Murat ŞEREFLİCAN, BETÜL ŞEREFLİCAN, Bengü TUMAN, Nadir GÖKSÜGÜR, Selcan KESGİN, Veysel YURTTAŞ

Evaluation of mean platelet volume and neutrophil to lymphocyte ratio as a diagnostic indicator in patients with recurrent aphthous stomatitis

Amaç: Rekürren aftöz stomatit (RAS) oral mukozanın tekrarlayan,ağrılı ülserlerle karakterize, kronik inflamatuar bir hastalığıdır. Sıkgörülen bir durum olmasına karşın etyolojisi ve patogenezi tam olarak bilinmemektedir. Etyolojisinin idiyopatik veya multifaktöryel olduğu belirtilmektedir. Ortalama trombosit hacmi (MPV) trombositaktivasyonunu gösteren, nötrofil lenfosit oranı (NLR) ise kronik inflamasyon göstergesi olan ve her ikisi de rutin tam kan tetkiklerindeölçülebilen değerlerdir. Bu çalışmanın amacı RAS'lı ve kontrol grubuhastalardaki MPV ve NLR değerlerini araştırmaktır. Yöntem:Bu çalışmaya 39 RAS'ı bulunan ve 34 kontrol grubu hastadahil edildi. Bulgular:Hasta ve kontrol grubu karşılaştırıldığında MPV, ESR, CRP,vitamin B12 değerlerinin hasta grubunda kontrol grubuna göre anlamlı derecede yüksek çıktı ve NLR, WBC, hemoglobin, nötrofil, lenfositdeğerleri arasında her iki grup arasında anlamlı fark bulunmadı. Sonuç:Ortalama trombosit hacminin, RAS'lı hastalarda tanısal birgösterge olabileceği ortaya konuldu

Rekürren aftöz stomatitli hastalarda bir tanıindikatörü olarak ortalama trombosit hacmi ve nötrofil/lenfosit oranının değerlendirilmesi

Objective:Recurrent aphthous stomatitis (RAS) is a chronic inflammatory disease of oral mucosa characterized by recurrent painfululcers. Despite it is a condition seen frequently, its etiology andpathogenesis are not known fully. Its etiology is reportedly idiopathic or multifactorial. Mean platelet volume (MPV) indicates thrombocytic activation, while neutrophil/lymphocyte rate (NLR) is an indicator of chronic inflammation, and both of them can be measuredduring routine whole blood analysis. The aim of this study is to investigate MPV and NLR values in patients with RAS and the controlgroup. Methods:A total of 39 patients with RAS and 34 control subjectswere included in the study. Results: When the patient and the control groups were compared,MPV, ESR, CRP and vitamin B12 values were significantly higher inthe patient group while NLR, WBC, hemoglobin, neutrophil and lymphocyte values were not significantly different between both groups. Conclusion:It was shown that MPV can be used as a diagnostic indicator in patients with RAS

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1. Chavan M, Jain H, Diwan N, Khedkar S, Shete A, Durkar S. Recurrent aphthous stomatitis: a review. J Oral Pathol Med 2012;41:577–83.
2. Brailo V, Boras VV, Cekic-Arambasin A. Recurrent aphthous ulcerations: analysis of predisposing factors in 68 patients. [Article in Croatian] Lijec Vjesn 2007;129:4–7.
3. Scully C, Gorsky M, Lozada-Nur F. The diagnosis and management of recurrent aphthous stomatitis: a consensus approach. J Am Dent Assoc 2003;134:200–7.
4. Ekiz O, Balta I, Sen BB, et al. Mean platelet volume in recurrent aphthous stomatitis and Behçet disease. Angiology 2014;65: 161–5.
5. Kapsoritakis AN, Koukourakis MI, Sfiridaki A, et al. Mean platelet volume: a useful marker of inflammatory bowel disease activity. Am J Gastroenterol 2001;96:776–81.
6. Yazici S, Yazici M, Erer B, Calik Y, Ozhan H, Ataoglu S. The platelet indices in patients with rheumatoid arthritis: mean platelet volume reflects disease activity. Platelets 2010;21:122–5.
7. Balta S, Demirkol S, Cakar M, Celik T. Mean platelet volume as a surrogate marker of low-grade inflammation in osteoarthritis. Platelets 2014;25:643–4.
8. Zahorec R. Ratio of neutrophil to lymphocyte counts – rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001;102:5–14.
9. Taflo¤lu ‹, Sert D, Colak N, Uzun A, Songur M, Ecevit A. Neutrophil-lymphocyte ratio and the platelet-lymphocyte ratio predict the limb survival in critical limb ischemia. Clin Appl Thromb Hemost 2014;20:645–50.
10. Biyik M, Ucar R, Solak Y, et al. Blood neutrophil-to-lymphocyte ratio independently predicts survival in patients with liver cirrhosis. Eur J Gastroenterol Hepatol 2013;25:435–41.
11. McLeod RI. Drug-induced aphthous ulcers. Br J Dermatol 2000;143:1133–9.
12. Landsberg R, Fallon M, Insel R. Alterations of T helper / inducer and T Supresser / inducer cells in patients with recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1990;69:205– 8.
13. Rogers RS 3rd. Recurrent aphthous stomatitis in the diagnosis of Behçet's disease. Yonsei Med J 1997;38:370–9.
14. Preeti L, Magesh K, Rajkumar K, Karthik R. Recurrent aphthous stomatitis. J Oral Maxillofac Pathol 2011;15:252–6.
15. Slebioda Z, Szponar E, Kowalska A. Etiopathogenesis of recurrent aphthous stomatitis and the role of immunologic aspects: literature review. Arch Immunol Ther Exp (Warsz) 2014;62: 205–15.
16. Geri G, Terrier B, Rosenzwajg M, et al. Critical role of IL-21 in modulating TH17 and regulatory T cells in Behçet disease. J Allergy Clin Immunol 2011;128:655–64.
17. Macey M, Hagi-Pavli E, Stewart J, et al. Age, gender and diseaserelated platelet and neutrophil activation ex vivo in whole blood samples from patients with Behçet’s disease. Rheumatology (Oxford) 2011;50:1849–59.
18. Pamuk GE, Pamuk ON, Orüm H, Demir M, Turgut B, Cakir N. Might platelet-leucocyte complexes be playing a role in major vascular involvement of Behçet’s disease? A comparative study. Blood Coagul Fibrinolysis 2010;21:113–7.
19. Akar S, Ozcan MA, Atefl H, et al. Circulated activated platelets and increased platelet reactivity in patients with Behçet's disease. Clin Appl Thromb Hemost 2006;12:451–7.
20. Demirkol S, Balta S, Kucuk U, Kucuk HO. The neutrophil lymphocyte ratio may be useful inflammatory indicator before applying other expensive and invasive procedures. Indian J Nephrol 2014;24:65–6.
21. Wang X, Zhang G, Jiang X, Zhu H, Lu Z, Xu L. Neutrophil to lymphocyte ratio in relation to risk of all-cause mortality and cardiovascular events among patients undergoing angiography or cardiac revascularization: a meta-analysis of observational studies. Atherosclerosis 2014;234:206–13.
22. Ozturk C, Balta S, Balta I, et al. Neutrophil-lymphocyte ratio and carotid-intima media thickness in patients with Behçet disease without cardiovascular involvement. Angiology 2015;66: 291–6.
23. Demir M. The relationship between neutrophil lymphocyte ratio and non-dipper hypertension. Clin Exp Hypertens 2013; 35:570–3.
24. Muhammed Suliman MA, Bahnacy Juma AA, Ali Almadhani AA, Pathare AV, Alkindi SS, Uwe Werner F. Predictive value of neutrophil to lymphocyte ratio in outcomes of patients with acute coronary syndrome. Arch Med Res 2010;41:618–22.
25. Kisacik B, Tufan A, Kalyoncu U, et al. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 2008;75:291–4.
26. Acikgoz N, Karincaoglu Y, Ermis N, et al. Increased mean platelet volume in Behçet’s disease with thrombotic tendency. Tohoku J Exp Med 2010;221:119–23.
27. Karabudak O, Ulusoy RE, Erikci AA, Solmazgul E, Dogan B, Harmanyeri Y. Inflammation and hypercoagulable state in adult psoriatic men. Acta Derm Venereol 2008;88:337–40.
28. Canpolat F, Akpinar H, Eskioglu F. Mean platelet volume in psoriasis and psoriatic arthritis. Clin Rheumatol 2010;29:325–8.
29. Pasceri V, Willerson JT, Yeh ET. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Circulation 2000;102:2165–8.