Is there clinical value in counting nucleated red blood cells and platelet indices in primary immunodeficiency disease?

Abstract

Ekici-Günay N, Çakır I, Çelik T. Is there clinical value in counting nucleated red blood cells and platelet indices in primary immunodeficiency disease? Turk J Pediatr 2017; 59: 657-663. Infections are the most common presentation of primary immunodeficiency diseases (PIDs). The increase of nucleated red blood cell (NRBC) count is interpreted as a systemic inflammatory response. Platelets play an important role in the pathogenesis of inflammatory disease. The relationship of platelet indices (PIs) and disease activity have been demonstrated in various inflammatory diseases. The aims of this study was to evaluate and compare NRBC and platelet/lymphocyte ratio (PLR), PIs [mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (PLCR)] with a possible indirect inflammatory marker in children with PIDs. Data were recorded retrospectively from 66 PIDs patients, < 16 years of age. The relationships between peripheral NRBC, C-reactive protein (CRP) and PIs were analyzed. NRBC was positively correlated with CRP (p < 0.037), white blood cells (WBC) (p < 0.020), PLR (p < 0.044), PDW (p < 0.037) and PLCR (p < 0.001) and it was negatively correlated with platelet distribution width (PDW) (p < 0.036) in PIDs patients. A cutoff level of 0.80% NRBC, ≥15.55% PDW, ≥8.65 MPV and ≥43.67 PLR showed the best performance to predict PIDs, with 81% sensitivity, 27% specificity; 61% sensitivity, 37% specificity; 70% sensitivity, 43% specificity; 54% sensitivity, 40% specificity, respectively. Our results suggested that these indices may be used as auxillary diagnostic markers of PIDs with positive NRBC, showing more meaningful results than those known as the traditional infection markers for PIDs prediction. Elevated NRBC and MPV and low PDW are associated with infections and could be helpfull in the early diagnostic susception of PIDs. They can be used as rapidly accessible parameters for awareness of PIDs. These markers are easy to use in daily practice and without extra costs.

Comparison Evaluation of Automated Nucleated Red Blood Cell Enumeration by Sysmex XN 1000 in Comparison With Microscopic Reference in Children Under 1 Year

“…In accordance with previous studies, we found a negative correlation between age and NRBC counts within the entire study cohort. Interestingly, our data yielded no interrelation between NRBC and inflammation markers, which is in contrast to former findings, reporting on a correlation of NRBC counts with CRP concentrations in adults with primary and/or secondary immundeficiency [ 26 , 27 ] and IL‐6 concentrations in adult and neonatal patients, requiring intensive care [ 28 , 29 , 30 ]. A possible explanation for these conflicting results might be the fact, that studies used different inclusion criteria with respect to age and health status: in the present investigation on children under 1 year of age, also preterm newborns were included, in whom CRP production is still not adequately accomplished by the immature liver.…”

A routine blood test-associated predictive model and application for tuberculosis diagnosis: a retrospective cohort study from northwest China

“…Second, MTB infection may be associated with other chronic infections. 30,31 In the present study, we observed changes in the reduction of PDW between the DSTB and DRTB subgroups in the training cohort, which supports the possibility of a positive correlation with the MPV. 32 Additionally, we observed an increase in PLT level, suggesting that increases in PLT level may be partly associated with the development of drug resistance in MTB.…”

Diagnostic Value and Prognostic Significance of Nucleated Red Blood Cells (NRBCs) in Selected Medical Conditions

“…The prompt diagnosis of prenatal conditions is crucial for ensuring proper neonatal care. Several studies have identified NRBCs as biomarkers in diagnosing increased erythropoiesis, acute and chronic hypoxia, anemia or hemolysis, and blood loss [12][13][14]. Christensen et al showed that this easily accessible and low-cost analysis might be additionally useful in the diagnosis of other medical conditions and can be identified as a prognostic marker among severely ill patients.…”