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Correlation between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume with severity of carditis in children with rheumatic fever

Part of: Infectious

Published online by Cambridge University Press:  14 October 2021

I Gusti Ayu D. Aryani Open the ORCID record for I Gusti Ayu D. Aryani [Opens in a new window] ,
Ni Putu V. K. Yantie ,
Eka Gunawijaya  and
I Wayan Gustawan
I Gusti Ayu D. Aryani*
Affiliation:
Department of Pediatric, Medical School of Universitas Udayana/Integrated Cardiac Center, Sanglah Hospital, Denpasar, Indonesia
Ni Putu V. K. Yantie
Affiliation:
Department of Pediatric, Medical School of Universitas Udayana/Integrated Cardiac Center, Sanglah Hospital, Denpasar, Indonesia
Eka Gunawijaya
Affiliation:
Department of Pediatric, Medical School of Universitas Udayana/Integrated Cardiac Center, Sanglah Hospital, Denpasar, Indonesia
I Wayan Gustawan
Affiliation:
Department of Pediatric, Medical School of Universitas Udayana/Integrated Cardiac Center, Sanglah Hospital, Denpasar, Indonesia
*
Author for correspondence: I. G. A. D. Aryani, Department of Pediatric, Medical School of Universitas Udayana/Integrated Cardiac Center, Sanglah Hospital, Denpasar, Bali, Indonesia. Email: [email protected]
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Abstract

Background:

The most serious manifestation of rheumatic fever is carditis, as it can lead to chronic rheumatic heart disease. Neutrophil-to-lymphocyte ratio, platelet-to lymphocyte ratio and mean platelet volume have been accepted as novel indicators of the continuing inflammation that is correlated with the severity of valvular involvement in patients with rheumatic carditis.

Objective:

As a diagnostic study to investigate the correlation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume with the severity of carditis in children with rheumatic fever.

Methods:

This was a cross-sectional study at Sanglah Hospital, Bali. Data were collected retrospectively from medical records. Severity of carditis was characterised by a clinical, audible murmur during physical examination and demonstration of valvular involvement by echocardiography. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume were calculated from complete blood count. The correlation between parameters was assessed using Spearman’s correlation tests.

Results:

From January 2018 to December 2020, we found 45 cases admitted to Sanglah Hospital. Carditis was present in 40 (88.9%) subjects. Neutrophil-to-lymphocyte ratio had a strong positive correlation with severity of carditis (r = 0.66, p = 0.001), while platelet-to-lymphocyte ratio had a weak positive correlation with the severity of carditis (r = 0.23, p = 0.13) and mean platelet volume had a very weak negative correlation with the severity of carditis (r = −0.01, p = 0.95). Using a cut-off of 3.4, neutrophil-to-lymphocyte ratio predicted severe carditis with a sensitivity of 81.8% and specificity of 91.3%.

Conclusion:

There was a positive correlation between neutrophil-to-lymphocyte ratio and severity of carditis in children with rheumatic fever. Neutrophil-to-lymphocyte ratio might be used as a diagnostic tool to predict the diagnosis of carditis severity.

Keywords

Rheumatic feverneutrophil-to-lymphocyte ratioplatelet-to lymphocyte ratiomean platelet volume
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 9 , September 2022 , pp. 1396 - 1400
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Giray, D, Hallioglu, O. Are there any novel markers in acute rheumatic fever: neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio. Cardiol Young 2020; 30: 1–5. DOI 10.1017/S104795112000089X.Google ScholarPubMed
Orun, UA, Ceylan, O, Bilici, M, et al. Acute rheumatic fever in the Central Anatolia Region of Turkey: a 30-year experience in a single center. Eur J Pediatr 2012; 171: 361–368. DOI 10.1007/s00431-011-1555-x.CrossRefGoogle ScholarPubMed
Kucuk, M, Ozdemir, R, Karadeniz, C, et al. Red blood cell distribution width: can it be a predictive marker for long-term valvular involvement in children with acute rheumatic carditis? Int J. Lab Hematol 2016; 38: 1–7. DOI 10.1111/ijlh.12544.Google ScholarPubMed
Rhodes, KL, Rasa, MM, Yamamoto, LG. Acute rheumatic fever: revised diagnostic criteria. Pediatr Emerg Care 2018; 34: 436–442. DOI 10.1097/PEC.0000000000001511.CrossRefGoogle ScholarPubMed
Celik, SF, Celik, E. The neutrophil-to-lymphocyte ratio and mean platelet volume can be associated with severity of valvular involvement in patients with acute rheumatic carditis. Cardiovasc J Afr 2018; 29: 296–300. DOI 10.5830/CVJA-2018-031.CrossRefGoogle ScholarPubMed
Karpuz, D, Giray, D, Ozyurt, A, Bozlu, G, Unal, S, Hallioglu, O. Can whole-blood parameters be used in follow-up of children with rheumatic valvular heart disease? Cardiol Young 2017; 27: 764–769. DOI 10.1017/S1047951116001281.CrossRefGoogle ScholarPubMed
Kumar, RK, Antunes, CMJ, Beaton, A, et al. Contemporary diagnosis and management of Rheumatic Heart Disease: implications for closing the gap: a scientific statement from the American Heart Association. Circulation 2020; 142: e1–e21. DOI 10.1161/CIR.0000000000000921.CrossRefGoogle ScholarPubMed
Dougherty, S, Nascimento, B, Carapetis, J. Clinical evaluation and diagnosis of acute rheumatic fever. In: Dougherty, S, Carapetis, J, Zuhlke, L, Wilson, N (eds). Acute Rheumatic Fever and Rheumatic Heart Disease, New Zealand, Elsevier Inc., 2021: 31–54. DOI 10.1016/B978-0-323-63982-8.00003-9.Google Scholar
Asik, A, Duru, NS, Elevli, M. An evaluation of platelet parameters and neutrophil/lymphocyte ratios in children with acute rheumatic fever. J Pediatr Res 2019; 6: 37–43. DOI 10.4274/jpr.galenos.2018.30075.Google Scholar
Buyukoflaz, H, Arslan, D. The neutrophil-lymphocyte ratio and platelet-lymphocyte ratio acute rheumatic fever in children with cardiac involvement. Ann Clin Anal Med 2019; 10: 441–444. DOI 10.4328/ACAM.5960.Google Scholar
Boyarchuk, O, Boytsanyuk, S, Hariyan, T. Acute rheumatic fever: clinical profile in children in western Ukraine. J Med Life 2017; 10: 122–126.Google ScholarPubMed
Ozturk, N, Baygutalp, NK, Bakan, E, Altas, GF, Polat, H, Dorman, E. Changes in platelet parameters in leukocytosis. Pan Afr Med J 2016; 24: 185–189. DOI 10.11604/pamj.2016.24.185.7510.CrossRefGoogle ScholarPubMed
Park, Y, Schoene, N, Harris, W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 2002; 13: 301–306. DOI 10.1080/095371002220148332.Google ScholarPubMed
Polat, N, Yildiz, A, Yuksel, M, et al. Association of neutrophil-lymphocyte ratio with the presence and severity of rheumatic mitral valve stenosis. Clin Appl Thromb/Hemost 2014; 20: 793–798. DOI 10.1177/1076029613514131.CrossRefGoogle ScholarPubMed
Sert, A, Aypar, E, Odabas, D. Mean platelet volume in acute rheumatic fever. Platelets 2012; 24(5): 1–5. DOI 10.3109/09537104.2012.701029.Google ScholarPubMed
Schmoeller, D, Picarelli, MM, Munhoz, TP, Figuiredo, CEP, Staub, HL. Mean platelet volume and immature platelet fraction in autoimmune disorders. Front Med 2017; 4: 1–5. DOI 10.3389/fmed.2017.00146.CrossRefGoogle ScholarPubMed
Gasparyan, AY, Ayvazyan, L, Mikhailidis, DP, Kitas, GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des 2011; 17: 47–58. DOI 10.4274/jpr.galenos.2018.30075.CrossRefGoogle ScholarPubMed
Ozdemir, R, Karadeniz, C, Doksoz, O, et al. Are mean platelet volume and platelet distribution width useful parameters in children with acute rheumatic carditis? Pediatr Cardiol 2013; 35: 53–56. DOI 10.1007/s00246-013-0738-9.CrossRefGoogle ScholarPubMed