Yeni tanılı epilepsi ve febril konvülziyon hastalarında otoimmünitenin araştırılması
Küçük Resim Yok
Tarih
2011
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bolu Abant İzzet Baysal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Epileptik ve febril konvülziyonlu (FK) hastalarda etiyolojik neden olarak otoimmün mekanizmaların rolü olabileceğine dair kanıtlar giderek artmaktadır. Epileptik hastalarda otoimmün araştırmaya yönelik çalışmalar bulunmakla birlikte, yeni tanılı FK'lı hastalarda benzer bir çalışma bulunmamaktadır. Biz de bu çalışmamızda her iki paroksismal bozukluğun otoimmünite ile ilişkisini araştırmak istedik.Çalışmaya 32 hasta ve 16 sağlıklı çocuk dâhil edildi; Anti Glutamat NMDA reseptör, Anti-GAD ve Anti-Gangliozid antikorları (GM1, GM2, GM3, GD1a, GD1b, GT1b, GQ1b) düzeyleri değerlendirildi.Hastaların yaklaşık üçte birinde (%34,4, 11/32) Anti-Gangliozid antikorları pozitif bulundu. Kontrol grubu ile karşılaştırıldığında (%18,8, 3/16), epilepsi grubunda bu oran %43,8 (7/16, p>0,05), FK grubunda %25 (4/16, p>0,05) olarak belirlendi. Çalışma grubunda, otoantikor pozitifliği saptanan hastaların (11/32, %34,3) yaş ortalaması (36,6±37 ay), negatif sonuca sahip hastaların (21/32, %65,6) yaş ortalamalarından (67,9±47,4 ay) anlamlı derecede düşük bulundu (p<0,05). Epilepsi grubunda da bu değerlerde anlamlı derecede düşüklük bulundu (otoantikor pozitif hastalar yaş ortalaması: 43,7±45,8 ay, otoantikor negatif hastalar yaş ortalaması: 112±36,5 ay, p<0,05). Epilepsi grubunda Anti-Gangliozid GT1b oranı en yüksek iken (%37,5; n=6/16, p>0,05); FK (%25; n=4/16, p>0,05) ve kontrol grubunda (%18,8; n=3/16, p>0,05) bu oranlar giderek azalmakta idi. Ayrıca Anti-Gangliozid GT1b pozitifliği bulunan dört FK'lı hastanın tümünde EEG pozitifliği anlamlı bulunurken (basit FK: 3/3, komplike FK: 1/1, p<0,05); epilepsi grubunda bu pozitiflik anlamlı bulunmadı (jeneralize: 2/2, fokal: 3/4, p>0,05).Bu çalışmanın sonucunda, yeni tanılı epilepsi ve FK'lı hastalarda otoantikor pozitifliğinin, epilepsi riski ve süreğen EEG bozukluğu yönünden uyarıcı olabileceği; küçük hasta yaşının otoantikor pozitifliği ile ilişkili olabileceği belirlenmiştir.
There is increasing evidence that autoimmune mechanisms may have a role in etiology of patients with epilepsy and febrile convulsion (FC). Although there have been studies on autoimmune research in epileptic patients, there is no similar study in patients with newly diagnosed FC. In this study, we aimed to evaluate the relationship of autoimmunity with epilepsy and FC.32 patients and 16 healthy children were included in the study. Anti Glutamate NMDA receptor, Anti-GAD and Anti-Ganglioside antibody (GM1, GM2, GM3, GD1a, GD1b, GT1b, GQ1b) levels were measured.Anti-Ganglioside antibodies were positive in approximately one third of the patients (34.4%, 11/32). Compared with the control group (18.8%, 3/16), this ratio was determined 43.8% in epilepsy group (7/16, p>0.05) and 25% in FS group (4/16, p> 0.05). Mean age (36.6±37 months) of autoantibody-positive patients (11/32, 34.3%) was detected significantly lower than mean age (67.9±47.4 months) of patients with negative results (21/32, 65.6%). These values were significantly lower in patients with epilepsy too (mean age of autoantibody-positive patients: 43.7±45.8 months, mean age of autoantibody-negative patients: 112±36.5 months, p<0.05). Rate of Anti-Ganglioside GT1b was highest in epilepsy group (37.5%, n=6/16, p>0.05). The rates were decreasing steadily in FC (25%, n=4/16, p>0.05) and the control group (18.8%, n=3/16, p>0.05). In addition, EEG positivity was significant in all four FC patients with positivity of Anti-Ganglioside GT1b (simple FC: 3/3, complex FC: 1/1, p<0.05). In the epilepsy group, these positivities were not significant (generalized: 2/2, focal: 3/4, P>0.05).As a result of this study, positivity for autoantibodies in patients with newly diagnosed epilepsy and FC, may be stimulating in terms of risk of epilepsy and persistent EEG. And also autoantibody positivity was determined to be associated with young patient age.
There is increasing evidence that autoimmune mechanisms may have a role in etiology of patients with epilepsy and febrile convulsion (FC). Although there have been studies on autoimmune research in epileptic patients, there is no similar study in patients with newly diagnosed FC. In this study, we aimed to evaluate the relationship of autoimmunity with epilepsy and FC.32 patients and 16 healthy children were included in the study. Anti Glutamate NMDA receptor, Anti-GAD and Anti-Ganglioside antibody (GM1, GM2, GM3, GD1a, GD1b, GT1b, GQ1b) levels were measured.Anti-Ganglioside antibodies were positive in approximately one third of the patients (34.4%, 11/32). Compared with the control group (18.8%, 3/16), this ratio was determined 43.8% in epilepsy group (7/16, p>0.05) and 25% in FS group (4/16, p> 0.05). Mean age (36.6±37 months) of autoantibody-positive patients (11/32, 34.3%) was detected significantly lower than mean age (67.9±47.4 months) of patients with negative results (21/32, 65.6%). These values were significantly lower in patients with epilepsy too (mean age of autoantibody-positive patients: 43.7±45.8 months, mean age of autoantibody-negative patients: 112±36.5 months, p<0.05). Rate of Anti-Ganglioside GT1b was highest in epilepsy group (37.5%, n=6/16, p>0.05). The rates were decreasing steadily in FC (25%, n=4/16, p>0.05) and the control group (18.8%, n=3/16, p>0.05). In addition, EEG positivity was significant in all four FC patients with positivity of Anti-Ganglioside GT1b (simple FC: 3/3, complex FC: 1/1, p<0.05). In the epilepsy group, these positivities were not significant (generalized: 2/2, focal: 3/4, P>0.05).As a result of this study, positivity for autoantibodies in patients with newly diagnosed epilepsy and FC, may be stimulating in terms of risk of epilepsy and persistent EEG. And also autoantibody positivity was determined to be associated with young patient age.
Açıklama
Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
Anahtar Kelimeler
Çocuk Sağlığı ve Hastalıkları, Child Health and Diseases
