Kronik böbrek yetmezlikli olgularda tüberkülin cilt testi yanıtı ve T-lenfosit alt grupları
Küçük Resim Yok
Tarih
2006
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Kronik böbrek yetmezliği (KBY) olan olgularda anerji sık görüldüğü için tüberküloz (Tbc) tanısında tüberkülin cilt testi (TCT)’nin yararı tartışmalıdır. Bu nedenle, TCT yanıtını etkileyen faktörlerin bilinmesi, testin tanısal değerini artıracaktır. Bu çalışmada, KBY olgularında TCT yanıtını etkileyebilecek faktörlerin belirlenmesi, yanı sıra TCT yanıtı ile T-lenfosit alt grupları arasındaki ilişkinin araştırılması amaçlanmıştır. Çalışmaya KBY tanılı 44 (yaş ortalaması 46.6 ± 15.6 yıl, 25 erkek, hastalık süresi 5.6 ± 5.2 yıl) olgu alınarak tümüne biyokimyasal incelemeler, T-lenfosit alt grup analizleri ve TCT yapılmış, 5 mm ve üzeri pozitif kabul edilmiştir. Olguların 23’ü hemodiyaliz, altısı periton diyalizi, sekizi tıbbi tedavi altında olup, yedisine renal transplantasyon uygulanmıştır. Onbir (%25) olguda immünsüpresif tedavi öyküsü vardır. Dört (%9) olguda BCG skarı yokken, 29 (%66) olguda bir, 11 (%25) olguda iki skar izlenmiştir. Beden kitle indeksi (BKİ) 5 (%11) olguda düşük saptanmıştır. T-lenfosit alt grup analizlerinde; CD4= %40.7 ± 7.6, CD8= %32 ± 8.9, CD4/CD8= %1.7 ± 2.5, CD3= %71.4 ± 9.4, CD19= %6.3 ± 5.1 ve natural killer (NK)= %9.7 ± 5.9 bulunmuştur. Olguların %50’sinde TCT pozitif bulunmuştur. TCT’yi etkileyen parametreler değerlendirildiğinde; yaş, cinsiyet, eşlik eden hastalık, BCG skarı, BKİ, KBY süre ve tedavisi, immünsüpresif tedavi ile TCT pozitifliği arasında ilişki saptanmamıştır. Çalışmaya alınan olguların biyokimyasal parametreleri ve T-lenfosit alt grup analizleri ile TCT yanıtı arasında da ilişki bulunmamıştır. Bu bulgularla, KBY’li olgularda T-lenfosit alt grup değerlerinin ve olguların klinik özelliklerinin TCT yanıtını etkilemediği sonucuna varılmıştır.
As anergy is common in patients with chronic renal failure (CRF), the use of tuberculin skin test (TST) is controversial. Therefore, determination of the factors that affect the TST reactivity would increase the diagnostic value of the test. The aim of the present study was to investigate the factors affecting TST reactivity and evaluate the relationship between T-lymphocyte subsets and TST reactivity. We thus examined 44 patients (mean age 46.6 ± 15.6 years, 25 males, duration of CRF 5.6 ± 5.2 years), performed TST (an induration with a diameter of 5 mm or more was considered as positive) and measured Tlymphocyte subsets and biochemical parameters. Twenty-three patients were on hemodialysis, six were on peritoneal dialysis, seven were transplant recipients, and eight were on medical treatment. Eleven patients (25%) had immunosuppressive treatment. Eleven patients (25%) had two, 29 patients (66%) had one, and four patients (9%) had no BCG scars. Five patients (11%) had low body mass index (BMI). T-lymphocyte subsets were as follows: CD4= 40.7 ± 7.6%, CD8= 32 ± 8.9%, CD4/CD8= 1.7 ± 2.5%, CD3= 71.4 ± 9.4%, CD19= 6.3 ± 5.1%, NK= 9.7 ± 5.9. Twenty-two patients had positive TST reactivity. No relation was found between TST reactivity and age, gender, co-morbidity, BCG vaccination, BMI, immunosuppressive therapy, duration and treatment of CRF. Similarly, TST reactivity was not related to the biochemical parameters and Tlymphocyte subsets. These data provide that tuberculin reactivity does not seem to be associated with T-lymphocyte dysfunction and clinical features in patients with chronic renal failure.
As anergy is common in patients with chronic renal failure (CRF), the use of tuberculin skin test (TST) is controversial. Therefore, determination of the factors that affect the TST reactivity would increase the diagnostic value of the test. The aim of the present study was to investigate the factors affecting TST reactivity and evaluate the relationship between T-lymphocyte subsets and TST reactivity. We thus examined 44 patients (mean age 46.6 ± 15.6 years, 25 males, duration of CRF 5.6 ± 5.2 years), performed TST (an induration with a diameter of 5 mm or more was considered as positive) and measured Tlymphocyte subsets and biochemical parameters. Twenty-three patients were on hemodialysis, six were on peritoneal dialysis, seven were transplant recipients, and eight were on medical treatment. Eleven patients (25%) had immunosuppressive treatment. Eleven patients (25%) had two, 29 patients (66%) had one, and four patients (9%) had no BCG scars. Five patients (11%) had low body mass index (BMI). T-lymphocyte subsets were as follows: CD4= 40.7 ± 7.6%, CD8= 32 ± 8.9%, CD4/CD8= 1.7 ± 2.5%, CD3= 71.4 ± 9.4%, CD19= 6.3 ± 5.1%, NK= 9.7 ± 5.9. Twenty-two patients had positive TST reactivity. No relation was found between TST reactivity and age, gender, co-morbidity, BCG vaccination, BMI, immunosuppressive therapy, duration and treatment of CRF. Similarly, TST reactivity was not related to the biochemical parameters and Tlymphocyte subsets. These data provide that tuberculin reactivity does not seem to be associated with T-lymphocyte dysfunction and clinical features in patients with chronic renal failure.
Açıklama
Anahtar Kelimeler
Kulak, Burun, Boğaz, Solunum Sistemi
Kaynak
Tüberküloz ve Toraks
WoS Q Değeri
Scopus Q Değeri
Cilt
54
Sayı
1
