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Psoriazis Hastalarında Sistemik Tedavinin Hematolojik Parametreler Üzerine Etkisi

Year 2019, Volume: 11 Issue: 1, 95 - 100, 25.03.2019
https://doi.org/10.18521/ktd.498236

Abstract

Amaç: Nötrofil lenfosit oranı (NLO)- Trombosit lenfosit oranı (TLO), eritrosit dağılım
değişikliği (RDW) , ortalama trombosit hacmi (OTH) düzeyleri sistemik inflamasyonun bir
göstergesi olabileceği ve birçok kardiyovasküler hastalık, maliniteler, romatolojik hastalıklar,
enfeksiyon hastalıklarında prognoz ve mortalite ile ilişkili olabileceği son yıllarda yapılan
çalışmalarda gösterilmiştir. Bu çalışmanın amacı sistemik kronik inflamatuar bir hastalık
olan psoriazis hastalarının sistemik tedavi öncesi ve tedavinin 12. haftasında PAŞİ(Psoriatik
Alan Şiddet İndeksi)75 değerine ulaşan hastalarda Lökosit, Nötrofil, Trombosit, NLO, TLO,
OTH ve RDW düzeylerindeki değişimi incelemektir.
Gereç ve Yöntem: Metotreksat(Mtx)- Siklosporin- Asitretin- dbUVB- İnfiksimab ve
Adalimumab tedavisi başlanan kronik plak psoriazisli 60 hastanın hematolojik parametreleri
incelenmiştir. Tedavi öncesinde ve tedavinin 12. haftasında PAŞİ75 değerine ulaşan
hastaların Lökosit, Nötrofil, Trombosit, NLO, TLO, OTH ve RDW düzeyleri
değerlendirilmiştir.
Bulgular: Hastaların başlangıç PAŞİ değerleri 16,68±6,5 (Min:6,6,Max:29,6). Tedavi
sonrası lökosit, nötrofil ve trombosit ortalamaları tedavi öncesi ortalamalara göre anlamlı
derecede düşüş gösterirken (p=0,01; p<0,001; p<0,001), tedavi öncesi ve sonrası lenfosit,
OTH ve RDW ortalamaları arasında istatistiksel olarak anlamlı bir farklılık
gözlenmemiştir(her biri için p>0,05). Tedavi sonrası NLO ve TLO ortalamaları tedavi öncesi
ortalamalara göre istatistiksel olarak düşük bulunmuştur (p=0,043; p=0,009). Tedavi
seçeneklerine göre tedavi öncesi ve sonrası ortalamalar karşılaştırıldığında MTX nötrofil,
trombosit ve RDW üzerine etkili olmuşken, Asitretin ve Siklosporin nötrofil ve OTH üzerine
etkili olmuştur. dbUVB tedavisi verilen hastalarda tedavi öncesi ve tedavi sonrası
ortalamalar arasında anlamlı farklılık gözlenmemiştir.
Sonuç: NLO ve TLO düzeylerinin tedavi sonrasında anlamlı farklılık göstermesi literatürde
yapılan çalışmalarla benzerlik göstermektedir. Çalışmada verilen sistemik tedavi
ajanlarından kardiyovasküler risk belirteçleri olarak bilinen hematolojik parametreler üzerine
en etkili ilacın Mtx olabileceği düşünülmektedir

References

  • Referans1. Coimbra S, Oliveira H, Reis F, et al. C-reactive protein and leucocyte activation in psoriasis vulgaris according to severity and therapy. J EurAcad Dermatol Venereol. 2010;24(7):789-796.
  • Referans2. Deng Y, Chang C, Lu Q. The Inflammatory Response in Psoriasis: a Comprehensive Review. Clin Rew Allergy Immunol. 2016;50(3):377-389.
  • Referans3. Ünal M, Küçük A, Ünal G, ve ark. Psoriasiste ortalama trombosit hacmi, nötrofil/lenfosit oranı ve trombosit/lenfosit oranı. Türkderm 2015; 49: 112-116.
  • Referans4. Kılıç E, Rezvani A, Toprak AE, ve ark. RomatoidArtritte Nötrofil/ Lenfosit ve Platelet/ Lenfosit Oranlarının Değerlendirilmesi. Dicle Tıp Dergisi. 2016;43(2): 241-247.
  • Referans5. Kim DS, Shin D, Jee H, et al. Red blood cell distribution width is increased in patients with psoriasis vulgaris: A retrospective study on 261 patients. J Dermatol. 2015;42(6):567-571.
  • Referans6. Imtiaz F, Shafique K, Mirza SS, et al. Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. IntArchMed 2012; 5(1): 2.
  • Referans7. Briggs C. Qualitycounts: new parameters in blood cell counting. Int J LabHematol 2009;31(3):277-297.
  • Referans8. Hwang S, Shin T, Jo I, et al. Neutrophil-to-lymphocyte ratio as a prognostic marker in critically-ill septic patients. Am J Emerg Med. 2017;35(2):234-239.
  • Referans9. Wang X, Zhang G, Jiang X, et al. Neutrophil to lymphocyte ratio in relation to risk of all-cause mortality and cardiovascular events among patients undergoing angiography or cardiac revascularization: a meta-analysis of observational studies. Atherosclerosis. 2014;234(1):206-213.
  • Referans10. Eryigit U, Altunayoglu C, Sahin A, et al. The diagnostic value of the neutrophil-lymphocyte ratio in distinguishing between subarachnoid hemorrhage and migraine. Am J Emerg Med. 2017;35(9):1276-1280.
  • Referans11. Oflazoğlu U, Alacacıoğlu A, Somali I, ve ark. Nötrofil/Lenfosit Oranı, Trombosit/Lenfosit Oranı ve Ortalama Trombosit Hacminin Kolorektal Karsinomlu Hastalarda Prognostik Değeri. ActaOncol Tur. 2017;50(1):1-6.
  • Referans12. Celikbilek M, Dogan S, Ozbakir O, et al. Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J ClinLab Anal 2013;27(1):72-76.
  • Referans13. Lippi G, Targher G, Montagnana M, et al. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009;133(4):628-32.
  • Referans14. Grozdev I, Korman N, Tsankov N. Psoriasis as a systemic disease. Clin Dermatol 2014;32(3):343-350.
  • Referans15. Kalkan G. Psöriazisde Komorbiditeler. Turkderm-Turk Arch Dermatol Venereolgy. 2017;51:71-77.
  • Referans16. Çerman AA, Karabay AE, Altunay Kİ. Psoriazisli Hastalarda Nötrofil Lenfosit Oranı ve Ortalama Trombosit Hacminin Değerlendirilmesi. Şişli Etfal Tıp Bülteni. 2016;50(2): 137-141.
  • Referans17. Kim DS, Shin D, Lee MS, et al. Assessment of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis. J Dermatol. 2016;43(3):305-310.
  • Referans18. Paliogiannis P, Satta R, Deligia G, et al. Associations between the neutrophil-to-lymphocyte and the platelet-to-lymphocyte ratios and the presence and severity of psoriasis: a systematic review and meta-analysis. 2018 Nov 26. doi: 10.1007/s10238-018-0538-x. [Epubahead of print]
  • Referans19. Cemil Ç.B, Ataş H. Psoriasis Hastalarında Biyolojik Tedavinin Sistemik İnflamatuvar Belirteçler ve Plateletcrit Üzerine Etkisi. Dicle Tıp Dergisi. 2016; 43(4):477-483.
  • Referans20. Balevi A, Olmuşçelik O, Ustuner P, et al. Is there any Correlation between Red Cell Distribution Width, Mean Platelet Volume Neutrophil Count, Lymphocyte Count, and Psoriasis Area Severity Index in Patients Under Treatment for Psoriasis?. Acta Dermatovenerol Croat. 2018;26(3):199-205.
  • Referans21. Asahina A, Kubo N, Umezawa Y, et al. Neutrophil-lymphocyteratio, platelet-lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis: Response to therapy with biologics. J Dermatol. 2017;44(10):1112-1121.
  • Referans22. Tamhane UU, Aneja S, Montgomery D, et al. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008;102:653-657.

The Effect of Systemic Treatment on Hematological Parameters in Psoriasis Patients

Year 2019, Volume: 11 Issue: 1, 95 - 100, 25.03.2019
https://doi.org/10.18521/ktd.498236

Abstract

Objective: Neutrophil lymphocyte ratio (NLR) – Platelet lymphocyte ratio (PLR),
erythrocyte distribution change (RDW), mean platelet volume (MPV) levels are an indicator
of systemic inflammation. Recent studies have shown that these values are associated with
many cardiovascular diseases, malignancies, rheumatic diseases, infectious diseases,
prognosis and mortality. The aim of this study was to evaluate the changes in leukocyte,
neutrophil, platelet, NLR, PLR, MPV and RDW levels in patients with systemic chronic
inflammatory disease psoriasis patients who reached the PASI75 value before the systemic
treatment and at the 12th week of the treatment.
Methods: The hematological parameters of 60 patients with chronic plaque psoriasis who
were treated with methotrexate (Mtx)-Cyclosporin-Acitretin-NBUVB-Infliximab and
Adalimumab were investigated.
Results: The initial PASI values of the patients were 16.68 ± 6.5 (Min: 6.6, Max: 29.6).
Post-treatment leukocyte, neutrophil and thrombocyte averages decreased significantly (p =
0.011; p <0.001; p <0.001), but there was no statistically significant difference between pretreatment and post-treatment lymphocytes, MPV and RDW averages (each p> 0.05). After
treatment, NLR and PLR averages were found to be statistically lower than the pre-treatment
averages (p = 0.043; p = 0.009). When compared to the pre-and post-treatment average, Mtx
was effective on neutrophil, platelet and RDW, Acitretin and cyclosporine were effective on
neutrophil and MPV.
Conclusion: Significant differences in NLR and PLR levels after treatment are similar to
those in the literature. The most effective drug on hematological parameters, known as
cardiovascular risk markers, is thought to be Mtx. 

References

  • Referans1. Coimbra S, Oliveira H, Reis F, et al. C-reactive protein and leucocyte activation in psoriasis vulgaris according to severity and therapy. J EurAcad Dermatol Venereol. 2010;24(7):789-796.
  • Referans2. Deng Y, Chang C, Lu Q. The Inflammatory Response in Psoriasis: a Comprehensive Review. Clin Rew Allergy Immunol. 2016;50(3):377-389.
  • Referans3. Ünal M, Küçük A, Ünal G, ve ark. Psoriasiste ortalama trombosit hacmi, nötrofil/lenfosit oranı ve trombosit/lenfosit oranı. Türkderm 2015; 49: 112-116.
  • Referans4. Kılıç E, Rezvani A, Toprak AE, ve ark. RomatoidArtritte Nötrofil/ Lenfosit ve Platelet/ Lenfosit Oranlarının Değerlendirilmesi. Dicle Tıp Dergisi. 2016;43(2): 241-247.
  • Referans5. Kim DS, Shin D, Jee H, et al. Red blood cell distribution width is increased in patients with psoriasis vulgaris: A retrospective study on 261 patients. J Dermatol. 2015;42(6):567-571.
  • Referans6. Imtiaz F, Shafique K, Mirza SS, et al. Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. IntArchMed 2012; 5(1): 2.
  • Referans7. Briggs C. Qualitycounts: new parameters in blood cell counting. Int J LabHematol 2009;31(3):277-297.
  • Referans8. Hwang S, Shin T, Jo I, et al. Neutrophil-to-lymphocyte ratio as a prognostic marker in critically-ill septic patients. Am J Emerg Med. 2017;35(2):234-239.
  • Referans9. Wang X, Zhang G, Jiang X, et al. Neutrophil to lymphocyte ratio in relation to risk of all-cause mortality and cardiovascular events among patients undergoing angiography or cardiac revascularization: a meta-analysis of observational studies. Atherosclerosis. 2014;234(1):206-213.
  • Referans10. Eryigit U, Altunayoglu C, Sahin A, et al. The diagnostic value of the neutrophil-lymphocyte ratio in distinguishing between subarachnoid hemorrhage and migraine. Am J Emerg Med. 2017;35(9):1276-1280.
  • Referans11. Oflazoğlu U, Alacacıoğlu A, Somali I, ve ark. Nötrofil/Lenfosit Oranı, Trombosit/Lenfosit Oranı ve Ortalama Trombosit Hacminin Kolorektal Karsinomlu Hastalarda Prognostik Değeri. ActaOncol Tur. 2017;50(1):1-6.
  • Referans12. Celikbilek M, Dogan S, Ozbakir O, et al. Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J ClinLab Anal 2013;27(1):72-76.
  • Referans13. Lippi G, Targher G, Montagnana M, et al. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009;133(4):628-32.
  • Referans14. Grozdev I, Korman N, Tsankov N. Psoriasis as a systemic disease. Clin Dermatol 2014;32(3):343-350.
  • Referans15. Kalkan G. Psöriazisde Komorbiditeler. Turkderm-Turk Arch Dermatol Venereolgy. 2017;51:71-77.
  • Referans16. Çerman AA, Karabay AE, Altunay Kİ. Psoriazisli Hastalarda Nötrofil Lenfosit Oranı ve Ortalama Trombosit Hacminin Değerlendirilmesi. Şişli Etfal Tıp Bülteni. 2016;50(2): 137-141.
  • Referans17. Kim DS, Shin D, Lee MS, et al. Assessment of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis. J Dermatol. 2016;43(3):305-310.
  • Referans18. Paliogiannis P, Satta R, Deligia G, et al. Associations between the neutrophil-to-lymphocyte and the platelet-to-lymphocyte ratios and the presence and severity of psoriasis: a systematic review and meta-analysis. 2018 Nov 26. doi: 10.1007/s10238-018-0538-x. [Epubahead of print]
  • Referans19. Cemil Ç.B, Ataş H. Psoriasis Hastalarında Biyolojik Tedavinin Sistemik İnflamatuvar Belirteçler ve Plateletcrit Üzerine Etkisi. Dicle Tıp Dergisi. 2016; 43(4):477-483.
  • Referans20. Balevi A, Olmuşçelik O, Ustuner P, et al. Is there any Correlation between Red Cell Distribution Width, Mean Platelet Volume Neutrophil Count, Lymphocyte Count, and Psoriasis Area Severity Index in Patients Under Treatment for Psoriasis?. Acta Dermatovenerol Croat. 2018;26(3):199-205.
  • Referans21. Asahina A, Kubo N, Umezawa Y, et al. Neutrophil-lymphocyteratio, platelet-lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis: Response to therapy with biologics. J Dermatol. 2017;44(10):1112-1121.
  • Referans22. Tamhane UU, Aneja S, Montgomery D, et al. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008;102:653-657.
There are 22 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Ebru Karagün 0000-0002-5032-7429

Publication Date March 25, 2019
Acceptance Date February 16, 2019
Published in Issue Year 2019 Volume: 11 Issue: 1

Cite

APA Karagün, E. (2019). Psoriazis Hastalarında Sistemik Tedavinin Hematolojik Parametreler Üzerine Etkisi. Konuralp Medical Journal, 11(1), 95-100. https://doi.org/10.18521/ktd.498236
AMA Karagün E. Psoriazis Hastalarında Sistemik Tedavinin Hematolojik Parametreler Üzerine Etkisi. Konuralp Medical Journal. March 2019;11(1):95-100. doi:10.18521/ktd.498236
Chicago Karagün, Ebru. “Psoriazis Hastalarında Sistemik Tedavinin Hematolojik Parametreler Üzerine Etkisi”. Konuralp Medical Journal 11, no. 1 (March 2019): 95-100. https://doi.org/10.18521/ktd.498236.
EndNote Karagün E (March 1, 2019) Psoriazis Hastalarında Sistemik Tedavinin Hematolojik Parametreler Üzerine Etkisi. Konuralp Medical Journal 11 1 95–100.
IEEE E. Karagün, “Psoriazis Hastalarında Sistemik Tedavinin Hematolojik Parametreler Üzerine Etkisi”, Konuralp Medical Journal, vol. 11, no. 1, pp. 95–100, 2019, doi: 10.18521/ktd.498236.
ISNAD Karagün, Ebru. “Psoriazis Hastalarında Sistemik Tedavinin Hematolojik Parametreler Üzerine Etkisi”. Konuralp Medical Journal 11/1 (March 2019), 95-100. https://doi.org/10.18521/ktd.498236.
JAMA Karagün E. Psoriazis Hastalarında Sistemik Tedavinin Hematolojik Parametreler Üzerine Etkisi. Konuralp Medical Journal. 2019;11:95–100.
MLA Karagün, Ebru. “Psoriazis Hastalarında Sistemik Tedavinin Hematolojik Parametreler Üzerine Etkisi”. Konuralp Medical Journal, vol. 11, no. 1, 2019, pp. 95-100, doi:10.18521/ktd.498236.
Vancouver Karagün E. Psoriazis Hastalarında Sistemik Tedavinin Hematolojik Parametreler Üzerine Etkisi. Konuralp Medical Journal. 2019;11(1):95-100.