AI Summary & Key Takeaways
AI InsightDD status was found significantly correlated with the radiographie stage of disease, the presence of dyspnea, lower DLCO and elevated ACE level.
📌 3 Key Takeaways
Abstract
The coagulation and fibrinolytic systems have been impilicated in the pathogenesis of sarcoidosis. Enhanced expression of procoagulant activity was noted in bronchoal-veolar lavage fluid in patients with sarcoidosis. Intraalveolar activation of the coagulation cascade is thought to lead to the deposition of fibrin in the pulmonary interstisium and alveoli. Fibrin and its degradation products potentiate inflammation by modulating chemotaxis and endothelial cell injury. D dimer (DD) results from the breakdown of fibrin and can serve as a marker for fibrinolytic system activity. Additionally, circulating DD can be measured easily. DD levels have been shown to correlate with disease acitivity in lupus erythematosus and Crohn's disease. Significance of fibrinolysis in sarcoidosis and association of DD with disease activity in disorders potentially similiar to sarcoidosis suggest that DD may correlate with disease activity in sarcoidosis. Sarcodisosis patients (whether newly diagnosed or diagnosis is established before) seen in our Internal Medicine-Pulmonary Clinic between January 2000 and April 2002 were eligible to the study.The diagnosis was based on the histologie demonstration of nonnecrotizing granulomas. Presence of fungal or other mycobacterial organisms were excluded with special stains. Patients under the age of 18 years, clinical diagnosis without histologie confirmation and treatment with steroids within one year were the exclusion criterias. Patients had DD measured by D-Dimer Plus kits with turbidimetric test method. A titer of >375 mg/ml was considered a positive DD. In healthy individuals the circulating DD level measured by this method is: mean D-dimer level 125-375 mg/ml. DD was interpreted by technicians blinded to the patient's clinical data. Patients were also evaluated with history, physical examination, chest X-ray, ECG, spirometric tests and DLCO. Angiotensin converting enzyme (ACE ) levels, CRP; ESR and other labaratory parameters were also measured. DD was frequently positive among sarcoidosis patients.This implies that the coagulation system is active in these patients. DD status was found significantly correlated with the radiographie stage of disease, the presence of dyspnea, lower DLCO and elevated ACE level.
Özet
Koagulasyon ve fibrinolitik sistemin sarkoidoz patogenezisinde rol oynadığı ileri sürülmektedir. Sarkoidozlu hastaların bronkoalveolar lavaj sıvısında prokoagulant aktivitenin arttığı bildirilmiştir. Koagulasyon sisteminin intraalveolar aktivasyonunun, interstisyum ve alveollerde fibrin birikimine yol açtığı sanılmaktadır. Fibrin ve fibrin yıkım ürünleri kemotaksis ve endotel hücre hasarına neden olarak inflamasyonu artırırlar. D-Dimer (DD) fibrin yıkımı sonucu oluşur ve fibrinolitik sistem aktivitesini gösteren bir marker olarak kullanılabilir. Ayrıca, serum DD düzeyi kolaylıkla ölçülebilir. DD düzeylerinin SLE ve Kron hastalığında hastalık aktivitesiyle uyumlu olduğu gösterilmiştir. Sarkoidozda fibrinolizin önemi ve sarkoidoz benzeri hastalıklarda DD seviyesi yüksekliğinin hastalık aktivitesiyle ilişkili olması; serum DD ölçümünün sarkoidoz aktivitesini yansıtabileceğini düşündürmektedir. Ocak 2000 ile Nisan 2002 arasında İç Hastalıkları-Akciğer Birimi kliniğimizde yada polikliniğimizde izlediğimiz eski veya yeni tanı konulan sarkoidoz hastaları bu çalışma için uygun bulundu. Sarkoidoz tanısı klinik ve histolojik olarak özel boyalarla yapılan incelemelerle fungal ve miko-bakteriyel mikroorganizmaların olmadığı non-kazeifiye (diğer granulomatöz hastalıkların dışlandığı) granulomlarm gösterilmesiyle konuldu. Çalışmaya aşağıdaki hastalar alınmadı. 1.