Platelet/lymphocyte ratio and mean platelet volume in patients with granulomatosis with polyangiitis

Abstract

Background: Granulomatosis with polyangiitis (GPA) is a granulomatous necrotizing vasculitis with high morbidity and mortality. Anti-neutrophil cytoplasmic antibody is a valuable diagnostic marker, however its titer lacks predictive value for the severity of organ involvement. Platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) has been regarded as a potential marker in assessing systemic inflammation. We aimed to explore the value of PLR and MPV in the assessment of disease activity and manifestations of disease in GPA. Methods: 56 newly diagnosed GPA patients and 53 age-sex matched healthy controls were included in this retrospective and cross-sectional study with comparative group. Complete blood count was performed with Backman Coulter automatic analyzer, erythrocyte sedimentation rate (ESR) with Westergen method and C-reactive protein (CRP) levels with nephelometry. The PLR was calculated as the ratio of platelet and lymphocyte counts. Result: Compared to control group, ESR, CRP and PLR were significantly higher and MPV significantly lower in GPA patients. In patients group, PLR was positively correlated with ESR and CRP (r = 0.39, p = 0.005 and r = 0.51, p < 0.001, respectively). MPV was negatively correlated with ESR and CRP (r = − 0.31, p = 0.028 and r = − 0.34 p = 0.014, respectively). Patients with renal involvement had significantly higher PLR than patients without renal involvement (median:265.98, IQR:208.79 vs median:180.34 IQR:129.37, p = 0.02). PLR was negatively correlated with glomerular filtration rate (r = − 0.27, p = 0.009). A cutoff level of 204 for PLR had 65.6% sensitivity and 62.5 specificity to predict renal involvement. Conclusion: PLR exhibit favorable diagnostic performance in predicting renal involvement in patients with GPA.

Evaluation of inflammatory biomarkers in patients with keratoconus

“…34 These markers are involved in the literature as inflammatory markers and studies have shown a significant correlation between the severity of disease and this marker in liver failure and rheumatological diseases. 35,36 In our study, we could not find a significant difference between the KC patient group and the control group. We think that this might be the result of the lack of diffuse systemic inflammation in keratoconus and possible inflammation not to be accompanied by thrombotic events.…”

Long-Term Prognostic Factors in Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A 15-Year Multicenter Retrospective Study

“…Platelet-to-lymphocyte ratio (PLR) was identified to be an independent predictor of current vasculitis activity in AAV ( 18 ). Moreover, PLR was negatively correlated with GFR, and was a predictor for renal involvement ( 19 ). Liver involvement is related to the disease activity and predicts poor clinical outcomes in GPA ( 20 ).…”

Factors Affecting Dilation Interval in Patients With Granulomatosis With Polyangiitis‐Associated Subglottic and Glottic Stenosis

“…Biomarkers such as ANCA titers, ESR, and C‐reactive protein may be elevated in, but are not correlated with, disease activity and prediction of GPA relapses 52–54 . One study found that a combined increase in neutrophil count, C‐reactive protein, and anti‐PR3 antibodies may successfully predict relapse 52 , 55 . In GPA‐associated SGS, the role of systemic inflammatory biomarkers is even more complex because SGS frequently occurs in the absence of systemically active GPA 11 , 12 .…”

“…The utility of biomarkers in predicting GPA activity is controversial. Biomarkers such as ANCA titers, ESR, and C‐reactive protein may be elevated in, but are not correlated with, disease activity and prediction of GPA relapses 52–54 . One study found that a combined increase in neutrophil count, C‐reactive protein, and anti‐PR3 antibodies may successfully predict relapse 52 , 55 .…”

“…[52][53][54] One study found that a combined increase in neutrophil count, Creactive protein, and anti-PR3 antibodies may successfully predict relapse. 52,55 In GPA-associated SGS, the role of systemic inflammatory biomarkers is even more complex because SGS frequently occurs in the absence of systemically active GPA. 11,12 In our study, 62% of GPA-associated SGS cases were positive for c-ANCA, which is consistent with reports in the literature ranging between 67% and 70%.…”