Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis)

Sarkoidoz, idiyopatik granülomatöz bir hastalıktır. Genellikle akciğer tutulumu vardır. Tanısı, granülomatöz inflamasyonun bilinen diğer nedenlerinin dışlanması gerekliliği yüzünden zor olabilir. Çok merkezli çalışmamızda sarkoidozun klinik görünümleri ve tanısal yaklaşımlarının değerlendirilmesi amaçlandı. Çalışma protokolü internet üzerinden araştırmacılara gönderildi ve yeni tanı almış sarkoidoz olgularına ait bilgilerini göndermeleri istendi (klinik, radyolojik ve tanısal). İki yıl içinde 293 hasta verisi toplandı. Solunumsal yakınmalar, hastaların %73.3’ünde bulundu ve öksürük en sık yakınmaydı (%53.2), dispne (%40.3) ikinci sıklıktaydı. Konstitüsyonel yakınmalar hastaların yarısında görüldü. En sık olanı yorgunluktu (%38.6). En yaygın bulgu eritema nodozum (%17.1) idi. En sık akciğer radyogramı bulgusu bilateral hiler lenfadenomegali (%78.8) idi. Radyolojik evrelemede hastaların çoğunluğunun Evre I ve Evre II olduğu bulundu (sırasıyla %51.9 ve %31.7). Histolojik doğrulama 265 (%90.4) hastada gerçekleşmişti. Bronkoskopilerin üçte biri normal iken, mukozal hiperemi (%19.8) ve bronş duvarının dışarıdan basısı (%16.8) yaygın anormal bulgular idi. Sık kullanılan örnekleme yöntemleri arasında yer alan mediastinoskopide tanı başarısı %100 idi. En sık kullanılan tanı yöntemi olan transbronşiyal biyopsinin başarı oranı %48.8 idi. Sarkoidoza çok yönlü yaklaşım, sık ve seyrek rastlanan bulguları göz önünde bulundurularak ayırıcı tanı listelerinde yer alması, olası tutulmuş alanlara yönelik tanısal incelemelerin organizasyonu ve birarada çalışan ekip üyelerinin konunun uzmanı olması sayesinde iyileştirilir.

Anahtar Kelime:

Konular: Solunum Sistemi Kulak, Burun, Boğaz

Sarkoidozlu olgularda klinik görünüm ve tanısal yaklaşım: Türk olgu serisi (sarkoidoz kliniği ve tanı yaklaşımları)

Öz:

Sarcoidosis is an idiopathic granulomatous disease. It usually affects the lung. The diagnosis may be problematic since the known causes of granulomatous inflammation must be excluded. This multicenter study aimed to evaluate the clinical presentations and diagnostic approaches of sarcoidosis. The study protocol was sent via internet, and the participants were asked to send the information (clinical, radiological and diagnostic) on newly diagnosed sarcoidosis cases. 293 patients were enrolled within two years. Pulmonary symptoms were found in 73.3% of the patients, and cough was the most common one (53.2%), followed by dyspnea (40.3%). Constitutional symptoms were occured in half of the patients. The most common one was fatigue (38.6%). The most common physical sign was eritema nodosum (17.1%). The most common chest radiograhical sign was bilateral hilar lymphadenomegaly (78.8%). Staging according to chest X-ray has revealed that most of the patients were in Stage I and Stage II (51.9% and 31.7%, respectively). Sarcoidosis was confirmed histopathologically in 265 (90.4%) patients. Although one-third of the bronchoscopy was revealed normal, mucosal hyperemi (19.8%) and external compression of the bronchial wall (16.8%) were common abnormal findings. The 100% success rate was obtained in mediastinoscopy among the frequently used sampling methods. Transbronchial biopsy was the most frequently used method with 48.8% success rate. Considering sarcoidosis with its most common and also rare findings in the differential diagnosis, organizing the related procedures according to the possibly effected areas, and the expertise of the team would favour multimodality diagnosis.

Anahtar Kelime:

Konular: Solunum Sistemi Kulak, Burun, Boğaz

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	KITER G, Musellim B, ÇETİNKAYA E, Turker H, UZASLAN K, Yentürk E, uzun o, SAĞLAM L, ÖZDEMİR KUMBASAR Ö, ÇELİK G, Okumus G, ARBAK P, ALTIAY G, Tabak L, COŞKUN Ş, ERTURAN S, turktas h, YALNIZ E, AKKOÇLU A, ÖĞÜŞ C, DOGAN O, Ozkan M, ÖZKAN S, Uzel F, ÖNGEN H (2011). Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis). , 248 - 258.
Chicago	KITER Göksel,Musellim Benan,ÇETİNKAYA Erdoğan,Turker Hatice,UZASLAN Kunt A. Esra,Yentürk Esin,uzun oğuz,SAĞLAM Leyla,ÖZDEMİR KUMBASAR ÖZLEM,ÇELİK Gökhan,Okumus Gulfer,ARBAK PERİ MERAM,ALTIAY Gündeniz,Tabak Levent,COŞKUN Şakar Ayşin,ERTURAN Serdar,turktas haluk,YALNIZ ENVER,AKKOÇLU ATİLA,ÖĞÜŞ Candan,DOGAN OMER TAMER,Ozkan Metin,ÖZKAN SERİR,Uzel Fatma Işıl,ÖNGEN HÜRREM GÜL Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis). (2011): 248 - 258.
MLA	KITER Göksel,Musellim Benan,ÇETİNKAYA Erdoğan,Turker Hatice,UZASLAN Kunt A. Esra,Yentürk Esin,uzun oğuz,SAĞLAM Leyla,ÖZDEMİR KUMBASAR ÖZLEM,ÇELİK Gökhan,Okumus Gulfer,ARBAK PERİ MERAM,ALTIAY Gündeniz,Tabak Levent,COŞKUN Şakar Ayşin,ERTURAN Serdar,turktas haluk,YALNIZ ENVER,AKKOÇLU ATİLA,ÖĞÜŞ Candan,DOGAN OMER TAMER,Ozkan Metin,ÖZKAN SERİR,Uzel Fatma Işıl,ÖNGEN HÜRREM GÜL Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis). , 2011, ss.248 - 258.
AMA	KITER G,Musellim B,ÇETİNKAYA E,Turker H,UZASLAN K,Yentürk E,uzun o,SAĞLAM L,ÖZDEMİR KUMBASAR Ö,ÇELİK G,Okumus G,ARBAK P,ALTIAY G,Tabak L,COŞKUN Ş,ERTURAN S,turktas h,YALNIZ E,AKKOÇLU A,ÖĞÜŞ C,DOGAN O,Ozkan M,ÖZKAN S,Uzel F,ÖNGEN H Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis). . 2011; 248 - 258.
Vancouver	KITER G,Musellim B,ÇETİNKAYA E,Turker H,UZASLAN K,Yentürk E,uzun o,SAĞLAM L,ÖZDEMİR KUMBASAR Ö,ÇELİK G,Okumus G,ARBAK P,ALTIAY G,Tabak L,COŞKUN Ş,ERTURAN S,turktas h,YALNIZ E,AKKOÇLU A,ÖĞÜŞ C,DOGAN O,Ozkan M,ÖZKAN S,Uzel F,ÖNGEN H Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis). . 2011; 248 - 258.
IEEE	KITER G,Musellim B,ÇETİNKAYA E,Turker H,UZASLAN K,Yentürk E,uzun o,SAĞLAM L,ÖZDEMİR KUMBASAR Ö,ÇELİK G,Okumus G,ARBAK P,ALTIAY G,Tabak L,COŞKUN Ş,ERTURAN S,turktas h,YALNIZ E,AKKOÇLU A,ÖĞÜŞ C,DOGAN O,Ozkan M,ÖZKAN S,Uzel F,ÖNGEN H "Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis)." , ss.248 - 258, 2011.
ISNAD	KITER, Göksel vd. "Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis)". (2011), 248-258.

APA	KITER G, Musellim B, ÇETİNKAYA E, Turker H, UZASLAN K, Yentürk E, uzun o, SAĞLAM L, ÖZDEMİR KUMBASAR Ö, ÇELİK G, Okumus G, ARBAK P, ALTIAY G, Tabak L, COŞKUN Ş, ERTURAN S, turktas h, YALNIZ E, AKKOÇLU A, ÖĞÜŞ C, DOGAN O, Ozkan M, ÖZKAN S, Uzel F, ÖNGEN H (2011). Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis). Tüberküloz ve Toraks, 59(3), 248 - 258.
Chicago	KITER Göksel,Musellim Benan,ÇETİNKAYA Erdoğan,Turker Hatice,UZASLAN Kunt A. Esra,Yentürk Esin,uzun oğuz,SAĞLAM Leyla,ÖZDEMİR KUMBASAR ÖZLEM,ÇELİK Gökhan,Okumus Gulfer,ARBAK PERİ MERAM,ALTIAY Gündeniz,Tabak Levent,COŞKUN Şakar Ayşin,ERTURAN Serdar,turktas haluk,YALNIZ ENVER,AKKOÇLU ATİLA,ÖĞÜŞ Candan,DOGAN OMER TAMER,Ozkan Metin,ÖZKAN SERİR,Uzel Fatma Işıl,ÖNGEN HÜRREM GÜL Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis). Tüberküloz ve Toraks 59, no.3 (2011): 248 - 258.
MLA	KITER Göksel,Musellim Benan,ÇETİNKAYA Erdoğan,Turker Hatice,UZASLAN Kunt A. Esra,Yentürk Esin,uzun oğuz,SAĞLAM Leyla,ÖZDEMİR KUMBASAR ÖZLEM,ÇELİK Gökhan,Okumus Gulfer,ARBAK PERİ MERAM,ALTIAY Gündeniz,Tabak Levent,COŞKUN Şakar Ayşin,ERTURAN Serdar,turktas haluk,YALNIZ ENVER,AKKOÇLU ATİLA,ÖĞÜŞ Candan,DOGAN OMER TAMER,Ozkan Metin,ÖZKAN SERİR,Uzel Fatma Işıl,ÖNGEN HÜRREM GÜL Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis). Tüberküloz ve Toraks, vol.59, no.3, 2011, ss.248 - 258.
AMA	KITER G,Musellim B,ÇETİNKAYA E,Turker H,UZASLAN K,Yentürk E,uzun o,SAĞLAM L,ÖZDEMİR KUMBASAR Ö,ÇELİK G,Okumus G,ARBAK P,ALTIAY G,Tabak L,COŞKUN Ş,ERTURAN S,turktas h,YALNIZ E,AKKOÇLU A,ÖĞÜŞ C,DOGAN O,Ozkan M,ÖZKAN S,Uzel F,ÖNGEN H Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis). Tüberküloz ve Toraks. 2011; 59(3): 248 - 258.
Vancouver	KITER G,Musellim B,ÇETİNKAYA E,Turker H,UZASLAN K,Yentürk E,uzun o,SAĞLAM L,ÖZDEMİR KUMBASAR Ö,ÇELİK G,Okumus G,ARBAK P,ALTIAY G,Tabak L,COŞKUN Ş,ERTURAN S,turktas h,YALNIZ E,AKKOÇLU A,ÖĞÜŞ C,DOGAN O,Ozkan M,ÖZKAN S,Uzel F,ÖNGEN H Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis). Tüberküloz ve Toraks. 2011; 59(3): 248 - 258.
IEEE	KITER G,Musellim B,ÇETİNKAYA E,Turker H,UZASLAN K,Yentürk E,uzun o,SAĞLAM L,ÖZDEMİR KUMBASAR Ö,ÇELİK G,Okumus G,ARBAK P,ALTIAY G,Tabak L,COŞKUN Ş,ERTURAN S,turktas h,YALNIZ E,AKKOÇLU A,ÖĞÜŞ C,DOGAN O,Ozkan M,ÖZKAN S,Uzel F,ÖNGEN H "Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis)." Tüberküloz ve Toraks, 59, ss.248 - 258, 2011.
ISNAD	KITER, Göksel vd. "Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis)". Tüberküloz ve Toraks 59/3 (2011), 248-258.