Prognostic value of inflammatory markers determined during diagnosis in patients with sarcoidosis: chronic versus remission

Abstract

OBJECTIVE: This study aimed to evaluate the prognostic value of inflammatory markers determined during admission among patients with sarcoidosis with chronic and remission groups.METHODS: This study was designed as retrospective single-center study. Patients with sarcoidosis without treatment and who had at least two years of follow-up were included in this study. Patients were divided into two groups as chronic and remission. The primary outcome is to evaluate hematological parameters in remission and chronic sarcoidosis groups.RESULTS: Out of 348 patients with sarcoidosis, 142 patients without treatment and followed up for at least two years were included in this study. Groups had similar demographic features with the predominance of females (80.4 and 77.9%, respectively) and stage I disease (78.6 and 68.6%, respectively). Lymphocyte count [median (IQR) 1.7 (1.3-2.3) 109/L versus 2.1 (1.6-2.4) 109/L, p=0.034] was significantly lower, whereas neutrophil to lymphocyte ratio (NLR) was significantly higher [median (IQR) 2.6 (2.0-3.1) versus 2.0 (1.6-2.8), p=0.006] at admission in the chronic group. No significant difference was determined in inflammatory parameters at admission between groups.CONCLUSION: Lower lymphocyte count and higher neutrophil to lymphocyte ratio were determined in patients with chronic sarcoidosis compared with the remission group, based on monitoring of radiological staging up to five-year after the initial diagnosis. Accordingly, the identification of neutrophil to lymphocyte ratio at diagnosis seems to be a potential prognostic marker in patients with sarcoidosis beside its low cost and easy determination in routine clinical practice.

Pan-immune-inflammation value and systemic immune-inflammation index: Are they useful markers in sarcoidosis?

“…Another study showed a higher frequency of high NLR in patients with extrapulmonary involvement [42]. Bekir et al [25] demonstrated that lymphocyte count was significantly lower in the chronic group upon admission, while NLR was significantly higher in the chronic group compared to the remitting sarcoidosis group, suggesting a possible association between lymphocyte count, NLR levels, and prognosis. A review reported that tumor necrosis factor alpha and chemokine ligand 18 might help identify patients at high risk of developing pulmonary fibrosis or progressive disease [13].…”

“…All pathological analyses were conducted in the pathology laboratory of our hospital. In cases where patients did not consent to biopsy and/or presented with Löfgren's syndrome, the diagnosis of sarcoidosis was made based on clinical, radiological, and laboratory findings in accordance with established criteria [25].…”

SACE and IL-2R as serum biomarkers for evaluation of multi-organ involvement and prognosis of sarcoidosis

“…Beijer et al reported that serum amyloid A (SAA) levels were higher in fibrotic sarcoidosis patients compared to those without fibrosis [8]. Other investigators have reported that an increased neutrophil to lymphocyte ratio (NLR) can be seen in patients with lung parenchymal involvement and chronic sarcoidosis [9,10]. However, the value of serum biomarkers has not been clearly identified for the prediction of multi-organ involvement or prognostic outcome assessment for patients with sarcoidosis.…”