Immature granulocyte and other hematological inflammatory parameters in patients with migraine headache

Background: Today, many hypotheses have been proposed in the pathogenesis of migraine. The inflammatory hypothesis is one of them. The immature granulocyte count (IGC) is also an inflammatory parameter which importance has been understood recently. There are no studies evaluating IGC in migraine. The aim of the study to investigate the levels of IGC and other hematological inflammatory parameters in migraine. Material and Method: Materials and Methods: Forty-eight patients diagnosed with migraine who applied to Kastamonu Training and Research Hospital Neurology outpatient clinic between 07.01.2020 and 10.01.2021 were included in the study. 42 people with similar age and gender distribution were included for the control group. Data on laboratory tests, age and gender of patients were obtained from the hospital Laboratory Information System (LIS). CBC parameters of the patients at the first admission and before any treatment, calculated with an automated hematological analyzer (XN-1000-Hematology-analyzer-Sysmex Corporation, Japan) were analyzed. Using Complete Blood Count (CBC) data, neutrophil count (NEUT#), neutrophil percentage (NEUT%), lymphocyte percentage (LYMPH%), and IGC were recorded. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic immune inflammation index (SII) values were calculated with the formula. Results: In our study, NLR and IGC was significantly higher than the healthy control group (p=0.002, p=0.025). PLR was also found to be high, but it was not statistically significant (p=0.063). Conclusion: The significantly higher NLR and IGC levels in migraine patients compared to the healthy controls support the role of inflammation in etiopathogenesis.

Immature granulocytes can help the diagnosis of pulmonary bacterial infections in patients with severe COVID-19 pneumonia

During COVID-19, immature granulocyte (IG) concentration is heterogeneous with higher concentrations than those found in bacterial sepsis. We investigated the relationship between IG levels at ICU admission and on days 7 (± 2) and 15 (± 2) and associated pulmonary bacterial infections in intensive care unit (ICU) patients hospitalized for an acute respiratory distress syndrome (ARDS) related to SARS-CoV-2. Patients with associated pulmonary bacterial infection had a peak of IGs. IG thresholds of 18% or 2 G/L allowed discriminating patients with ventilator associated pneumonia with 100% sensitivity and specificity. Our study supports that IGs could help identifying pulmonary bacterial infections in this population.

Neutrophil Maturation, Reactivity and Granularity Research Parameters to Characterize and Differentiate Convalescent Patients from Active SARS-CoV-2 Infection

Studying the dynamics changes of neutrophils during innate immune response in coronavirus 2019 (COVID-19) can help understand the pathogenesis of this disease. The aim of the study was to assess the usefulness of new neutrophil activation parameters: Immature Granulocyte (IG), Neutrophil Reactivity Intensity (NEUT-RI), Neutrophil Granularity Intensity (NEUT-GI), and data relating to granularity, activity, and neutrophil volume (NE-WX, NE-WY, NE-WZ) available in hematology analyzers to distinguish convalescent patients from patients with active SARS-CoV-2 infection and healthy controls (HC). The study group consisted of 79 patients with a confirmed positive RT-PCR test for SARS-CoV2 infection, 71 convalescent patients, and 20 HC. We observed leukopenia with neutrophilia in patients with active infection compared to convalescents and HC. The IG median absolute count was higher in convalescent patients than in COVID-19 and HC (respectively, 0.08 vs. 0.03 vs. 0.02, p < 0.0001). The value of the NEUT-RI parameter was the highest in HC and the lowest in convalescents (48.3 vs. 43.7, p < 0.0001). We observed the highest proportion of NE-WX, NE-WY, and NE-WZ parameters in HC, without differences between the COVID-19 and convalescent groups. New neutrophil parameters can be useful tools to assess neutrophils’ activity and functionalities in the immune response during infection and recovery from COVID-19 disease.

Can immature granulocytes indicate mortality in patients with acute ischemic stroke?

Background & Objective: Stroke is the most common cause of permanent disability and the most important cause of mortality. Acute ischemic stroke (AIS) reveals inflammation in the ischemic brain tissue. Ischemic tissue causes proinflammatory cytokine release and aggregation of immune cells. Therefore in this study, we aimed to investigate the role of immature granulocyte (IG) in showing 30-day mortality in patients with AİS. Methods: This study was designed as a single-centered, retrospective cohort study. Patients aged >18 years who were diagnosed with AIS in the tertiary emergency department were included in this study. Patients were divided into two groups as low (<0.6%) and high (≥0.6%) by IG values. Demographic and laboratory parameters were compared between the groups at admission to the emergency department. Results: Our study consisted of 172 patients diagnosed with AIS, who met the inclusion criteria. The average age of the study group was 69.19 ± 14.34 years, and 94 (54.7%) of the patients were male. 98 (56.9%) patients were in the low IG group, and 74 (43.1%) of them were in the poor outcome group. IG at the cut-off value of 1.3 was shown to predict mortality in patients with AIS with 80.5% sensitivity and 93.2% specificity (area under the curve: 0.715 95% CI: 0.623-0.807, p <0.001) Conclusion: The results of our study showed that IG is a new and simple predictor to predict 30-day prognosis in patients with AIS.

Role of Manual Immature to Total Neutrophil (I/T) Ratio and Automated Immature Granulocyte Count (IGC) and Percentage (IG%) in the Early Diagnosis of Neonatal Sepsis

Background: The diagnosis of neonatal sepsis is challenging due to non-specific and subtle clinical features, low sensitivity and delay in routine laboratory tests. Current study was conducted to evaluate the role of manual immature/total (I/T) neutrophil ratio and automated immature granulocyte count (IGC) and immature granulocyte percentage (IG%) in the diagnosis of neonatal sepsis. Materials and Methods: An analytical cross-sectional study was done during a period of 6 months with a sample of 55 neonates admitted to Colombo South Teaching Hospital, Sri Lanka. A combination of clinical and laboratory parameters including full blood count, C-reactive protein and blood culture were used to identify the neonates with probable sepsis. The population was subcategorized into five (5) groups and manual immature/total neutrophil (I/T) ratio, immature granulocyte count (IGC) and immature granulocyte%(IG%) were done in each neonate. Results: The sensitivity of manual I/T ratio was 93.75% and negative predictive value (NPV) was 95.24%. The sensitivity for lower cut off values, IGC of 0.03x103/µL and IG% of 0.5% was 80% and 73.33% respectively. The NPV for above cut-off values were 25% and 0.5% respectively. The NPV was improved with higher cut-off values with 70.90% for IGC 0.3 and 70.59% for IG 3%, but sensitivity remained low with 40% and 33.33% respectively.Conclusion: Manual I/T ratio remains as a useful diagnostic tool in diagnosing and excluding neonatal sepsis with a very good sensitivity and NPV. However, further studies and well defined reference intervals are required in automated IGC and IG%.