Neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio are associated with disease activity in polymyalgia rheumatica

Abstract

Background The neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and monocyte‐to‐lymphocyte ratio (MLR) are indicators of systemic inflammation and are useful as markers in systemic rheumatic diseases. In this study, we compared the NLR, PLR, and MLR among patients with polymyalgia rheumatica (PMR) and rheumatoid arthritis (RA), and explored possible associations with clinical features, disease activity, and prognosis in patients with PMR. Methods The study enrolled 94 patients with PMR and 242 patients with RA who were initially diagnosed at the rheumatology clinic of a university‐based tertiary hospital. Symptoms, physical examination, and medical histories were collected with the results of laboratory tests. Results Neutrophil‐to‐lymphocyte ratio (4.5 ± 3.3 vs 2.8 ± 1.8), PLR (222.7 ± 115.5 vs 159.7 ± 78.1), and MLR (0.4 ± 0.3 vs 0.3 ± 0.2) were higher in patients with PMR compared with patients with RA (all P < .001). NLR, PLR, and MLR were correlated with specific laboratory values, including CRP and albumin, in patients with PMR. After disease activity resolved, NLR (2.95 ± 2.32, P < .001), PLR (137.5 ± 82.3, P < .001), and MLR (0.26 ± 0.16, P < .001) decreased significantly. By comparing patients according to the disease course, swollen joint counts were higher in the chronic course group compared with the remission group (P = .03), while the NLR, PLR, and MLR were similar. Conclusions Neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, and monocyte‐to‐lymphocyte ratio levels were associated with disease activity and specific clinical features, although they could not predict prognosis in patients with PMR.

Neutrophil-Lymphocyte Ratio as A Complementary Biomarker of Periprosthetic Joint Infection: A Retrospective Review

“…Aside from that, NLR has been recognized as a marker of the systemic in ammatory response [8]. As such, NLR has been reported to re ect a heightened in ammatory reaction and has gained increasing attention as a prognostic marker in many conditions, such as solid tumors, in ammatory diseases, and postoperative infection [10,11,14]. A previous study reported that NLR was signi cantly higher in patients with polymyalgia rheumatica and was shown to be associated with disease activity and speci c clinical features [10].…”

“…As such, NLR has been reported to re ect a heightened in ammatory reaction and has gained increasing attention as a prognostic marker in many conditions, such as solid tumors, in ammatory diseases, and postoperative infection [10,11,14]. A previous study reported that NLR was signi cantly higher in patients with polymyalgia rheumatica and was shown to be associated with disease activity and speci c clinical features [10]. Inose et al retrospectively investigated the association of NLR with the surgical site infection in 242 patients who underwent spinal instrumentation surgery.…”

“…The neutrophil-lymphocyte ratio (NLR), an easily accessible, cost-effective, and reproducible marker, is calculated from the complete blood count (CBC), which is recognized as a well-established marker of the systemic in ammatory response [8]. The NLR has been demonstrated to be a crucial marker for solid tumors and systemic rheumatic diseases, such as rheumatoid arthritis [9][10][11]. Recently, studies have shown that the NLR was related to the postoperative pain and surgical site infection in orthopedic surgery and might be a predictive marker for deep vein thrombosis after total knee arthroplasty [12][13][14].…”

The prognostic value of NLR for early death in secondary Hemophagocytic lymphohistiocytosis patients: an analysis of 92 patients

“…In recent years, NLR as an in ammation indicator has been well studied in various in ammation associated pathological conditions [10][11][12][13]. Higher NLR was correlated with more advanced disease stage in autoimmune disease [17,18] and it was proved to be an independent prognosis factor in infections disease [11,19], diffuse large B-cell lymphoma [20,21], and so on. Whilst, a higher NLR predicts increased 30-day mortality in critically ill patients [13,22,23].…”

Neutrophil to lymphocyte ratio predicts glucocorticoid resistance in polymyalgia rheumatica

“…In oncology, high NLR and PLR are associated with poor prognostic outcomes across a range of solid organ malignancies 3,4 . These indices have similarly been found to correlate with disease activity in several rheumatic diseases including most recently PMR, but their role in predicting treatment response in this condition is less well‐defined 5‐8 …”