The prognostic value of hematological indices in systemic inflammatory diseases of connective tissue

Abstract

Introduction. The lack of available and effective laboratory markers makes predicting exacerbations and progression in systemic inflammatory diseases of connective tissue an intractable task for rheumatologists and primary care specialists who monitor patients. Hematological indices calculated from a complete blood count have demonstrated effectiveness in predicting the course of several diseases.Aim. To determine the prognostic value of hematological indices of complete blood count (RDW, MPV, PLR, NLR, LMR, PMR,PNR, SII) in predicting exacerbations and progression of systemic inflammatory diseases of connective tissueMaterials and methods. For a retrospective observational case-control study, patients with systemic lupus erythematosus (SLE) and ANCA-associated vasculitis (microscopic polyangiitis, granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis) were selected. Patients with an exacerbation or progression of the disease that occurred within 3–12 months were assigned to the main group, patients with stable disease were assigned to the control group.Results. 60 patients were selected, of which 25 had an exacerbation or progression over the next 3–12 months, 35 had a stable course of the disease. The initial clinical and demographic characteristics of patients had no significant differences, including between the subgroups with ANCA-associated vasculitis (n = 35) and systemic lupus erythematosus (n = 25). Patients in the main group had a higher initial erythrocyte distribution width (p < 0.001). Statistically significant differences were observed between the groups in the baseline level of platelet-lymphocytic, neutrophil-lymphocytic, platelet-neutrophil ratios and the index of systemic inflammation, but in the subgroups of SLE and ANCA-associated vasculitis, the differences were divergent.Conclusion. The red blood cell distribution width demonstrated a higher prognostic value in relation to exacerbations and progression of ANCA-associated vasculitis and SLE compared with ESR and C-reactive protein and appears to be the most universal among the studied markers of prognosis of systemic inflammatory diseases of connective tissue.