Kelimeler

Sarkoidoz, prognoz, progresyon, EBUS TBNA

Effectiveness Of Clinical Parameters And Laboratory Values In Predicting The Clinical Course of Sarcoidosis

Öz

Aim: The natural course of sarcoidosis is heterogeneous. There is no clear marker that can predict the course of this disease and its characteristics over months/years. We aimed to analyze our patients' data to identify a prediction parameter at admission.

Methods: The patients with sarcoidosis and followed-up between 01/01/2015 and 31/12/2020 comprised the study group. The patients were staged by a Scadding staging system. Improvement or deterioration in at least two of the clinical-laboratory-radiological parameters indicates regression, stable disease, progression, or relapse of sarcoidosis.

Results: The study group comprised 4 cases (6.9%) defined as stage 0; 15 cases (25.86%) as stage 1; 39 cases (67.24%) were defined as stage 2. The mean age at diagnosis was 40.84±13.56 in stage 0 + stage 1 group, while it was 48.05±13.36 in the stage 2 group (p=0.06). 74.1% of the cases were women. The female/male ratio was found at 2.86. 57 out of 58 cases had a pathological diagnosis (EBUS TBNA). While PFTs values and DLCO were significantly lower at advanced stages but the same statistical significance was not identified between these values and the clinical course of the disease. As a result of the multivariate analysis, it was observed that only the presence of chest pain at admission affected the progression of the disease in the follow-up period.

Conclusion: Sarcoidosis is a multi-systemic disease and there is no clear finding for predicting the poor prognosis of the disease. We conclude that chest pain symptom at admission is valuable predictive finding and can be used as a clue for the progression at follow-up.      

Anahtar Kelimeler

Sarcoidosis, prognosis, progression, EBUS TBNA

Kaynakça

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