An Evaluation of Platelet Parameters and Neutrophil/Lymphocyte Ratios in Children with Acute Rheumatic Fever

Abstract

Acute rheumatic fever (ARF) is an inflammatory disease resulting from an autoimmune response to group A beta haemolytic streptococcal infection in sensitive individuals. It is particularly important due to being capable of leading to rheumatic heart disease associated with high morbidity and mortality (1-4). Cytokines produced by lymphocytes and macrophages that are differentiated following an antigenic stimulus play an important role in the triggering of immunological and inflammatory reactions and therefore in the pathogenesis of ARF (5-7).

Correlation between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume with severity of carditis in children with rheumatic fever

“…Platelets are increased by IL-6 stimulation. 1,9,12 Unfortunately, in our study, there was no statistically significant correlation between platelet-to-lymphocyte ratio and severity of carditis. Ozdemir et al showed higher platelet levels in children with rheumatic fever compared with healthy children.…”

“…Rheumatic heart disease is the most common form of paediatric heart disease in the world and is the leading cause of cardiac death in the first five decades of life. 9 Mitral regurgitation ranging from mild to severe was present in 95%, mitral stenosis in 16%, aortic regurgitation in 44% and tricuspid regurgitation in 56% of the patients in our study. More subjects had severe carditis with a combination of mitral regurgitation and aortic regurgitation.…”

“…Another study described IL-1 as a minor criterion for the diagnosis of carditis and IL-6 for the diagnosis of arthritis in patients with rheumatic fever. 9 In recent years, there has been a focus on white blood cell subtypes, such as neutrophils and lymphocytes, and neutrophilto-lymphocyte ratio as predictors of cardiovascular risk. Many studies have shown that high neutrophil-to-lymphocyte ratios are associated with increased inflammation in various cardiovascular diseases.…”

“…Low mean platelet volume values during rheumatic fever attacks can be attributed to IL-6 due to its effect on platelets. 9,[14][15][16][17][18] This may be related to the effect of IL-6. Mean platelet volume value was correlated with IL-6 but carditis was correlated with IL-1.…”

Novel Biomarkers and Echocardiographic Findings in Acute Rheumatic Fever Patients

“…[29] In a study conducted by Aşık et al, in which 50 patients with ARF and 50 control groups participated, a statistically significant difference was found, with WBC, neutrophil count, neutrophil/lymphocyte count ratio, and platelet high in the case group, while lymphocyte, hemoglobin, and MPV were high in the control group. [30] In the literature, SII and L/CRP has not yet been studied in patients with ARF. In our study, when the laboratory values of the patients were examined, it was determined that WBC, PLT, MPV, NE, PCT, MCHC, MO, CRP, ESH, NLR, NMO, TLO, EO, and SII values decreased significantly after treatment, while MCH, RDW, PDW, L/CRP values increased significantly after treatment.…”