scholarly journals Can NLR, PLR and LMR be used as prognostic indicators in patients with pulmonary embolism? A commentary

2020 ◽  
Author(s):  
Cihan Bedel ◽  
Mustafa Korkut ◽  
Hamit Hakan Armağan
Keyword(s):  
Pulmonary Embolism ◽  
Inflammatory Diseases ◽  
Systemic Infection ◽  
Clinical Severity ◽  
Prognostic Indicators ◽  
Trauma Patients ◽  
Sample Collection ◽  
Laboratory Parameters ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

We read with great interest the article “Prognostic role of NLR, PLR, and LMR in patients with pulmonary embolism” by Köse et al.[1]. They found that the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) were related to the prognosis and clinical severity of patients with pulmonary embolism (PE). First of all, we congratulate the authors for their invaluable contribution to literature. However, we think that there are some points that should be discussed regarding the use of these laboratory parameters. White blood cell subtypes NLR, PLR, and LMR have been associated with many inflammatory diseases, including PE [2,3]. These parameters, which can be easily determined by simple and easy measurement of systemic inflammation, maintain their importance today. However, these parameters are affected by many factors such as trauma, local or systemic infection, acute coronary syndromes, and malignancy [3-5]. For these reasons, it would be better for the authors to mention these factors and exclude them from the tables that included malignancy and trauma patients in the study. It is known that drugs including steroids can increase neutrophils and decrease lymphocytes and therefore affect NLR, PLR and LMR values [6]. Therefore, it will be more valuable to exclude patients who use drugs that may affect laboratory parameters. In addition, plasma inflammatory biomarkers are time dependent variables, the time of sample collection and the time from the onset of the symptom to the sampling may have an impact on the parameters [3-6]. Therefore, it is important to identify the time from first symptom to sample collection and the factors that may affect it. In conclusion, because NLR, PLR and LMR can be affected by many factors, prospective studies with large populations are needed to show the accuracy of use in critically ill patients.

scholarly journals Can Neutrophil-lymphocyte Ratio Be a Useful Criterion for Neuroleptic Malignant Syndrome in the Absence of Leukocytosis?

2021 ◽  
Author(s):  
Tevfik Kalelioglu ◽  
Guler Celikel ◽  
Ozlem Devrim Balaban ◽  
Nesrin Karamustafalioglu ◽  
Jennifer Kim Penberthy
Keyword(s):  
Case Report ◽  
Neuroleptic Malignant Syndrome ◽  
Systemic Inflammation ◽  
Antipsychotic Medication ◽  
Systemic Infection ◽  
Severe Side Effect ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Relationship Of ◽  
The Relationship

Objective: Neuroleptic malignant syndrome (NMS) is a rare but severe side effect of antipsychotic medication. Neutrophil-lymphocyte ratio (NLR) is a simple marker used to measure systemic inflammation. Method: In this case report we explore the relationship of inflammation in the etiology of NMS. In our case involving NMS, although there was no leukocytosis, the NLR was increased up to systemic infection levels. Conclusion: We hypothesized that systemic inflammation may take a role in developing NMS. If so, NLR could be a new marker of NMS that may be able to provide more sensitive results than leukocyte levels.

scholarly journals Prognostic value of neutrophil/lymphocyte ratio in patients with pulmonary embolism

2014 ◽  
Vol 44 ◽  
pp. 50-55 ◽  
Author(s):  
Umut Yücel ÇAVUŞ ◽  
Sinan YILDIRIM ◽  
Ertan SÖNMEZ ◽  
Çağatay ERTAN ◽  
Özcan ÖZEKE
Keyword(s):  
Pulmonary Embolism ◽  
Prognostic Value ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

scholarly journals The effect of neutrophil/lymphocyte ratio on 1-year mortality in pulmonary embolism diagnosed patients

2018 ◽  
Vol 29 (10) ◽  
Author(s):  
Rifat Urnal ◽  
Pinar Yesim Akyol ◽  
Zeynep Karakaya ◽  
Umut Payza ◽  
Fatih Esad Topal ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

scholarly journals The role of monocyte to high-density lipoprotein cholesterol ratio in prediction of increased systemic inflammation and the risk of cardiovascular disease in endometriosis

2021 ◽  
Vol 38 (2) ◽  
pp. 106-110
Author(s):  
İsmail BIYIK ◽  
Fatih KESKİN ◽  
Nagihan SAZ
Keyword(s):  
Systemic Inflammation ◽  
Demographic Data ◽  
Hdl Cholesterol ◽  
Reproductive Age ◽  
Prognostic Indicators ◽  
Control Group ◽  
Distribution Width ◽  
Cholesterol Ratio ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Endometriosis occurs in about 5-10 in 100 women of reproductive age. The pathophysiology of endometriosis is controversial. Some studies claimed an association between endometriosis and increased levels of inflammatory factors in peritoneal fluid and/or peripheral blood. Monocyte / HDL cholesterol ratio (MHR) and neutrophil/lymphocyte ratio (NLR) are inflammatory markers and are used as predictors and prognostic indicators of mortality and morbidity in many diseases. In this study, we aimed to investigate whether Monocyte / HDL cholesterol ratio (MHR) and neutrophil/lymphocyte ratio (NLR) are increased in endometriosis as in patients with chronic inflammation and cardiovascular diseases. This is a retrospective case-control study conducted with 87 women, 45 in the endometriosis group and 42 in the control group. The demographic data, biochemical, complete blood count parameters and lipid profile of the cases were recorded and compared between the groups. The mean age of the endometriosis group was 33.88 years and was older than the control group. In terms of other demographic data, there were no difference between the two groups. Although the platelet distribution width and triglyceride values of the endometriosis group were higher than controls, they were interpreted as clinically insignificant. There were no significant differences between the groups in terms of other laboratory parameters including MHR and NLR. In this study, MHR and NLR are found similar in endometriosis and control groups. Further studies are needed to investigate the relationship between increased systemic inflammation.

scholarly journals Profile of mean platelet volume, neutrophil - lymphocyte ratio and platelet - lymphocyte ratio in patient with psoriasis

2021 ◽  
Vol 7 (6) ◽  
pp. 765
Author(s):  
Fatema Khatun ◽  
Zakir Ahmed ◽  
Harasit K. Paul ◽  
Zinat Amin ◽  
M. S. Z. Chowdhury
Keyword(s):  
Mean Platelet Volume ◽  
Inflammatory Diseases ◽  
Systemic Disease ◽  
Severity Index ◽  
Response To Therapy ◽  
Platelet Volume ◽  
Psoriasis Area Severity Index ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio

<p class="abstract"><strong>Background:</strong> Psoriasis is a chronic, inflammatory, systemic disease. In response to therapy in psoriasis patients, the psoriasis area severity index (PASI) is used to evaluate the disease activity. However more objective laboratory tools should be developed besides PASI. In various inflammatory diseases, mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR), and platelet lymphocyte ratio (PLR) are inflammatory biomarkers that are known to be evaluated. The aim of the study was to assess the frequency of platelet activation and leukocyte infiltration by measuring MPV, NLR, and PLR.</p><p class="abstract"><strong>Methods:</strong> This was a case-control observational study conducted at department of dermatology and venereology at Bangabandhu Sheikh Mujib Medical University from July 2016 to December 2017. A total of 55 psoriasis cases and 55 healthy controls were included according to inclusion and exclusion criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> We have investigated a total of 55 psoriasis patients and another 55 age-sex matched control. There were 31 males (56.36%) and 24 females (43.44%) psoriasis patients in the study. The mean age of the patient was 34.27±13.44 years. Mean±standard deviation (SD) value of MPV, NLR, and PLR in our study cases were 9.92±1.21, 4.32±8.53, and 292.96±88.80 whereas in the case of control values were 9.46±0.636, 4.54±8.51, and 162.26±103.38 respectively.</p><p class="abstract"><strong>Conclusions:</strong> In conclusion, we suggest MPV is a strong indicator of psoriasis severity. MPV and PLR should be followed up routinely to take preventive measures against psoriasis-related micro and macro vascular thrombotic complications.</p>

scholarly journals C-reactive protein and Neutrophil-Lymphocyte Ratio as predictors of clinical severity of COVID-19

2021 ◽  
Vol 13 (2) ◽  
pp. 1-14
Author(s):  
Stefan Pandilov ◽  
Suzana Klenkoski ◽  
Elena Jovanovska Janeva ◽  
Gazmend Mehmeti ◽  
Dragan Mijakoski ◽  
...  
Keyword(s):  
Clinical Manifestation ◽  
White Blood Cells ◽  
Clinical Severity ◽  
Bivariate Analysis ◽  
C Reactive Protein ◽  
Lethal Outcome ◽  
Laboratory Parameters ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Markers Of Inflammation

COVID-19 is an infectious disease that can manifest quite differently. In this study we examined the relationship between the value of serum CRP(C-reactive protein) andneutrophil-lymphocyte ratio (NLR) as predictor factors for the development of a severe clinical manifestation in COVID19 patients. Materials and methods: We followed 95 COVID-19 positive patients who were hospitalized at the University Clinic for Eye Diseases - COVID Center. We analyzed the initial laboratory parameters of white blood cells and CRP on admission of the patients and the results of laboratory analyses performed before they left the Clinic, or the last parameters before the lethal outcome in those patients who died. Several models of logistic regression were tested to analyze the predictive value of these markers of inflammation for lethal outcome in patients hospitalized for COVID-19. Results: Bivariate analysis demonstrated that the length of hospital stay was significantly shorter in patients with lethal outcome (p=0.001). The NLR was significantly higher in patients with lethal outcome at both times (p=0.005; and p=0.017). Leukocyte’s count (p=0.046, and p<0.001) and CRP (p=0.013,and p=0.005) were also significantly higher in patients with lethal outcome at both times. The increase on the NLR scale both at hospitalization and at discharge (or the last analysis before death) leads to increase in the odds of lethal outcome (T1:40.4% increased odds; T2:36% increased odds). Conclusion: CRP and NLR are laboratory parameters that can predict the severity of the clinical manifestation in patients with COVID-19.

Independent Predictors of Severity and Hospitalization in Acute Bronchiolitis: Neutrophil/Lymphocyte Ratio and Mean Platelet Volume

2018 ◽  
Vol 13 (04) ◽  
pp. 268-273
Author(s):  
Şahin Takçı ◽  
Buket Seyyah ◽  
Resul Yılmaz ◽  
Ali Gul
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Mean Platelet Volume ◽  
Clinical Severity ◽  
Healthy Controls ◽  
Acute Bronchiolitis ◽  
Platelet Volume ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Background and Aim Acute bronchiolitis is the most common cause of hospitalization in the first year of life. The neutrophil/lymphocyte ratio (NLR) and mean platelet volume (MPV) are readily calculable laboratory markers used to evaluate systemic inflammation. We aim to evaluate the optimal values of these markers for the prediction of severity and hospitalization in infants with acute bronchiolitis. Materials and Methods A total of 105 patients with acute bronchiolitis and 62 healthy controls aged 1 to 12 months were prospectively enrolled to the study. The patients' group was classified into two groups, namely, outpatient and inpatient, also divided into three groups according to clinical scoring: mild, moderate, and severe. The association of NLR and MPV with clinical severity and hospitalization was investigated. Results The mean age was 7.75 ± 2.98 months in patients and 7.69 ± 2.87 months in controls. The means of NLR were 0.47 and 0.64 in controls and patients, respectively (p = 0.032) and of MPV were 9.64 and 8.9 (p < 0.001), respectively. The means of NLR were 0.73 and 0.50 in inpatient and outpatient groups, respectively (p = 0.014) and of MPV were 8.65 and 9.32 (p = 0.046), respectively. NLR of 0.64 value was calculated as a cutoff for the prediction of hospitalization with 45% sensitivity and 83% specificity (positive predictive value = 81%, negative predictive value = 19%). Conclusion We found that blood neutrophil percentage and blood NLR are increased and also weakly predictive—but insufficient to be clinically useful—for the decision of hospitalization in acute bronchiolitis. When the positive predictive value of an NLR of 0.64 is sufficient to decide hospitalization, the negative predictive value is impractical. MPV value was less in infants with acute bronchiolitis than healthy controls and in inpatients than outpatients with acute bronchiolitis. Low MPV might be marker of inflammation in acute bronchiolitis.

scholarly journals HEMATOLOGICAL FINDINGS AND COMPLICATIONS IN COVID 19 PATIENTS: A REVIEW.

2020 ◽  
pp. 1-3
Author(s):  
Namita Bhutani ◽  
Bhanu Sharma ◽  
Sunil Arora ◽  
Pooja Poswal ◽  
Raj Kumar
Keyword(s):  
Degradation Products ◽  
Laboratory Finding ◽  
Systemic Infection ◽  
High Serum ◽  
Severe Thrombocytopenia ◽  
Disease Course ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Fibrin Degradation Products ◽  
Dismal Prognosis

COVID-19 is a systemic infection with a significant impact on the hematopoietic system and hemostasis. Lymphopenia may be considered as a cardinal laboratory finding, with prognostic potential. Neutrophil/lymphocyte ratio and peak platelet/lymphocyte ratio may also have prognostic value in determining severe cases. During the disease course, longitudinal evaluation of lymphocyte count dynamics and inflammatory indices, including LDH, CRP and IL-6 may help to identify cases with dismal prognosis and prompt intervention in order to improve outcomes. Biomarkers, such high serum procalcitonin and ferritin have also emerged as poor prognostic factors. Furthermore, blood hypercoagulability is common among hospitalized COVID-19 patients. Elevated D-Dimer levels are consistently reported, whereas their gradual increase during disease course is particularly associated with disease worsening. Other coagulation abnormalities such as PT and aPTT prolongation, fibrin degradation products increase, with severe thrombocytopenia lead to life-threatening Disseminated intravascular coagulation (DIC) which necessitates continuous vigilance and prompt intervention. COVID-19 infected patients whatever hospitalized or ambulatory are at high risk for VTE and an early and prolonged pharmacological thromboprophylaxis with low molecular weight heparin is highly recommended. Last but not least, the need for assuring blood donations during the pandemic is also of indispensable value.

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