Öz
Amaç: Akut enfeksiyonlardan sonra kanda dolaşan eozinofil sayısı önemli ölçüde azalır. Çocuklarda bakteriyel enfeksiyon tanısında eozinopeninin rolünü belirlemek ve diğer akut faz reaktanları ile karşılaştırmaktır.
Gereç ve yöntem: Bu çalışmaya Tepecik Eğitim ve Araştırma Hastanesi Çocuk Acil ve Çocuk Sağlığı Poliklinikleri’ne 01.01.2008-31.12.2008 tarihleri arasında başvuran, ilk 24 saat içinde hemogram ve C-reaktif protein çalışılan 0-14 yaş arası hastalar dahil edildi. Sisteme girilen hastalıkların ve sağlık sorunlarının uluslararası sınıflama sistemi (ICD-10) tanı koduna göre hastalar ayrıştırıldı.
Bulgular: Toplam 1857 hasta çalışmaya alındı. Hastalar 3 grupta değerlendirildiğinde; 519 (%28) olgu bakteriyel enfeksiyon, 356 (%19,2) olgu viral enfeksiyon ve 972 (%52,6) olgu kontrol grubuna alındı. Bakteriyel enfeksiyon grubunda ortalama mutlak eozinofil sayısı 103,7±76,9 hc/mm3 iken viral enfeksiyon grubunda 192,8±129,3 hc/mm3 saptandı ve bu fark istatistiksel olarak anlamlıydı (p<0,001). En yüksek C-reaktif protein, en düşük mutlak eozinofil sayısı ve en düşük mutlak eozinofil sayısı/beyaz kan hücresi (BK) oranı bakteriyel enfeksiyon grubunda saptandı ve bunun istatistiksel olarak anlamlı olduğu belirlendi (p<0,001). En yüksek duyarlılığa sahip parametre %73,7 ile mutlak eozinofil sayısı/beyaz kan hücresi oranı ve en yüksek özgüllük %82,4 ile mutlak eozinofil sayısı idi.
Sonuç: Çocuklarda bakteriyel enfeksiyon tanısında mutlak eozinofil sayısı ve mutlak eozinofil sayısı / beyaz kan hücresi oranı özgül ve duyarlı belirteçler olarak, günlük pratikte kullanabilme kolaylığı sağlayarak umut vaad eden tanısal parametreler olabilirler.
Anahtar Kelimeler
Destekleyen Kurum
Yok
Kaynakça
- 1. Bass DA. Behavior of eosinophil leukocytes in acute inflammation. II. Eosinophil dynamics during acute inflammation. J Clin Invest 1975;56(4):870-879. doi:10.1172/JCI108166
- 2. Bass DA, Gonwa TA, Szejda P, Cousart MS, DeChatelet LR, McCall CE. Eosinopenia of Acute Infection. J Clin Invest 1980;65(6):1265-1271. doi:10.1172/JCI109789
- 3. Gil H, Magy N, Mauny F, Dupond J-L. [Value of eosinopenia in inflammatory disorders: an “old” marker revisited]. Rev Med Interne 2003;24(7):431-435. doi:10.1016/s0248-8663(03)00138-3
- 4. Abidi K, Khoudri I, Belayachi J, et al. Eosinopenia is a reliable marker of sepsis on admission to medical intensive care units. Crit Care 2008;12(2):R59. doi:10.1186/cc6883
- 5. Debray A, Nathanson S, Moulin F, Salomon J, Davido B. Eosinopenia as a marker of diagnosis and prognostic to distinguish bacterial from aseptic meningitis in pediatrics. Eur J Clin Microbiol Infect Dis 2019;38(10):1821-1827. doi:10.1007/s10096-019-03614-y
- 6. Tanni F, Akker E, Zaman MM, Figueroa N, Tharian B, Hupart KH. Eosinopenia and COVID-19. J Osteopath Med 2020;120(8):504-508. doi:10.7556/jaoa.2020.091
- 7. Outh R, Boutin C, Gueudet P, Suzuki M, Saada M, Aumaître H. Eosinopenia <100/μL as a marker of active COVID-19: an observational prospective study. J Microbiol Immunol Infect 2021;54(1):61-68. doi:10.1016/j.jmii.2020.12.005
- 8. Smithson A, Perelló R, Nicolas J-M. Is eosinopenia a reliable marker of sepsis? Crit Care 2009;13(3):409. doi:10.1186/cc7877
- 9. Wilar R. Diagnostic value of eosinopenia and neutrophil to lymphocyte ratio on early onset neonatal sepsis. Korean J Pediatr 2019;62(6):217-223. doi:10.3345/kjp.2018.06723
- 10. Xia Z. Eosinopenia as an early diagnostic marker of COVID-19 at the time of the epidemic. EClinicalMedicine 2020;23:100398. doi:10.1016/j.eclinm.2020.100398
- 11. Garnacho-Montero J, Huici-Moreno MJ, Gutiérrez-Pizarraya A, et al. Prognostic and diagnostic value of eosinopenia, C-reactive protein, procalcitonin, and circulating cell-free DNA in critically ill patients admitted with suspicion of sepsis. Crit Care Lond Engl 2014;18(3):R116. doi:10.1186/cc13908
- 12. Soni M. Evaluation of eosinopenia as a diagnostic and prognostic indicator in COVID‐19 infection Int J Lab Hematol. 2021;43(S1):137-141. doi:10.1111/ijlh.13425
- 13. Karakonstantis S, Gryllou N, Papazoglou G, Lydakis C. Eosinophil count (EC) as a diagnostic and prognostic marker for infection in the internal medicine department setting. Rom J Intern Med 2019;57(2):166-174. doi:10.2478/rjim-2018-0039
- 14. Lavoignet CE, Le Borgne P, Slimani H, et al. Relevance of eosinopenia as marker of sepsis in the emergency department. Rev Médecine Interne 2016;37(11):730-734. doi:10.1016/j.revmed.2016.02.018
Öz
Purpose: Number of eosinophils circulating in the blood decreased significantly after acute infections. Our aim in this study is to determine the role of eosinopenia in the diagnosis of bacterial infection in children and to compare it with other acute phase reactants.
Material and methods: Patients aged 0-14 years, who applied to İzmir Tepecik Training and Research Hospital Pediatrics Polyclinics and Pediatric Emergency Service between 01.01.2008 and 31.12.2008, whose hemogram and C-reactive protein were studied within the first 24 hours of admission were included in this study. The cases were screened according to the International Classification of diseases (ICD-10) diagnostic codes.
Results: Totally 1857 patients were included in the study. The patients were evaluated in 3 groups; 519 cases (28%) with bacterial infection,356 cases (19.2%) with viral infection, and 972 cases (52.6%) in the control groups. The mean absolute eosinophil count in the bacterial infection group was 103.7±76.9/mm³, while it was 192.8±129.3/mm³, in the viral infection group, and this difference was statistically significant (p<0.001). It was determined that the bacterial infection group had the highest C-reactive protein value, the lowest absolute eosinophil count, and the lowest absolute eosinophil count /white blood cell ratio, and this was statistically significant (p<0.001). The parameter with the highest sensitivity was absolute eosinophil count/white blood cell with 73.7%, and highest specificity was absolute eosinophil count with 82.4%.
Conclusion: Absolute eosinophil count and absolute eosinophil count / white blood cell ratio as specific and sensitive markers in the diagnosis of bacterial infection in children, can be promising diagnostic parameters by providing ease of use in daily practice.
Anahtar Kelimeler
Kaynakça
- 1. Bass DA. Behavior of eosinophil leukocytes in acute inflammation. II. Eosinophil dynamics during acute inflammation. J Clin Invest 1975;56(4):870-879. doi:10.1172/JCI108166
- 2. Bass DA, Gonwa TA, Szejda P, Cousart MS, DeChatelet LR, McCall CE. Eosinopenia of Acute Infection. J Clin Invest 1980;65(6):1265-1271. doi:10.1172/JCI109789
- 3. Gil H, Magy N, Mauny F, Dupond J-L. [Value of eosinopenia in inflammatory disorders: an “old” marker revisited]. Rev Med Interne 2003;24(7):431-435. doi:10.1016/s0248-8663(03)00138-3
- 4. Abidi K, Khoudri I, Belayachi J, et al. Eosinopenia is a reliable marker of sepsis on admission to medical intensive care units. Crit Care 2008;12(2):R59. doi:10.1186/cc6883
- 5. Debray A, Nathanson S, Moulin F, Salomon J, Davido B. Eosinopenia as a marker of diagnosis and prognostic to distinguish bacterial from aseptic meningitis in pediatrics. Eur J Clin Microbiol Infect Dis 2019;38(10):1821-1827. doi:10.1007/s10096-019-03614-y
- 6. Tanni F, Akker E, Zaman MM, Figueroa N, Tharian B, Hupart KH. Eosinopenia and COVID-19. J Osteopath Med 2020;120(8):504-508. doi:10.7556/jaoa.2020.091
- 7. Outh R, Boutin C, Gueudet P, Suzuki M, Saada M, Aumaître H. Eosinopenia <100/μL as a marker of active COVID-19: an observational prospective study. J Microbiol Immunol Infect 2021;54(1):61-68. doi:10.1016/j.jmii.2020.12.005
- 8. Smithson A, Perelló R, Nicolas J-M. Is eosinopenia a reliable marker of sepsis? Crit Care 2009;13(3):409. doi:10.1186/cc7877
- 9. Wilar R. Diagnostic value of eosinopenia and neutrophil to lymphocyte ratio on early onset neonatal sepsis. Korean J Pediatr 2019;62(6):217-223. doi:10.3345/kjp.2018.06723
- 10. Xia Z. Eosinopenia as an early diagnostic marker of COVID-19 at the time of the epidemic. EClinicalMedicine 2020;23:100398. doi:10.1016/j.eclinm.2020.100398
- 11. Garnacho-Montero J, Huici-Moreno MJ, Gutiérrez-Pizarraya A, et al. Prognostic and diagnostic value of eosinopenia, C-reactive protein, procalcitonin, and circulating cell-free DNA in critically ill patients admitted with suspicion of sepsis. Crit Care Lond Engl 2014;18(3):R116. doi:10.1186/cc13908
- 12. Soni M. Evaluation of eosinopenia as a diagnostic and prognostic indicator in COVID‐19 infection Int J Lab Hematol. 2021;43(S1):137-141. doi:10.1111/ijlh.13425
- 13. Karakonstantis S, Gryllou N, Papazoglou G, Lydakis C. Eosinophil count (EC) as a diagnostic and prognostic marker for infection in the internal medicine department setting. Rom J Intern Med 2019;57(2):166-174. doi:10.2478/rjim-2018-0039
- 14. Lavoignet CE, Le Borgne P, Slimani H, et al. Relevance of eosinopenia as marker of sepsis in the emergency department. Rev Médecine Interne 2016;37(11):730-734. doi:10.1016/j.revmed.2016.02.018
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Çocuk Sağlığı ve Hastalıkları |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Temmuz 2022 |
| Gönderilme Tarihi | 18 Kasım 2021 |
| Kabul Tarihi | 18 Şubat 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 15 Sayı: 3 |
Kaynak Göster
