Paraproteinemili olguların geriye dönük değerlendirilmesi
Küçük Resim Yok
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Paraproteinemiler; birçok hastalığın ortak laboratuvar bulgusu olup tarama ve tanılarında serum protein elektroforezi önemli bir yere sahiptir. Çalışmamıza; Trakya Üniversitesi Sağlık Araştırma ve Uygulama Merkezi'ne dört yıl sürecinde başvuran olguların arşivde var olan 4106 adet serum protein elektroforezi dahil edildi. Monoklonal gammopati tespit edilen olguların demografik, klinik ve laboratuvar özellikleri geriye dönük olarak ayrıntılı değerlendirildi. İstatistiksel metotlar ile hastalıkların görülme sıklıkları ve diğer özelliklerinin karşılaştırmaları yapıldı. Elektroforezlerin %46.2'sinin patolojik olduğu, %22.6'sında poliklonal gammopati, %4.8'inde monoklonal gammopati ve %1.3'ünde hipogammaglobulinemi saptandı. Monoklonal gammopati'li olgularda; %64.8 ile en sık multipl myelom, 2. sıklıkta %25.1 ile önemi bilinmeyen monoklonal gammopati izlendi. Hastanemizde önemi bilinmeyen monoklonal gammopati görülme sıklığı %1.2 bulundu. Bu olguların yaş ortalaması 70.2'ydi. Erkeklerde 4 kat daha fazla görüldüğü, 40 yaş altında olgu görülmediği ve 80 yaş üzerinde %3.6 oran ile en sık görüldüğü saptandı. Multipl myelom görülme sıklığı %3.4 olarak bulundu. Bu grubun yaş ortalaması 68.9 olup erkeklerde 1.5 kat daha fazlaydı. 70-79 yaş arası grupta %6.7 ile en sıktı. Waldenström makroglobulinemisi sıklığı %0.09, sessiz multipl myelom sıklığı da %0.07 olarak bulundu. Önemi bilinmeyen monoklonal gammopatili olguların izlem sürecinde myeloma ya da diğer hematolojik habis hastalıklara dönüşümü görülmedi. Sonuç olarak; dünya genelinde en sık görülen paraproteinemi önemi bilinmeyen monoklonal gammopati iken çalışmamızda en sık multipl myelom görülmüştür. Bu farklılığın hastanemizin üçüncü basamak bölge hastanesi olması ve hastaların çevre illerden myelom ön tanısı ile gelmiş olmasından kaynaklandığını düşünmekteyiz. Anahtar kelimeler: serum protein elektroforezi, paraproteinemi, önemi bilinmeyen monoklonal gammopati
Paraproteinemias are the laboratory findings of many diseases and protein electrophoresis has an important role for screening and diagnosis of them. 4106 serum protein electrophoresis of the cases who have admitted to Trakya University Medical Faculty Hospital during 4 years were included in our study. Demographic, clinical and laboratory findings of the cases in which monoclonal gammopathy were detected were evaluated retrospectively. We compared prevelans of diseases and other features with statistical methods. %46.2 of electrophoresis were pathologic and in %22.6 of them polyclonal gammopathy, in %4.8 monoclonal gammopathy, in %1.3 hypogammaglobulinemia was detected. Among the cases with monoclonal gammopathy, multiple myeloma was the most common pathology with %64.8 and monoclonal gammopathy with undetermined significance was the second one with %25.1. The prevelance of monoclonal gammopathy in our hospital was %1.2. Mean age of this cases was 70.2 It was detected four times more in men, not detected in age <40 and most commonly seen in age >80 with %3.6. The prevelance of multipl myelom was %3.4. Mean age of patients with this disease was 68.9 and it was detected 1.5 times more in men. It was most commonly detected in 70-79 age group with %6.7. Waldenström makroglobulinemia's prevelance was %0.09, smoldering multipl myeloma's prevelance was %0.07. Transformation of monoclonal gammopathies to myeloma or other heamatologic malignant diseases during follow up was not seen. In conclusion while the most common paraproteinemia is monoclonal gammapathy in the world, in our study it was multiple myeloma. We think that this difference is due to our hospital is a third level regional hospital and the patients frequently admit to our hospital as they are already prediagnosed as multiple myeloma. Key words: Serum protein electrophoresis, monoclonal gammopathy with undetermined significance
Paraproteinemias are the laboratory findings of many diseases and protein electrophoresis has an important role for screening and diagnosis of them. 4106 serum protein electrophoresis of the cases who have admitted to Trakya University Medical Faculty Hospital during 4 years were included in our study. Demographic, clinical and laboratory findings of the cases in which monoclonal gammopathy were detected were evaluated retrospectively. We compared prevelans of diseases and other features with statistical methods. %46.2 of electrophoresis were pathologic and in %22.6 of them polyclonal gammopathy, in %4.8 monoclonal gammopathy, in %1.3 hypogammaglobulinemia was detected. Among the cases with monoclonal gammopathy, multiple myeloma was the most common pathology with %64.8 and monoclonal gammopathy with undetermined significance was the second one with %25.1. The prevelance of monoclonal gammopathy in our hospital was %1.2. Mean age of this cases was 70.2 It was detected four times more in men, not detected in age <40 and most commonly seen in age >80 with %3.6. The prevelance of multipl myelom was %3.4. Mean age of patients with this disease was 68.9 and it was detected 1.5 times more in men. It was most commonly detected in 70-79 age group with %6.7. Waldenström makroglobulinemia's prevelance was %0.09, smoldering multipl myeloma's prevelance was %0.07. Transformation of monoclonal gammopathies to myeloma or other heamatologic malignant diseases during follow up was not seen. In conclusion while the most common paraproteinemia is monoclonal gammapathy in the world, in our study it was multiple myeloma. We think that this difference is due to our hospital is a third level regional hospital and the patients frequently admit to our hospital as they are already prediagnosed as multiple myeloma. Key words: Serum protein electrophoresis, monoclonal gammopathy with undetermined significance
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Hematoloji, Hematology
