Promjene hematoloških parametara kod bolesnika s Cushingovim sindromom

master's thesis

• Title (english): Changes in hematological parameters in patients with Cushing's syndrome
• Author: Dora Darapi
• Mentor: Darko Kaštelan (mentor)
• Committee member: Tina Dušek (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Darko Kaštelan (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Cushingov sindrom (CS) je skup različitih simptoma i znakova nastalih uslijed izloženosti organa i tkiva suvišku glukokortikoidnih hormona. Endogeni CS se prema uzroku nastanka može podijeliti u dvije skupine: o ACTH ovisan i o ACTH neovisan CS. Kod ACTH ovisnog CS porijeklo prekomjernog lučenja glukokortikoida najčešće je kortikotropni adenom hipofize i tada govorimo o Cushingovoj bolesti. ACTH neovisni CS najčešće nastaje zbog adenoma ili karcinoma nadbubrežne žlijezde. Cilj ovog retrospektivnog istraživanja bila je usporedba hematoloških parametara pacijenata oboljelih od CS s parametrima pacijenata iz kontrolne skupine. U istraživanju su analizirani hematološki parametri 55 pacijenata s endogenim CS (46 žena i 9 muškaraca), liječenih na Zavodu za endokrinologiju Klinike za unutarnje bolesti Kliničkog bolničkog centra Zagreb u razdoblju od svibnja 2011. do ožujka 2018. U kontrolnu skupinu su uključeni pacijenti liječeni zbog tumora hipofize ili nadbubrežne žlijezde na istom Zavodu. Kriteriji pri izboru kontrola bili su: odsutnost poremećaja u osovini hipotalamus-hipofiza-nadbubrežna žlijezda i odsutnost poremećaja razine androgena. Žene s CS imale su statistički značajno više vrijednosti E i Hb od žena u kontrolnoj skupini (p<0,05). Muškarci s CS imali su niže vrijednosti E i Hb u odnosu na muškarce u kontrolnoj skupini, iako navedena razlika nije bila statistički značajna. Različite promjene vrijednosti E i Hb između spolova vjerojatno se pojavljuju zbog inhibitornog učinka glukokortikoida na gonadotropine i posljedičnog hipogonadizma u muškaraca. Vrijednosti L i Ne bile su statistički značajno više u CS kod oba spola, u usporedbi s kontrolnim skupinama. Rezultati ovog istraživanja su pokazali da je povišena koncentracija glukokortikoida povezana s većim brojem leukocita dok se učinak na broj eritrocita razlikuje ovisno o spolu.

Abstract (english)

Cushing's syndrome (CS) is a collection of signs and symptoms that develop as a result of high glucocorticoid levels in the body. The endogenous CS can be divided into two groups according to the cause of it's occurrence: ACTH dependent and ACTH independent CS. Pituitary corticotroph adenoma is the most common cause of ACTH dependent CS. In this case the disorder is called Cushing's disease. ACTH independent CS is most commonly caused by adrenocortical adenoma or adrenocortical carcinoma. The aim of this retrospective study was to compare haematological parameters between patients with CS and control groups. The study included 55 patients (46 woman and 9 men) with endogenous CS treated between May 2011 and January 2018 at the Division of Endocrinology, Department of Internal Medicine, University Hospital Centre Zagreb. Control groups consisted of subjects who were treated at the same Department for pituitary or adrenal gland tumors. Criteria for the choice of patients for the control groups were: absence of hypothalamic-pituitary-adrenal axis dysfunction and normal androgen levels. Female patients had higher values of E and Hb compared to women in the control group. This result was statistically significant (p<0,05). Men with CS had lower values of E and Hb compared to men in the control group, although this difference in male patients was not statistically significant. Different changes in E and Hb values between genders probably occur due to the inhibitory effect of glucocorticoids on gonadotropins and consequent hypogonadism in male patients. L and Ne values were higher in both women and men with CS compared to control groups. The result regarding L and Ne values was also statistically significant. This study showed that glucocorticoid excess is associated with high blood leukocyte count. Conversely, there is a gender difference in glucocorticoid effect on blood erythrocyte count.

• Keywords: Cushingov sindrom; hematološki parametri; spol
• Keywords (english): Cushing's syndrome; haematological parameters; gender
• Language: croatian
• URN:NBN: urn:nbn:hr:105:182798
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-11-21 10:10:55