İmmün trombositopenik purpuranın tekrarlanması ve kronikleşmesi ile çeşitli parametrelerin ve helikobakter pilorinin ilişkisi
Başlık çevirisi mevcut değil.
- Tez No: 171830
- Danışmanlar: PROF.DR. FERİDE DURU
- Tez Türü: Tıpta Uzmanlık
- Konular: Çocuk Sağlığı ve Hastalıkları, Child Health and Diseases
- Anahtar Kelimeler: Immune thrombocytopenic purpura, helicobacter pylori XII
- Yıl: 2006
- Dil: Türkçe
- Üniversite: Ondokuz Mayıs Üniversitesi
- Enstitü: Tıp Fakültesi
- Ana Bilim Dalı: Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 83
Özet
ÖZET İmmün trombositopenik purpura (İTP) trombosit membran glikoproteinleri üzerinde bulunan antijenik yapılara karşı oluşan antikorlarla kaplı trombositlerin retiküloendotelyal sistem (RES) makrofajlan tarafından fagosite edilmesi sonucu, hastalarda izole trombositopeni (trombosit sayısı
Özet (Çeviri)
SUMMARY Immune thrombocytopenic purpura (ITP) is an autoimmune disease characterized with isolated thrombocytopenia (thrombocyte count is less than 150xl09/L) developing by fagocytosis of thrombocytes which coated with antibodies produced against to antigenic compounds on the membrane glycoproteins of thrombocytes. ITP is seen acute, chronic and recurrent forms in clinical practice. In acute ITP thrombocytopenia improves in six months and than never relapses. In the chronic cases thrombocytopenia persists longer than six months without improvement, in recurrent cases thrombocytopenia improves but than thrombocyte count falls again. Because recurrent ITP cases take place in chronic form of the disease in literature there has been known little about recurrent ITP even if there is no data about the frequency of recurrent forms. In our study 328 ITP children diagnosed as ITP between 01.01.2000 and 31.06.2005 were retrospectively evaluated and among them 190 cases in whom sufficient data could be obtained for the study and having enough follow up time (7months to 3 years) were included in this study. We evaluated age, sex, thrombocyte count, preceeding infection or immunization history, the localization of the bleeding, immunglobulin levels, MPV and the improvement of thrombocytopenia by 14 days in patients in each group. Then we compared above parameters between each group to see whether or not any of these parameters could be predictive in showing the prognosis of the disease. In recent years a relationship between helicobacter pylori and chronic ITP has brought to the attention in the literature. There have been some studies with contradiction results, but very few of them were performed in children. For this reason in the prospective part of our study we aimed to investigate the relationship between helicobacter pylori and chronic or recurrent ITP. In the event such a relation is present helicobacter pylori eradication would prevent bleeding in these children. Urea breath test was performed for the diagnosis of helicobacter pylori infection in 21 patients XIhaving been in our follow up with chronic or recurrent ITP. In this 21 patients the prevalance of helicobacter pylori infection was compared with age matched healthy control group. Helicobacter pylori eradication therapy was given to 1 1 patients with chronic or recurrent ITP m whom helicobacter pylori was detected, thereafter thrombocyte counts were foil wed up for 6 months. As a result we concluded that immunglobulin levels preceeding infection history at last 1 -8 weeks, the localization of bleeding at the time of diagnosis did not differ between the chronic, recurrent and acute ITP groups and it suggested that those parameters could not be predictive in showing the prognosis of the disease. However MPV were higher in the chronic ITP than the acute or recurrent form of the disease. As well if the initial platelet count was above 50x1 09/L development of chronic ITP seems to be more frequent than the recurrent or acute ITP, whereas it developes rarely in the patients younger than 2 years old. Our study revealed that recurrent ITP resembled acute ITP regarding MPV, prognosis in the children younger than 2 years and improvement of thrombocytopenia in 50% of the patients within the first six days. These findings haven't been brought to the attention before because recurrent ITP cases were included within the chronic ITP in the literature. In our study we didn't find any relation between helicobacter pylori infection and development of chronic or recurrent form of ITP.
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