Agustos 2017
Inflamatuvar barsak hastaliklarinda Entamoeba histolytica süperenfeksiyonu ülkemizde bir sorun mu?
Is Entamoeba histolytica superinfection a problem in inflammatory bowel disease in our country?
- Ana Sayfa
- Sayılar
- Agustos 2017
- Inflamatuvar barsak hastaliklarinda Entamoeba histolytica süperenfeksiyonu ülkemizde bir sorun mu?...
Özet
Giris ve Amaç: Inflamatuvar barsak hastaliginda amebiyazisin sikligini ve bu durumun ülkemizde sorun olusturup olusturmadigini arastirmak. Gereç ve Yöntem: Mart 2002 ile Mayis 2003 tarihleri arasinda inflamatuvar barsak hastaligi tanisi ile gelen 137 hasta [ülseratif kolitli 115 hasta; 58 kadin (%50.4), 57 erkek (%49.6), Crohn’lu 22 hasta; 15 kadin (%68.1), 7 erkek (%31.9)] amebiyazis açisindan degerlendirildi. Kontrol grubu olarak 32 saglikli hasta; 17 kadin (%53.1), 15 erkek (%46.9) alindi. Hastalarin ve kontrollerin hepsinden kan ve diski örnekleri alinarak, diski örnekleri gözle görülür kanama varligi açisindan incelendi ve bekletilmeden serum fizyolojik ve lügol damlatma yöntemi ile isik mikroskobunda Entamoeba histolytica kist ve trofozoitleri açisindan degerlendirildi. Bulgular: 137 hastadan 23’ünde (%16.8) diskida kanama saptandi ve kanama saptanan hastalarin hepsi ülseratif kolit olgulariydi. 137 hastadan 31’inde (%22.6) diskida Entamoeba histolytica kisti saptanirken, kontrol grubunda 4 olguda (%12.5) kist saptandi. Incelenen hiçbir diski örneginde Entamoeba histolytica trofozoitleri gözlenmedi. 137 hastanin 26’sinda (%19.0) 1/64 ve alti titrelerde ve bir hastada (%0.7) ise 1/64 pozitiflik saptanirken, üç kontrol hastasinda (%9.4) düsük titre pozitiflik elde edildi. Çalisma sonucunda hiçbir deger pozitif kabul edilmedi. Bu çalismada inflamatuvar barsak hastaliginda Entamoeba histolytica enfeksiyonu saptanmamis oldu. Çalismada diskida kan varligi açisindan; ülseratif kolit ile Crohn hastaligi ve kontrol grubu arasinda istatistiksel olarak anlamli derecede yüksek kanama varligi saptandi (ki-kare, p=0.02). Sonuç: Ülkemizde inflamatuvar barsak hastaligi ile amebiyazis birlikteligi nadir bir durumdur.
Abstract
Background and Aims: To evaluate whether superinfection of amebiasis in inflammatory bowel disease is a problem in Turkey. Materials and Methods: One hundred and thirty-seven patients with inflammatory bowel disease were evaluated between March 2002 and May 2003. One hundred and fifteen had ulcerative colitis; 58 females (50.4%) and 57 males (49.6%), 22 had Crohn’s disease; 15 females (68.1%) and 7 males (31.9%). For the control group, 32 healthy cases; 17 females (53.1%) and 15 males (46.9%), were evaluated. Fresh stool samples and serum samples were obtained from all members of both groups. Stool samples were evaluated by the naked eye for bleeding and light microscopy for Entamoeba histolytica cysts, and trophozoites using wet mount and lugol application methods. Results: In 137 patients with inflammatory bowel disease, 23 (16.8%) had bloody diarrhea. All patients with bloody diarrhea had a diagnosis of ulcerative colitis. In 137 patients and 32 control cases, 31 patients (22.6 %) and four control cases (12.5%) had Entamoeba histolytica cysts in their stools. Entamoeba histolytica trophozoites were not seen in any case. In 137 patients, 26 (19.0%) had titers 1/64 and below, and one (0.7%) had titer 1/64. In 32 control cases, three (9.4%) had low titers. No patients with inflammatory bowel disease had Entamoeba histolytica infection. Blood found in stools in ulcerative colitis cases was statistically higher than that found in both Crohn’s disease cases and control group (Chi-square test, p=0.02). Conclusion: Superinfection of amebiasis in inflammatory bowel disease patients is a seldom occurrence in our country.
