Diagnostic role of mean platelet volume and neutrophil to lymphocyte ratio in childhood brucellosis

Abstract

Background/AimsBrucellosis patients present various non-specific clinical symptoms, such as fever, fatigue, sweating, joint pain, arthritis, myalgia, and headache. Based on the nonspecifity of its clinical signs and symtoms, we decided to evaluate whether mean platelet volume (MPV) , neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) will contribute to the diagnosis.MethodsIn this retrospective study, we reviewed hospital-records of 60 children with a confirmed diagnosis of brucellosis in Kayseri between January 2013 and January 2016, and compared the hematological parameters; white blood cell (WBC) count, hemoglobin (Hb), neutrophil count, lymphocyte count, platelet count, MPV, NLR, and PLR with 55 healthy age and gender matched children. Also, the well known inf lammation markers; erytrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were compared between the patient and control group.ResultsWe found significant difference among the Hb, platelet count, MPV and NLR values between the patient and control group (p < 0.05). There was no difference between WBC, neutrophil count, lymphocyte count and PLR between the patient and control group (p > 0.05). When the patients were divided into groups as arthritis positive and arthritis negative and compared to the control group; we found that the NLR is more significant in between the arthritis positive and control group (p = 0.013). Also, we found significant difference among the ESR and CRP values between the patient and control group (p < 0.001).ConclusionsThe results of this study indicates that MPV and NLR values can be used as markers of inflammation in childhood brucellosis. Also, NLR is more valuable in children with brucella arthritis.

<p>Usefulness of Blood Parameters for Preliminary Diagnosis of Brucellosis</p>

“…Research results show that hematological parameters in patients with brucellosis differ from patient to patient and these parameters can return to their normal value after the treatment of brucellosis. 6 The inflammatory process that occurs during brucellosis is associated with an increase in acute-phase reactants. 18 CRP is an acute-phase protein that increases up to 1000fold in the blood of patients with infection or inflammation.…”

“…22 Another study reported that patients with the acute brucellosis exhibited higher CRP levels than the control group. 6,13,23 Some other studies have suggested that elevated CRP level may also be associated with disease severity and mortality in hospitalized patients with community-acquired pneumonia. 24 In our study, CRP was significantly higher in brucellosis patients, which indicates that CRP is a valuable marker for the diagnosis of brucellosis.…”

“…Therefore, serological tests are often used as diagnostic and screening tools. 5,6 Serological tests sometimes have false results, in particular in case of cross-reactions with other gram-negative bacteria such as Escherichia coli, Yersinia enterocolitica, and Salmonella Urbana. 5 Since a high rate of false-positive results with serological tests, the confirmatory tests are required for positive samples.…”

“…Following infection, Brucella spreads to the lymph nodes and from there to the blood and causes systemic infection. 6 As a result, the increase in the number of leukocytes and neutrophils, as well as changes in inflammatory indices, occurs during infection. 10,11 Research has shown that platelets also contribute to the inflammatory response.…”

“…[12][13][14] Changes in hematological markers are commonly observed in brucellosis. 6 Hematological markers, including white blood cell count, platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), and CRP test, have been used in the preliminary diagnosis of brucellosis, along with serological tests. 14 Both diagnosis and follow-up of treatment for brucellosis are complicated, and it may be helpful to use routine laboratory tests for better management of this disease.…”