Anti-Nötrofil Sitoplazmik Antikor İlişkili Vaskülitlerde Hematolojik Parametrelerin Prognostik Değeri

Giriş ve Amaç: Nötrofil-Lenfosit oranı (NLO), Platelet-Lenfosit oranı (PLO) ve Monosit-Lenfosit oranı (MLO) dahil olmak üzere hematolojik parametreler, çeşitli hastalıklarda prognoz ve aktivitenin yeni belirleyicileri olarak gösterilmiştir. Bu çalışmada, anti-nötrofil sitoplazmik antikor (ANCA) ilişkili vaskülit (AİV) tanısı olan hastalarda NLO, PLO ve MLO' nun hastalık şiddeti ve prognozu ile ilişkisini araştırmayı amaçladık. Gereç ve Yöntemler: 92 AİV hastasının tıbbi kayıtları geriye dönük olarak incelendi. Klinik ve laboratuvar verileri ve hastalık sonuçları kaydedildi. Beş faktör skoru (FFS) ≥ 2 olan hastalar ağır hastalık olarak sınıflandırıldı. Bulgular: Ortanca yaşı 60 olan 92 hasta dahil edildi. NLO≥4.8 (RR 1.83), PLO≥151.8 (RR 2.02) ve MLO≥0.38 (RR 1.85) olan hastalarda ciddi hastalık riski daha yüksekti. Korelasyon analizinde, NLO, PLO ve MLO, C reaktif protein düzeyi ve eritrosit sedimantasyon hızı (ESH) ile pozitif korelasyon gösterdi. NLO, PLO ve MLO remisyon ile ilişkilendirildi. Sadece PLO'su yüksek olan hastalarda nüks oranı daha yüksekti. MLO ayrıca son dönem böbrek hastalığının (SDBY) gelişimi ile de korele idi. NLO, PLO ve MLO düzeyleri yüksek olan hastalarda böbrek tutulumu daha sıktı. Sonuç: Tanı anında NLO, PLO ve MLO'nun AİV şiddeti ve prognozu ile ilişkili olduğunu gösterdik. Bu çalışma AİV'li hastalarda MLO'nun hastalık şiddeti ve SDBY ile ilişkisini gösteren ilk çalışmadır.

Anahtar Kelimeler:

Antinötrofil sitoplazmik antikor ilişkili vaskülit, nötrofil/lenfosit oranı, trombosit/lenfosit oranı, monosit/lenfosit oranı

Prognostic Value of Hematological Parameters in Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis

Objective: Hematological parameters including neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and monocyte–lymphocyte ratio (MLR) have been demonstrated as new predictors of prognosis and activity in various diseases. In this study, we aimed to investigate the associations of NLR, PLR and MLR with disease severity and prognosis in patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). Materials and Methods: Medical records of 92 AAV patients were investigated retrospectively. The clinical and laboratory data, and disease outcomes were recorded. The patients having five factor score (FFS) ≥ 2 were categorized as severe disease. Results: 92 patients with a median age of 60 years were included. Patients with NLR≥4.8 (RR 1.83), PLR≥151.8 (RR 2.02) and MLR≥0.38 (RR 1.85) had higher risk of severe disease. In correlation analysis, NLR, PLR and MLR were positively correlated with C reactive protein and erythrocyte sedimentation rate (ESR). NLR, PLR and MLR were associated with remission. Conclusion: Only the patients with high PLR had higher relapse rate. MLR was also correlated with development of end-stage renal disease (ESRD). Renal involvement was more frequent in patients with high levels of NLR, PLR and MLR. Conclusions: We showed that NLR, PLR and MLR at diagnosis were associated with the severity and prognosis of AAV. This is the first study, showing the correlation of MLR with disease severity and ESRD in patients with AAV.

Keywords:

Antineutrophil cytoplasmic antibody-associated vasculitis, eutrophil / lymphocyte ratio, platelet / lymphocyte ratio, monocyte / lymphocyte ratio,

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