The relationship of neutrophil-to-lymphocyte ratio with gastrointestinal bleeding in Henoch–Schonlein purpura

Abstract

Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis of childhood. Gastrointestinal (GI) bleeding is one of the major complications of HSP. The blood neutrophil-to-lymphocyte ratio (NLR) is identified as a potentially useful marker of clinical outcome in inflammatory diseases. NLR may be a useful biomarker of GI bleeding in children with HSP, which has a neutrophil-dominated inflammation. The aim of this study was to evaluate NLR in patients with HSP and to investigate the relationship with GI bleeding. The study consisted of 63 HSP patients and 38 age- and sex-matched healthy children. C-reactive protein, white blood cell count, platelet count, mean platelet volume (MPV), hemoglobin level, and NLR were evaluated. Logistic regression analysis and receiver operating characteristic (ROC) analysis were used to determine the variables associated with GI bleeding. NLR and MPV were the only two indicators associated with GI bleeding in HSP in logistic regression analysis. The area under the ROC curve analysis indicated that NLR could be a more efficient potential predictor of GI bleeding in HSP when compared to MPV. This study suggested that higher NLR might predict GI bleeding in HSP.

Neutrophil to Lymphocyte Ratio and Mean Platelet Volume as Inflammatory Indicators in Systemic Lupus Erythematosus Nephritis

“…24,25 High levels of MPV and NLR have been found as a predictor for gastrointestinal bleeding in the Henoch-Schonlein purpura. 26,27 Decreased MPV and NLR have been shown with the treatment of rheumatoid arthritis and ankylosing spondylitis. 28,29 Increased MPV in systemic sclerosis patients was found to be a predictive marker for macrovascular and microvascular disease involvement of systemic sclerosis.…”

Neutrophil-lymphocyte ratio in children with familial Mediterranean fever: original article

“…The N/L ratio was found to be significantly higher in patients with bacterial pneumonia than in those with viral pneumonia (17). In addition, the N/L ratio was considered a useful marker for predicting gastrointestinal bleeding in children with Henoch-Schönlein purpura (16). In children with cystic fibrosis, an elevated N/L ratio was associated with lower body mass index and lower forced expiratory volume in 1 second.…”

“…White blood cell (WBC) counts, neutrophil counts, lymphocyte counts, age, sex, and mutation types of patients were extracted. The N/L ratio was calculated by dividing the absolute neutrophil counts with the absolute lymphocyte counts, obtained from the differential WBC count (12)(13)(14)(15)(16)(17).…”

“…It was shown that inflammation continues not only during attacks but also during symptom-free periods (8)(9)(10)(11). The neutrophil/lymphocyte (N/L) ratio can be easily obtained from the differential white blood cell (WBC) count and has been studied in the context of many diseases (12)(13)(14)(15)(16)(17). It is a marker of inflammation and predicts disease prognosis (7,15).…”

Response to: Predictive role of neutrophil-to-lymphocyte ratio in Henoch–Schonlein purpura-related gastrointestinal bleeding

“…We would like to thank for the valuable contributions of our colleagues Tanoglu and Karagöz [1] about our article "The relationship of neutrophil-to-lymphocyte ratio with gastrointestinal bleeding in Henoch-Schonlein purpura" [2].…”