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

Abstract

Objective: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.

Which hemogram-derived indices might be useful in predicting the clinical outcomes of sepsis patients in the intensive care unit?

“…As far as we know, there is no study evaluating all NLR, MLR and PLR together in predicting mortality in sepsis patients previously hospitalized in ICU. Studies evaluating all 3 parameters have been conducted in the emergency room or with the aim of confirming the diagnosis of sepsis and bacteremia 11,18,36,37 [36][37][38] .…”

“…Besides the efficiency of these 3 parameters, another advantage is that they can be found cheap, simple, fast and easily in almost all healthcare facilities. Consequently, using these parameters together with other (CRP, erythrocyte sedimentation rate) markers may provide important advantages to the clinician in predicting the outcome of sepsis 37 .…”

The lymphocyte/monocyte ratio and red blood cell transfusion during radical retropubic prostatectomy

“…Therefore, the LM ratio is being studied as a potential prognosis predictor in cancer patients [11,[37][38][39]. Besides being a novel marker of the baseline inflammatory response, the LM ratio decreases in several clinical conditions, including bacterial infections, osteoporosis, stroke, acute rheumatic fever, and coronary artery atherosclerosis [14,16,[40][41][42][43]. Because an unexpected decrease in the LM ratio may be associated with poor outcomes in various clinical circumstances, its clinical application as a prognostic factor is being closely investigated.…”

Korelasi antara Neutrophil-Lymphocyte Ratio dan NT-proBNP pada Pasien Gagal Jantung Anak Akibat Penyakit Jantung Rematik

“…Selain itu, sebagian besar populasi penelitian merupakan pasien anak gagal jantung akibat PJR yang sedang tidak mengalami gejala akut atau asimtomatis. Pada penelitian sebelumnya, Giray dkk 16 melaporkan bahwa nilai NLR pada pasien DRA dengan keterlibatan karditis lebih tinggi dibanding pasien sehat, yaitu rata-rata 1,81 vs 3,0. Hal ini menunjukkan proses inflamasi yang lebih berat pada pasien DRA dengan karditis.…”

“…Pada penelitian yang bertujuan mencari penanda inflamasi pada pasien DRA tersebut juga disebutkan bahwa pada DRA serangan pertama nilai NLR lebih tinggi bahkan pada pasien dengan karditis subklinis (tidak ditemukan suara bising jantung organik namun didapatkan kelainan katup khas rematik karditis) dibanding dengan pasien DRA tanpa keterlibatan jantung. 16 Hal ini juga disebabkan karena pada keadaan paska infeksi Strepotokokus terjadi granulosistosis mulai 15 jam dan limfopenia pada 6 jam paska infeksi.…”