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The journal publishes original articles revealing recent research results in public health and management, review articles providingup-to-date analysis or discussion on research previously published by others, case reports describing interesting and exceptional clinical cases the authors have confronted with.

 

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Starting with issue 1/2015, Acta Medica Transilvanica journal will publish the articles in English language only.

 

Published since 1996

EVALUAREA IMPLICĂRII IL-6 ŞI ERITROPOIETINEI ÎN TROMBOCITOZA SECUNDARĂ LA COPIL ÎN CONTEXTUL INFECŢIEI ŞI ANEMIEI

Rezumat:

Factorul de reglare principal al producţiei trombocitare este trombopoietina (TPO). Rezultatele unor studii nu au demonstrat o relaţie de proporţionalitate indirectă între gradul de trombocitoză şi nivelul seric al  TPO. Mecanismul trombocitozei secundare în contextul anemiei feriprive nu este complet elucidat. Se presupune o reacţie încrucişată a eritropoietinei (EPO) la nivelul receptorilor trombocitari c-Mpl datorată asemănării structurale a lanţurilor de aminoacizi. Material şi metodă. Studiul este prospectiv, un lot de 39 de pacienţi, cu trombocitoză secundară şi infecţie de căi respiratorii superioare şi/sau anemie feriprivă, la care s-au determinat hemoleucogramă completă, IL6, EPO, sideremie, CRP, VSH. Concluzii. 66.66% dintre pacienţi înregistrează nivel seric IL6 la valori normale. Valoarea medie a fost de 10,210 (std. dev. 12,7530, std. error 2,04). 15 pacienţi dintre cei cu nivel crescut de IL6 (57,69%) aveau CRP pozitivă, 18 pacienţi cu VSH peste valorile normale (69.23%), 23 de pacienţi din 26 aveau leucocitoză, sugerând trombocitoză secundar unui proces inflamator. Toţi pacienţii cu sideremie sub pragul minim acceptat au avut IL6 sau EPO peste valoarea maximă acceptată, majoritatea cu IL6 crescut, fapt ce sugerează etiologia intra-infecţioasă a anemiei şi mecanisme ce nu depind de EPO de reglare a eritropoiezei în acest context.

Abstract:

The main regulation factor for thrombopoiesis is thrombopoietin. A relationship between the degree of thrombocytosis and the level of IL6 has not been established yet. The mechanism of secondary thrombocytosis due to iron deficiency anemia is not fully known. A cross-reaction, due to structural similarity of EPO and TPO, involving the c-Mpl receptor is suspected but not yet confirmed. Method: The study is prospective, made up of 39 children with secondary thrombocytosis, anemia and upper respiratory infection. We determined full blood count, platelet and erythrocyte parameters, CRP, ESR, IL6, EPO. Conclusions: 66,66% patients had levels of IL6 above normal. The mean value was 10,210 (std. dev. 12,7530, std. error 2,04). 15 of these patients had CRP above normal, 18 had ESR above normal, 23 had leukocytosis, suggesting secondary thrombocytosis due to infection. All patients with iron level below normal values had increased levels of either EPO or IL6, most of them with increased IL6, suggesting intra-infection cause for anemia and regulation mechanism of erythropoiesis that do not involve EPO.
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