Kronik hepatit C’li hastalarda MRI ile abdominal lenfadenopati sikliginin arastirilmasi*
Researching frequency of abdominal lymphadenopathies in chronic hepatitis C patients with MRI
- Ana Sayfa
- Sayılar
- Kronik hepatit C’li hastalarda MRI ile abdominal lenfadenopati sikliginin arastirilmasi*...
Özet
Giris ve amaç: HCV ‘ünün periferik kan mononükleer hücrelerini infekte edip bu hücrelerde replike olmasi virüsün hepatotropik özelligi yaninda lenfotropik özelligi de oldugunu göstermistir. Kriyoglobulinemi ve non hodgkin lenfoma gibi B hücreli lenfoproliferatif hastaliklarla HCV‘ne bagli kronik karaciger hastaliklari arasinda iliski olabilecegini gösteren çok sayida çalisma mevcuttur. Bu iliskiyi arastirmaya yönelik olarak doppler ve B- mode USG ile MRI kullanilarak yapilan görüntülemelerde Kronik Hepatit C (KHC)‘li hastalarda anlamli oranlarda abdominal lenfadenopati (LAP) tespit edilmistir. Biz de çalismamizda lenfotropizm gösteren viral faktör olarak kabul edilen HCV infeksiyonlu kronik karaciger hastalarinda, yumusak doku ve damarlari çok iyi MRI ile abdominal LAP görülebilme sikligini arastirmayi amaçladik. Lenfotropik özelligi olmadigi ileri sürülen HBV’ne bagli kronik karaciger hastalari ni (KHB) da kontrol grubu olarak aldik. Gereç ve yöntem: Anti HCV ve kantitatif HCV-RNA pozitif, tümü1 b genotipine sahip, 43 hasta (26 kadin,17 erkek) ve kontrol grubu olarak 57 (19 kadin 38 erkek) HBV-DNA pozitif hasta çalismaya alindi. HCV lü hastalarin 5, HBV’ lü hastalarin ise 7 tanesi klinik ,ensefalopati olusumu,albümin, bilirubin düzeyleri, protrombin zamani, batin MRI ve özafagogastroskopik bulgulara göre karaciger sirozu tanisi almisti. Hastalar abdominal LAP açisindan MRI ile görüntülendi ve 10 mm ve daha büyük lenf nodlari patolojik olarak degerlendirildi. Bulgular: Kronik Hepatit C’li hastalarin 7’sinde (%16,3) ve kontrol grubu olarak alinan Kronik Hepatit B’li hastalari n 6’sinda (%10,5) abdominal MRI ile LAP saptandi. Sonuç: Çalismami z sonucunda elde ettigimiz %16,3’lük oran kronik hepatit C’li hastalarda bildirilen Abdominal LAP oranlarinin alt sinirinda kaldi.Buna ragmen hepatit C ile lenfoproliferatif hastaliklar arasindaki iliskiyi destekler görünüyordu. Ancak Kronik Hepatit B’li hastalarda bulunan %10,5 lik oran bize bu grup hastalarin da takibi ve ileri arastirilmasinin yapilamasi gerektigini telkin etmektedir.
Abstract
Background and aims: Mononuclear cells in peripheral blood can be infected by hepatitis C virus (HCV), and the virus can replicate in these cells. This ability of the virus demonstrates the lymphotrophic as well as hepatotrophic character of HCV. To date, there have been many studies showing a possible relationship between chronic liver disease caused by hepatitis C and B cell lymphoproliferative diseases, like cryoglobulinemia and non-Hodgkin lymphoma. To investigate this relationship, Doppler USG, B mode USG, and MRI were used. The investigators found abdominal lymphadenopathy in a significant percentage of patients. We aimed in our study to show the frequency of abdominal lymphadenopathy in chronic hepatitis patients infected by HCV, which is a lymphotrophic agent.We used MRI, which is better in imaging soft tissues and vessels. Our control group consisted of chronic liver disease patients caused by HBV since it is non-lymphotrophic. Materials and methods: Fortythree anti-HCV and HCV RNA-positive patients (26 female, 17 male) and 57 HBV DNA-positive patients (control group) (19 female, 38 male) were enrolled in this study. According to blood albumin level, prothrombin time, MRI and endoscopic findings, five of HCV-positive and seven of HBV-positive patients were assessed as liver cirrhosis. They received no new treatment, and it was the initial diagnosis for all patients. Histological assessment was not considered. MRI was used as imagining technique in all patients. Lymph nodules with a diameter of 10 mm or more were evaluated as pathologic. Results: Seven (16.5%) HCV-positive and 6 (10.5%) HBV-positive patients’ lymphadenopathies met the criteria. Conclusion: Our study result percentage of 16.5% is on the lower limit reported in chronic hepatitis C patients to date. This ratio supports the relation between hepatitis virus and lymphoproliferative disease. However, the ratio of about 10.5% found in chronic hepatitis B patients suggests that such a group of patients should be followed and investigated in this context.
