Are there any novel markers in acute rheumatic fever: neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio

2020 ◽  
Vol 30 (5) ◽  
pp. 717-721
Author(s):  
Dilek Giray ◽  
Olgu Hallioglu

AbstractObjective:The aim of this study was to investigate the relationship between C-reactive protein and erythrocyte sedimentation rate and neutrophil-to-lymphocyte, platelet-to-lymphocyte, and monocyte-to-lymphocyte ratios in acute rheumatic fever in children.Method:In this retrospective study, 182 patients with acute rheumatic fever and 173 controls were included. Complete blood count parameters, and neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios were recorded for all the patients underwent transthoracic echocardiography.Results:Neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios were significantly higher in patients with rheumatic heart disease than patients without cardiac involvement (p < 0.05). C-reactive protein and erythrocyte sedimentation rate levels were found to have a positive correlation with neutrophil-to-lymphocyte (r = 0.228, p = 0.001; r = 0.355, p = 0.001), platelet-to-lymphocyte (r = 0.227, p = 0.01; r = 0.149, p = 0.005), and monocyte-to-lymphocyte ratios (r = 0.117, p = 0.005; r = 0.107, p = 0.044). Cardiac involvement was present in 152 (83.5%) of the patients. Neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios were significantly higher in patients with rheumatic heart disease than patients without cardiac involvement (p < 0.05). Patients with carditis were grouped according to mitral, aortic, or both valve involvement but there was no significant difference between the groups with respect to neutrophil-to-lymphocyte, monocyte-to-lymphocyte, and platelet-to-lymphocyte ratios. In addition, neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios were significantly higher in patients with Sydenham’s chorea than without chorea (p < 0.05).Conclusion:Neutrophil-to-lymphocyte, platelet-to-lymphocyte, and monocyte-to-lymphocyte ratios may help make the diagnosis of acute rheumatic fever and its prognosis by serial measurements in follow-up but none of them tell us the severity of carditis. Also, this is the first study showing the positive correlation between Sydenham’s chorea and neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios. Further studies are needed to confirm this hypothesis, as this is the first study in the literature on this topic.

2020 ◽  
Vol 8 (B) ◽  
pp. 1185-1192
Author(s):  
Gede Febby Pratama Kusuma ◽  
Sri Maliawan ◽  
Tjokorda Gde Bagus Mahadewa ◽  
Tjokorda Gde Agung Senapathi ◽  
Anak Agung Wiradewi Lestari ◽  
...  

BACKGROUND: Immune system and inflammatory response play an essential role in the development of secondary brain injury (SBI) after traumatic brain injury (TBI). An inflammatory biomarker that can reflect the SBI severity is needed to increase the effectivity of TBI management and prevent morbidity and mortality post-TBI. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), which are more affordable than C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), theoretically have the potential to be used as a marker of the SBI severity. However, NLR and PLR in daily medical practice are not yet fully utilized. AIM: The aim of the study was to correlate NLR and PLR with CRP and ESR as a marker of SBI severity post-TBI. METHODS: This cross-sectional study was conducted at Sanglah Hospital Denpasar from January to April 2020. Patients diagnosed with TBI were included in this study by consecutive sampling. The blood samples were taken at 24-h post-TBI to obtain the NLR, PLR, CRP, and ESR results. Spearman’s correlation test was conducted to determine the correlation between NLR and PLR with CRP and ESR. RESULTS: Eighty-five patients were included in data analysis. Median ± (interquartile range) of the NLR, PLR, CRP, and ESR were 7.60 ± (6.83), 145.58 ± (76.95), 60.83 ± (66.3), and 12.50 ± (13.85) consecutively. NLR and PLR had a significant positive correlation with CRP (r = 0.472, **p < 0.01; r = 0.283, **p < 0.01 consecutively). But, NLR and PLR were not correlated with ESR. CONCLUSION: NLR and PLR can become a useful and more affordable marker for reflecting the SBI severity in acute TBI.


2021 ◽  
pp. 1-7
Author(s):  
Zahra Soleimani ◽  
Fatemeh Amighi ◽  
Zarichehr Vakili ◽  
Mansooreh Momen-Heravi ◽  
Seyyed Alireza Moravveji

BACKGROUND: The diagnosis of osteomyelitis is a key step of diabetic foot management. Procalcitonin (PCT) is a novel infection marker. This study aimed to investigate the diagnostic value of procalcitonin and other conventional infection markers and clinical findings in diagnosis of osteomyelitis in diabetic foot patients. METHODS AND MATERIALS: This diagnostic value study was carried out on ninety patients with diabetic infected foot ulcers admitted in Kashan Beheshti Hospital, 2016. After obtaining consent, 10 cc blood sample was taken for measuring serum PCT, CBC, ESR, CRP and FBS. Clinical characteristics of the wounds were noted. Magnetic resonance imaging of the foot was performed in all patients to diagnose osteomyelitis. All statistical analyses were done with the use of SPSS-16. RESULTS: PCT levels were 0.13 ± 0.02 ng/mili patients with osteomyelitis (n= 45) and 0.04 ± 0.02 ng/ml in patients without osteomyelitis (n= 45). PCT, Erythrocyte sedimentation rate and C-reactive protein was found significantly higher in patients with osteomyelitis (p< 0.001). The ROC curve was calculated for PCT. The area under the ROC curve for infection identification was 1 (p< 0.001). The best cut-off value for PCT was 0.085 ng/ml. Sensitivity, specificity, and positive and negative predictive values were 100%, 97.8%,97.8% and 100%, respectively. CONCLUSION: In this group of patients, PCT was useful to discriminate patients with bone infection. Also, Erythrocyte sedimentation rate and C-reactive protein can be used as a marker of osteomyelitis in diabetic patients.


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