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PANDEMİK İNFLUENZA A (H1N1) 2009: PATOGENEZ VE KLİNİK ÖZELLİKLER

PANDEMIC INFLUENZA A (H1N1) 2009: PATHOGENESIS AND CLINICAL FEATURES

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2010

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Pandemic 2009 H1N1 virus is able to bind to α2,6-linked receptors found on the surface of cells located deep in the lungs that seasonal influenza virus cannot bind, suggesting why people with the pandemic H1N1 influenza can experience more severe viral pneumonitis as compared to seasonal influenza. Although the initial viral load was found to be similar to that of patients with mild disease, there was a slower decline in viral load for severe cases of 2009 H1N1 virus infection. The main pathological features in the lung are varying degrees of diffuse alveolar damage with hyaline membranes and septal edema, tracheitis, and necrotizing bronchiolitis. Analyses have suggested that clinical manifestations of 2009 H1N1 influenza and seasonal influenza are similar with fever, nonproductive cough, sore throat, myalgia, malaise, chills, rhinorrhea, headache and dyspnea. Gastrointestinal symptoms occur more commonly than in seasonal influenza. Patients requiring hospitalization for 2009 H1N1 virus infection are much more likely to have underlying medical conditions. Pregnant women, especially in their second and third trimester, are also at a higher risk for severe disease. A number of infected patients with diffuse viral pneumonitis associated with severe hypoxemia become critically ill and require intensive care admission. Many hospitalized patients have had lymphocytopenia and elevations in levels of serum aminotransferases, lactate dehydrogenase, creatine kinase, and creatinine.
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Abstract (Original Language): 
Pandemik H1N1 virusunun akciğerlerde derinde yerleşmiş hücrelerin yüzeyinde bulunan ve mevsimsel influenza virusunun bağlanamadığı α2,6 bağlı reseptörlere bağlanabildiği bulunmuştur. Bu gözlem bu infeksiyonu geçirenlerin mevsimsel influenzadan daha ağır bir viral pnömonite yakalanmasını açıklar. Başlangıçtaki viral yük 2009 H1N1 virusu infeksiyonu olan ağır olgularda hafif hastalığı olanlarınki gibidir. Ancak bu hastalarda viral yükün düşmesi daha yavaş olur. Akciğerdeki başlıca patolojik değişiklikler değişen derecelerde olabilen hyalen membran ve septal ödemin eşlik ettiği yaygın bir alveol hasarı, trakeit ve nekrotizan bronşiyolittir. Yapılan analizler, 2009 H1N1 virusu infeksiyonuyla mevsimsel influenzanın klinik görünümlerinin benzer olduğunu ortaya koymuştur. Başlıca belirtiler, ateş, kuru öksürük, boğaz ağrısı, kas ağrısı, üşüme, nezle, baş ağrısı ve dispnedir. Gastrointestinal belirtiler, mevsimsel influenzadakinden daha sık görülür. 2009 H1N1 virusu infeksiyonuyla hastaneye yatırılmayı gerektiren hastaların çoğunda altta yatan hastalıklar söz konusudur. Hastalığı ağır geçirme riski, özellikle ikinci ve üçüncü trimestrdeki gebelerde de yüksektir. Ağır hipokseminin eşlik ettiği difüz viral pnömoniti olan birçok hasta, durumu kritik hale gelerek yoğun bakıma gereksinim duyar. Hastaneye yatırılan hastaların çoğunda lenfopeni, serum aminotransferaz, laktat dehidrogenaz, kreatin kinaz ve kreatinin düzeylerinde yükselmeler saptanır.
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  • Turkish

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