Sarkoidozda Görülen Lenfopeni Hastalık Aktivitesi İle İlişkilimidir?

GİRİŞ ve AMAÇ: Bu çalışmada sarkoidoz olgularında tespit edilen lenfopenin hastalık aktivitesi ile ilişkisi incelenmiştir.

YÖNTEM ve GEREÇLER: Çalışmaya Temmuz 2016–Haziran 2017 tarihleri arasında sarkoidoz tanısı alan olgular ve aynı dönem aktif hastalığı olmayan sağlıklı gönüllüler/aktif hastalık tanısı almayan olgular dahil edildi. Olguların tam kan sayımlarında mutlak lenfosit sayısı (MLS) <1.3 10³/mm³ olanlar lenfopenik kabul edildi. İki grubta lenfopeni görülme oranları birbirleri ile karşılaştırıldı. Sarkoidoz grubunda lenfopenisi olan ve olmayan olguların solunum fonksiyon testi-karbonmonoksit difizyon testi (SFT-DLCO) değerleri ve yüksek rezolüsyonlu bilgisayarlı tomografi (YRBT) bulguları birbirleri ile karşılaştırıldı.
BULGULAR: Sarkoidoz grubunda 77, kontrol grubunda 41 olgu dahil edildi. Sarkoidoz grubunda lenfopenik olgu sayısı 21 (%27.2) iken kontrol grubunda 1’di (%2.4) (p=0.001). Sarkoidoz grubunda 33 (%28) olgunun DLCO % değeri %80’nin altında iken, 44 olgunun DLCO % değeri %80’nin üstündeydi. Sarkoidoz grubunda DLCO <%80 olan olguların ortalama MLS’si 1.6±0.7 iken, DLCO >%80 olan olguların 2±0.7’di (p=0.016). MLS ile %DLCO arasında pozitif yönde korelasyon tespit edildi (p=0.044, r=0.230). DLCO <%80 olan olguların %42’sinde lenfopeni var iken, DLCO >%80 olan olguların %15’inde lenfopeni vardı (p=0.01). Olguların sarkoidoz evreleri, semptomları ve radyolojik bulgular ile MLS arasında anlamlı ilişki tespit edilemedi (p>0.05).

TARTIŞMA ve SONUÇ: Sarkoidoz olgularında lenfopeni sık görülür. Lenfopenik sarkoidoz olgularında düşük DLCO değerleri görülebilir.

Is Lymphopenia Detected in Sarcoidosis Associated with the Disease Activity?

INTRODUCTION: The association of lymphopenia detected in patients with sarcoidosis with disease activity was investigated in the present study.
METHODS: Patients who were diagnosed as having sarcoidosis and healthy volunteers/individuals with no diagnosis of active disease between July 2016 and June 2017 were included in this study. Patients who were detected to have an absolute lymphocyte count (ALC) of <1.3 × 10³/mm³ were accepted as lymphopenic patients. The detection rates of lymphopenia were compared between two groups. The respiratory function testing-diffusing capacity of the lungs for carbon monoxide (RFT-DLCO) levels and the high-resolution computed tomography (HRCT) results of patients with and without lymphopenia in the sarcoidosis group were compared.

RESULTS: In the sarcoidosis group, 77 patients were included, and in the control group, 41 patients were included. The number of lymphopenic patients in the sarcoidosis group was 21 (27.2%), and that in the control group was 1 (2.4%) (p=0.001). The percentaged DLCO value of 33 patients (28%) was below 80%; however, the percentaged DLCO value of 44 patients was higher than 80% in the sarcoidosis group. The mean ALC of patients in the sarcoidosis group who had a DLCO value of <80% was 1.6±0.7; however, the mean ALC of patients who had a DLCO value of >80% was 2±0.7 (p=0.016). A positive correlation was detected between ALC and DLCO% (p=0.044, r=0.230). Although lymphopenia was detected in 42% of patients whose DLCO value was <80%, lymphopenia was detected in 15% of patients whose DLCO value was >80% (p=0.01). No significant association was detected among the sarcoidosis stage, symptom, and radiologic findings of the patients with the absolute lymphocyte count (p>0.05).

DISCUSSION AND CONCLUSION: Lymphopenia is frequently detected in patients with sarcoidosis. Lower DLCO values may be detected in patients with lymphopenic sarcoidosis.