Advertisement

Clinical Rheumatology

, Volume 37, Issue 10, pp 2811–2817 | Cite as

Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in Behçet’s disease: which and when to use?

  • Marwa Hammad
  • Omaima Zakaria Shehata
  • Shaimaa Mohamed Abdel-Latif
  • Amany Mohamed Mohiey El-Din
Original Article

Abstract

Behçet’s disease (BD) is an uncommon autoimmune/autoinflammatory disease. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were investigated in many diseases as a marker of inflammation. In this study, we investigated NLR and PLR in patients with BD as a marker of disease activity and its association with different clinical manifestations. The study included 23 BD patients; their mean age was (32.5 ± 6.76) and M:F ratio was 16:7. Complete blood picture was done for all patients. NLR and PLR were compared in both active and inactive BD patients and its relation with different clinical manifestations was assessed. NLR was higher in active BD patients than in inactive BD patients (P < 0.01). Although both NLR and PLR were correlated with Behçet’s Disease Current Activity Form (BDCAF), the correlation of NLR with BDCAF was much stronger than that of PLR. NLR was associated with some mucocutaneous lesions. Both NLR and PLR were associated with articular and GIT manifestations, but also NLR showed more significant results. In our studied patients, both NLR and PLR were not informative about any ongoing ocular activity (P > 0.05). Both ratios were not affected by the presence of neurologic deficits nor previous vascular events (P > 0.05). NLR was superior to PLR as an indicator of disease activity. NLR was closely related to skin manifestations while PLR was not. In our study, both were not considered reliable in representing ocular activity.

Keywords

Behçet’s disease (BD) Disease activity Neutrophil to lymphocyte (NLR) 

Notes

Compliance with ethical standards

Disclosure

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    De Chambrun MP, Wechsler B, Geri G et al (2012) New insights into the pathogenesis of Behçet’s disease. Autoimmun Rev 11(10):687–698CrossRefGoogle Scholar
  2. 2.
    Davatchi F, AssaadKhalil S, Calamia KT et al (2014) The International Criteria for Behçet’s Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol 28(3):338–347CrossRefGoogle Scholar
  3. 3.
    Janeway CA Jr, Travers P, Walport M et al (eds) (2001) Autoimmune responses are directed against selfantigens. Immunobiology: the immune system in health and disease, 5th edn. Garland Science, New YorkGoogle Scholar
  4. 4.
    Bhat T, Teli S, Rijal J et al (2011) Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev Cardiovasc Ther 11(1):55–59CrossRefGoogle Scholar
  5. 5.
    Alexander NI (2016) Reference values of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and mean platelet volume in healthy adults in north Central Nigeria. J Blood Lymph 6:143Google Scholar
  6. 6.
    Macey M, Hagi-Pavli E, Stewart J, Wallace GR, Stanford M, Shirlaw P, Fortune F (2011) Age, gender and disease-related platelet and neutrophil activation ex vivo in whole blood samples from patients with Behçet’s disease. Rheumatology 50(10):1849–1859CrossRefPubMedGoogle Scholar
  7. 7.
    Yuksel M, Yildiz A, Oylumlu M, Turkcu FM, Bilik MZ, Ekinci A, Elbey B, Tekbas E, Alan S (2016) Novel markers of endothelial dysfunction and inflammation in Behçet’s disease patients with ocular involvement: epicardial fat thickness, carotid intima media thickness, serum ADMA level, and neutrophil-to-lymphocyte ratio. Clin Rheumatol 35(3):701–708CrossRefPubMedGoogle Scholar
  8. 8.
    Koseoglu HI, Altunkas F, Doruk S et al (2015) Platelet-lymphocyte ratio is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome. J Thromb Thrombolysis 39:179–185CrossRefPubMedGoogle Scholar
  9. 9.
    Koiwa M, Goto S, Takahashi K et al (2016) Neutrophil/lymphocyte ratio in patients with rheumatoid arthritis treated with biological agents. J Nippon Med Sch 83(3):122–123CrossRefGoogle Scholar
  10. 10.
    Wu Y, Chen Y, Chen L et al (2016) Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with disease activity in patients with systemic lupus erythematosus. Int Immunopharmacol 36:94–99CrossRefPubMedGoogle Scholar
  11. 11.
    Li X, Chen ZH, Xing YF, Wang TT, Wu DH, Wen JY, Chen J, Lin Q, Dong M, Wei L, Ruan DY, Lin ZX, Wu XY, Ma XK (2015) Platelet-to-lymphocyte ratio acts as a prognostic factor for patients with advanced hepatocellular carcinoma. Tumour Biol 36:2263–2269CrossRefPubMedGoogle Scholar
  12. 12.
    Racz JM, Cleghorn MC, Jimenez MC et al (2014) Predictive ability of blood neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in gastrointestinal stromal tumors. Ann Surg Oncol 22:2343–2350CrossRefPubMedGoogle Scholar
  13. 13.
    Balta S, Balta I, Ӧztürk C et al (2014) Neutrophil lymphocyte ratio in patients with Behçet’s disease and its association with carotid intimaemedia thickness. Am J Cardiol 113:7e11Google Scholar
  14. 14.
    Ozturk C, Balta S, Balta I, Demirkol S, Celik T, Turker T, Iyisoy A, Eksioglu M (2015) Neutrophil lymphocyte ratio and carotid-intima media thickness in patients with Behçet disease without cardiovascular involvement. Angiology 66:291e6Google Scholar
  15. 15.
    Alan S, Tuna S, Türkoğlu EB (2015) The relation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume with the presence and severity of Behçet’s syndrome. Kaohsiung J Med Sci 31:626e631Google Scholar
  16. 16.
    Avci A, Avci D, Erden F et al (2017) Can we use the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume values for the diagnosis of anterior uveitis in patients with Behcet’s disease? Ther Clin Risk Manag 13:881–886CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Erden F, Karagoz H, Avci A et al (2017) Which one is best? Platelet/lymphocyte ratio, neutrophil/lymphocyte ratio or both in determining deep venous thrombosis in Behcet’s disease? Biomed Res 28(12):5304–5309Google Scholar
  18. 18.
    Bhakta BB, Brennan P, James TE, Chamberlain MA, Noble BA, Silman AJ (1999) Behçet’s disease: evaluation of a new instrument to measure clinical activity. Rheumatology (Oxford) 38:728–733CrossRefGoogle Scholar
  19. 19.
    Neves FD, Caldas CAM, Medeiros DMD et al (2009) Cross-cultural adaptation of simplified version (s) of Behçet's Disease Current Activity Form (BDCAF) and comparison between two different instruments with Brazilian versions for evaluating Behçet's Disease Activity: BR-BDCAF and BR-BDCAF (s). Rev Bras Reumatol 49(1):20–31CrossRefGoogle Scholar
  20. 20.
    Balta S, Balta I, Demirkol S, Ozturk C, Demir M (2014) Endothelial function and Behçet disease. Angiology 65(8):657–659. 3CrossRefPubMedGoogle Scholar
  21. 21.
    Ozdemir R, Barutcu I, Sezgin AT, Acikgoz N, Ermis N, Metin Esen A, Topal E, Barıskaner E, Ozerol I (2004) Vascular endothelial function and plasma homocysteine levels in Behcet’s disease. Am J Cardiol 94(4):522–525CrossRefPubMedGoogle Scholar
  22. 22.
    Acikgoz N, Ermiş N, Yağmur J et al (2011) Elevated oxidative stress markers and its relationship with endothelial dysfunction in Behçet disease. Angiology 62(4):296–300CrossRefPubMedGoogle Scholar
  23. 23.
    Balta S, Demirkol S, Celik T, Kucuk U, Unlu M, Arslan Z, Balta I, Iyisoy A, Kocak N, Haqmal H, Yokusoglu M (2013) Association between coronary artery ectasia and neutrophil-lymphocyte ratio. Angiology 64(8):627–632CrossRefPubMedGoogle Scholar
  24. 24.
    Mendoza-Pinto C, Garcia-Carrasco M, Jimenez-Hernandez M et al (2010) Etiopathogenesis of Behcet’s disease. Autoimmun Rev 9:241–245CrossRefPubMedGoogle Scholar
  25. 25.
    Balkarli A, Kucuk A, Babur H et al (2015) AB0629 neutrophil/lymphocyte ratio and mean platelet volume in behçet’s disease. Ann Rheum Dis 74:1109CrossRefGoogle Scholar
  26. 26.
    Ozturk C, Balta S, Balta I, Demirkol S, Celik T, Turker T, Iyisoy A, Eksioglu M (2015) Neutrophil-lymphocyte ratio and carotid-intima media thickness in patients with Behcet disease without cardiovascular involvement. Angiology 66:291–296CrossRefPubMedGoogle Scholar

Copyright information

© International League of Associations for Rheumatology (ILAR) 2018

Authors and Affiliations

  1. 1.Rheumatology and Rehabilitation, Faculty of MedicineZagazig UniversityZagazigEgypt
  2. 2.Clinical pathology, Faculty of MedicineZagazig UniversityZagazigEgypt

Personalised recommendations