Monocyte-to-lymphocyte ratio and platelet-tolymphocyte ratio in opioid use disorder and marijuana use disorder

ABSTRACT Objective: Various methods are used to determine a person’s opioid/marijuana status. However, more specific and sensitive markers are needed that are easily applicable and accessible. Complete blood count (CBC) is a convenient method to be used for this purpose. In this study, we investigated the relationship between CBC values – particularly monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) – and opioid/marijuana use disorder. Method: We compared CBC values of 56 male patients diagnosed with opioid use disorder (OUD), 56 male patients diagnosed with marijuana use disorder (MUD), and 56 healthy subjects. Results: The percentage of monocytes was significantly higher in the MUD group compared to the OUD group (p=0.010). The monocyte count was significantly different in the MUD group compared to the other two groups (p=0.018). MLR was significantly higher in the MUD group than in the OUD group (p=0.049). PLR was significantly different from the other two groups in the OUD group (p=0.038). In the MUD group, percentage of monocytes was declining with age (r=-0.474, p=0.011). The area under the receiver operating characteristic curve of the monocyte count value for MUD was 0.670. Conclusion: Measurements like lymphocyte- and monocyte-related ratios in OUD and MUD can be important in monitoring and detecting the substance and for differentiating between acute and chronic conditions. In order to clarify the subject, further studies with fewer limitations are needed.

PDF

___

1. Verrotti A, Trotta D, Morgese G, Chiarelli F. Valproate-induced hyperammonemic encephalopathy. Metab Brain Dis 2002; 17:367-373.
2. Chopra A, Kolla BP, Mansukhani MP, Netzel P, Frye MA. Valproate-induced hyperammonemic encephalopathy: an update on risk factors, clinical correlates and management. Gen Hosp Psychiatry 2012; 34:290-298.
3. Segura-Bruna N, Rodriguez-Campello A, Puente V, Roquer J. Valproate-induced hyperammonemic encephalopathy. Acta Neurol Scand 2006; 114:1-7.
4. Lewis C, Deshpande A, Tesar GE, Dale R. Valproate-induced hyperammonemic encephalopathy: a brief review. Curr Med Res Opin 2012; 28:1039-1042.
5. Raskind JY, El-Chaar GM. The role of carnitine supplementation during valproic acid therapy. Ann Pharmacother 2000; 34:630-638.
6. Lewis C, Tesar GE, Dale R. Valproate-induced hyperammonemic encephalopathy in general hospital patients with one or more psychiatric disorders. Psychosomatics 2017; 58:415-420.
7. Velioglu SK, Gazioglu S. Non-convulsive status epilepticus secondary to valproic acid-induced hyperammonemic encephalopathy. Acta Neurol Scand 2007; 116:128-132.
8. Eryilmaz G, Gul IG, Unsalver BO, Salcini C, Saglam E. Valproic acid induced hyperammonaemic encephalopathy: case report. Journal of Mood Disorders 2014; 4:182-185.
9. Ciftci S, Guler A, Deveci E, Celebisoy N, Yuceyar N. A case with hyperammonemic encephalopathy triggered by single dose valproate. Neurol Sci 2016; 37:2017-2018.
10. Blackford MG, Do ST, Enlow TC, Reed MD. Valproic Acid and topiramate induced hyperammonemic encephalopathy in a patient with normal serum carnitine. J Pediatr Pharmacol Ther 2013; 18:128-136.
11. Rodrigues-Silva N, Venâncio Â, Bouça J. Risperidone, a risk factor for valproate-induced encephalopathy? Gen Hosp Psychiatry 2013; 35:452.e5-6.
12. Halaby A, Haddad R, Naja WJ. Hyperammonemia induced by interaction of valproate and quetiapine. Curr Drug Saf 2013; 8:284-286.
13. Tseng YL, Huang CR, Lin CH, Lu YT, Lu CH, Chen NC, et al. Risk factors of hyperammonemia in patients with epilepsy under valproic acid therapy. Medicine (Baltimore) 2014; 93:e66.
14. Yamamoto Y, Takahashi Y, Imai K, Mishima N, Kagawa Y, Inoue Y. Changing incidence of hyperammonemia in Japan from 2006 to 2013: expansion of new antiepileptic drugs reduces the risk of hyperammonemia. Eur J Clin Pharmacol 2015; 71:1517-1524.
15. Vossler DG, Wilensky AJ, Cawthon DF, Kraemer DL, Ojemann LM, Caylor LM, et al. Serum and CSF glutamine levels in valproate-related hyperammonemic encephalopathy. Epilepsia 2002; 43:154-159.
16. Eyer F, Felgenhauer N, Gempel K, Steimer W, Gerbitz KD, Zilker T. Acute valproate poisoning: pharmacokinetics, alteration in fatty acid metabolism, and changes during therapy. J Clin Psychopharmacol 2005; 25:376-380