Red cell distribution width and neutrophil–lymphocyte ratio in rheumatoid arthritis

Remalante, Patricia Pauline M.; Salido, Evelyn O.; Penserga, Ester G.; Gauiran, Deonne Thaddeus V.

doi:10.1007/s00296-020-04685-3

Cited by 11 publications

(20 citation statements)

References 34 publications

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“…In their studies, Al-Rawi et al 51 and Lin et al 52 reported a significant increase in RDW in RA patients and a positive correlation with CRP levels. Another study by Remalante et al 53 discovered no link between RDW and ESR.…”

Section: Discussionmentioning

confidence: 92%

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Can Complete Blood Count Picture Tell Us More About the Activity of Rheumatological Diseases?

Taha

Samaan

Ibrahim

et al. 2022

Clin Med�Insights�Arthritis�Musculoskelet Disord

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Background: In clinical practice, distinguishing disease activity in patients with rheumatological illnesses is challenging. Objectives: We aimed to investigate clinical associations of hemogram-derived indices, namely: red cell distribution width (RDW), mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII) with disease activity in patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis (AS). Methods: In 250 patients with rheumatological disease and 100 healthy age-matched controls, we investigated disease activity scores and indicators and evaluated their association with hemogram-derived indices values. Results: Compared with the control group, RDW, MPV, and PLR significantly increased ( P < .001) in the three studied disorders (RA, SLE, and AS), but LMR dramatically decreased. SII was considerably higher in RA and AS patients compared with controls but not in SLE patients. On the other hand, NLR rose dramatically in SLE patients compared with controls ( P = .043), but did not change much in RA and AS patients ( P > .05). RDW and MPV showed significant changes ( P < .001) in the three studied diseases (RA, SLE, and AS) according to disease activity. They significantly increased across worsening activity scores. Only in the SLE group, PLR was significantly increased with disease activity ( P < .001), while LMR showed a significant decrease ( P = .016). Conclusions: Clinicians must pay close attention to complete blood count (CBC) analysis and its various derived ratios to better characterize the activity of rheumatological disorders and anticipate the disease course and prognosis.

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Section: Discussionmentioning

confidence: 92%

“…Very few studies investigated the ability of CBC parameters to differentiate between active RA and RA in remission, 53 , 55 , 56 and most of the studies focused on the diagnostic value of CBC parameters in differentiating healthy controls from RA patients.…”

Section: Discussionmentioning

confidence: 99%

Can Complete Blood Count Picture Tell Us More About the Activity of Rheumatological Diseases?

Taha

Samaan

Ibrahim

et al. 2022

Clin Med�Insights�Arthritis�Musculoskelet Disord

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“…[ 15 ] Recently, several studies have reported significant associations among the NLR, PLR, LMR and the presence of RA, as well as disease activity. [ 16 – 22 ]…”

Section: Introductionmentioning

confidence: 99%

Neutrophil-lymphocyte, platelet-lymphocyte and lymphocyte-monocyte ratios may not be useful markers to assess disease activity in rheumatoid arthritis

et al. 2021

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The associations among the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) and disease activity in rheumatoid arthritis remains unclear.To evaluate these indicators as potential markers of disease activity in patients with rheumatoid arthritis (RA).This cross-sectional study included 547 adult patients with RA. The patients were divided into two groups according to the disease activity score (DAS) system: remission and disease activity. Differences in the NLR, PLR and LMR of the two groups were assessed. Correlations were analyzed using Spearman analysis, and receiver operating characteristic (ROC) curves were used to identify the sensitivity, specificity, and optimal cutoff values to differentiate active RA patients from inactive RA patients.There was a statistically significant difference in the NLR (4.2 ± 3.2 vs 3.4 ± 2.4, P = .034) and PLR (222.3 ± 136.4 vs 176.9 ± 89.8, P = .006) between the two groups, but not for the LMR (3.0 ± 1.8 vs 3.4 ± 2.4, P = .115). In addition, the DAS28 and traditional inflammatory markers, including ESR and CRP, were weakly positively correlated with the NLR and PLR. Based on the ROC curves, the NLR (sensitivity 31.8%, specificity 77.8%) and PLR (sensitivity 57.3%, specificity 63.9%) were less valuable than the ESR (sensitivity 67.2%, specificity 91.7%) and CRP (sensitivity 76.2%, specificity 91.7%) for differentiating inactive RA patients from active RA patients due to low sensitivity and specificity and combining NLR or PLR also cannot significantly improved the diagnostic value of ESR and CRP.NLR, PLR and LMR may not be an useful independent diagnostic or complementary marker for disease activity in RA patients.

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“…Monocytes are the largest white blood cells that play a crucial part in the defense system.Studies have shown that monocytes are signi cantly pluripotent in different in ammatory environments [30].Compared with other blood cells, monocytes contain more non-speci c lipases and have stronger phagocytosis.When in ammation or other immune diseases occur in the body, the number of total monocytes can be changed [31]. Similarly,Lymphocyte have a sensitive immune response in in ammation.Therefore, the examination of monocyte and lymphocyte counts have become an important method for auxiliary diagnosis [4].Besides, Platelets are also a component of the immune system and play a directrolein regulating and inducing tissue damage and pathogen responses.They contain and release or re-produce a large number of immune molecules that directly affect the development and outcome of in ammatory diseases [32].Morerecently, PLR, NLR, and LMR values have been often used as prognostic indicators of systemic in ammation,immunological diseases and malignancies [33][34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

The role of lymphocyte-monocyte ratio on Chronic inflammatory demyelinating polyradiculoneuropathy diagnosis and disease activity

hong¹,

Xia

zhang³

et al. 2022

Preprint

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Background: Chronic inflammatory demyelinating polyneuropathy (CIDP) is characterized by significant clinical heterogeneity, and as such reliable biomarkers help to identify and measure disease activity. The purpose of this study was to investigate the role of lymphocyte/monocyte ratio (LMR) in CIDP diagnosis and disease activity classification. Method: This retrospective study involved 36 patients with CIDP and 36 healthy controls (HC). The CIDP patients were grouped into 23 active CIDP patients and 13 with long-lasting remission. Hematological parameters, C-reactive protein (CRP) and erythrocyte sedimentation rate(ESR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) , and LMR were compared between the CIDP patients and HCs. Pearson or Spearman correlation analyses were used to evaluate the correlations between LMR and other indicators. Receiver operating characteristic (ROC) curves were used to determine the role of LMR in the diagnosis of CIDP.Results: The CIDP patients showed lower LMR compared to HCs (P<0.05), and active disease patients showed lower LMR levels compared to the remission group (P<0.05). Positive correlations were observed between LMR and Hb (Hemoglobin), RBC (Red blood cells), and A/G (Albumin/globulin ratio), whereas LMR was negatively correlated with NLR, PLR, RDW (Red cell distribution width) (P<0.05). ROC curves showed that the area under the curve (AUC) for LMR in the diagnosis of CIDP was 0.807 (95% CI=0.705-0.908) with a sensitivity and specificity of 77.78 and 75%, and the AUC (95% CI) for the combination of ESR, A/G and LMR was 0.885 (0.809- 0.961) with a sensitivity and specificity of 80.56% and 77.48% respectively. Conclusion: Our study suggests that LMR may be an important inflammatory marker for recognizing CIDP and assessing disease activity.

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Red cell distribution width and neutrophil–lymphocyte ratio in rheumatoid arthritis

Cited by 11 publications

References 34 publications

Can Complete Blood Count Picture Tell Us More About the Activity of Rheumatological Diseases?

Can Complete Blood Count Picture Tell Us More About the Activity of Rheumatological Diseases?

Neutrophil-lymphocyte, platelet-lymphocyte and lymphocyte-monocyte ratios may not be useful markers to assess disease activity in rheumatoid arthritis

The role of lymphocyte-monocyte ratio on Chronic inflammatory demyelinating polyradiculoneuropathy diagnosis and disease activity

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