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Platelet to lymphocyte ratio is associated with the current activity of ANCA-associated vasculitis at diagnosis: a retrospective monocentric study

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Abstract

Platelet to lymphocyte ratio (PLR) has been introduced as a useful index to estimate the current inflammatory burdens in various diseases. In this study, we investigate whether PLR is associated with the severity of ANCA-associated vasculitis (AAV). We retrospectively reviewed the medical records of 163 patients with AAV, collected clinical, laboratory and radiological data and calculated Birmingham vasculitis activity score (BVAS). We defined the lower limit of the highest tertile of BVAS as the cut-off for severe AAV (BVAS ≥ 16). The optimal cut-off of PLR for severe AAV was set as 272.0. The odds ratio (OR) of PLR for severe AAV was assessed using the univariable and multivariable logistic regression analyses. The median age at diagnosis was 58.0 years and 51 patients (31.3%) were men. Patients with severe AAV exhibited higher rate of ANCA positivity and higher blood urea nitrogen (BUN), creatinine (Cr), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) than those without. Patients with severe AAV exhibited significantly increased median PLR compared to those without (299.3 vs. 184.0). In the univariable binary logistic regression analysis, BUN ≥ 17.45 mg/dL (OR 3.730), Cr ≥ 1.12 mg/dL (OR 3.519), ESR ≥ 83.5 mm/h (OR 2.785), CRP ≥ 20.0 mg/L (OR 2.612), PLR ≥ 272.0 (OR 4.231) and ANCA positivity (OR 2.306) were associated with severe AAV. In the multivariable binary logistic regression analysis, only PLR ≥ 272.0 was an independent predictor of severe AAV at diagnosis (OR 2.734, 95% CI 1.247, 5.993). In conclusion, PLR at diagnosis is associated with the current activity of vasculitis in AAV patients.

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References

  1. Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, Flores-Suarez LF, Gross WL, Guillevin L, Hagen EC, Hoffman GS, Jayne DR, Kallenberg CG, Lamprecht P, Langford CA, Luqmani RA, Mahr AD, Matteson EL, Merkel PA, Ozen S, Pusey CD, Rasmussen N, Rees AJ, Scott DG, Specks U, Stone JH, Takahashi K, Watts RA (2013) 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 65(1):1–11

    Article  PubMed  CAS  Google Scholar 

  2. Watts R, Lane S, Hanslik T, Hauser T, Hellmich B, Koldingsnes W, Mahr A, Segelmark M, Cohen-Tervaert JW, Scott D (2007) Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. Ann Rheum Dis 66(2):222–227

    Article  PubMed  Google Scholar 

  3. Leavitt RY, Fauci AS, Bloch DA, Michel BA, Hunder GG, Arend WP, Calabrese LH, Fries JF, Lie JT, Lightfoot RW Jr et al (1990) The American College of Rheumatology 1990 criteria for the classification of Wegener’s granulomatosis. Arthritis Rheum 33(8):1101–1107

    Article  PubMed  CAS  Google Scholar 

  4. Masi AT, Hunder GG, Lie JT, Michel BA, Bloch DA, Arend WP, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY et al (1990) The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum 33(8):1094–1100

    Article  PubMed  CAS  Google Scholar 

  5. Mukhtyar C, Lee R, Brown D, Carruthers D, Dasgupta B, Dubey S, Flossmann O, Hall C, Hollywood J, Jayne D, Jones R, Lanyon P, Muir A, Scott D, Young L, Luqmani RA (2009) Modification and validation of the Birmingham Vasculitis Activity Score (version 3). Ann Rheum Dis 68(12):1827–1832

    Article  PubMed  CAS  Google Scholar 

  6. Stone JH, Hoffman GS, Merkel PA, Min YI, Uhlfelder ML, Hellmann DB, Specks U, Allen NB, Davis JC, Spiera RF, Calabrese LH, Wigley FM, Maiden N, Valente RM, Niles JL, Fye KH, McCune JW, St Clair EW, Luqmani RA, International Network for the Study of the Systemic Vasculitides (INSSYS) (2001) A disease-specific activity index for Wegener’s granulomatosis: modification of the Birmingham Vasculitis Activity Score. International Network for the Study of the Systemic Vasculitides (INSSYS). Arthritis Rheum 44(4):912–920

    Article  PubMed  CAS  Google Scholar 

  7. Kim HJ, Jung SM, Song JJ, Park YB, Lee SW (2018) Mean platelet volume can estimate the current vasculitis activity of microscopic polyangiitis. Rheumatol Int 38(6):1095–1101

    Article  PubMed  Google Scholar 

  8. Abaza NM, El-Latif EMA, Gheita TA (2017) Clinical significance of neutrophil/lymphocyte ratio in patients with granulomatosis with polyangiitis. Reumatol Clin. https://doi.org/10.1016/j.reuma.2017.11.003

    Article  PubMed  Google Scholar 

  9. Makay B, Gücenmez ÖA, Duman M, Ünsal E (2014) The relationship of neutrophil-to-lymphocyte ratio with gastrointestinal bleeding in Henoch-Schonlein purpura. Rheumatol Int 34(9):1323–1327

    Article  PubMed  CAS  Google Scholar 

  10. Gasparyan AY, Stavropoulos-Kalinoglou A, Mikhailidis DP, Douglas KM, Kitas GD (2011) Platelet function in rheumatoid arthritis: arthritic and cardiovascular implications. Rheumatol Int 31(2):153–164

    Article  PubMed  CAS  Google Scholar 

  11. Merayo-Chalico J, Rajme-López S, Barrera-Vargas A, Alcocer-Varela J, Díaz-Zamudio M, Gómez-Martín D (2016) Lymphopenia and autoimmunity: A double-edged sword. Hum Immunol 77(10):921–929

    Article  PubMed  CAS  Google Scholar 

  12. Schulze-Koops H (2004) Lymphopenia and autoimmune diseases. Arthritis Res Ther 6(4):178–180

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. Izzedine H, Cacoub P, Launay-Vacher V, Bagnis C, Deray G (2002) Lymphopenia in Wegener’s granulomatosis. A new clinical activity index? Nephron 92(2):466–471

    Article  PubMed  Google Scholar 

  14. Goupil R, Brachemi S, Nadeau-Fredette AC, Déziel C, Troyanov Y, Lavergne V, Troyanov S (2013) Lymphopenia and treatment-related infectious complications in ANCA-associated vasculitis. Clin J Am Soc Nephrol 8(3):416–423

    Article  PubMed  CAS  Google Scholar 

  15. Balta S, Ozturk C (2015) The platelet-lymphocyte ratio: a simple, inexpensive and rapid prognostic marker for cardiovascular events. Platelets 26(7):680–681

    Article  PubMed  CAS  Google Scholar 

  16. Templeton AJ, Ace O, McNamara MG, Al-Mubarak M, Vera-Badillo FE, Hermanns T, Seruga B, Ocaña A, Tannock IF, Amir E (2014) Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomark Prev 23(7):1204–1212

    Article  CAS  Google Scholar 

  17. Pan L, Du J, Li T, Liao H (2017) Platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio associated with disease activity in patients with Takayasu’s arteritis: a case-control study. BMJ Open 7(4):e014451

    Article  PubMed  PubMed Central  Google Scholar 

  18. Jiang Y, Zang M, Li S (2017) Serum PLR and LMR in Behçet’s disease: Can they show the disease activity? Medicine (Baltimore) 96(21):e6981

    Article  CAS  Google Scholar 

  19. Csernok E, Moosig F (2014) Current and emerging techniques for ANCA detection in vasculitis. Nat Rev Rheumatol 10(8):494–501

    Article  PubMed  CAS  Google Scholar 

  20. Noel N, André C, Bengoufa D, Dehoulle C, Mahler M, Limal N, Godeau B, Hüe S (2013) Performance evaluation of three assays for the detection of PR3-ANCA in granulomatosis with polyangiitis in daily practice. Autoimmun Rev 12(12):1118–1122

    Article  PubMed  CAS  Google Scholar 

  21. Stasi R (2012) How to approach thrombocytopenia. Hematol Am Soc Hematol Educ Program 2012:191–197

    Google Scholar 

  22. Oh YJ, Ahn SS, Park ES, Jung SM, Song JJ, Park YB, Lee SW (2017) Chest and renal involvements, Birmingham vascular activity score more than 13.5 and five factor score (1996) more than 1 at diagnosis are significant predictors of relapse of microscopic polyangiitis. Clin Exp Rheumatol 35 Suppl 103(1):47–54

    PubMed  Google Scholar 

  23. Yoo J, Kim HJ, Jung SM, Song JJ, Park YB, Lee SW (2017) Birmingham vasculitis activity score of more than 9.5 at diagnosis is an independent predictor of refractory disease in granulomatosis with polyangiitis. Int J Rheum Dis 20(10):1593–1605

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

This study was supported by a faculty research grant of Yonsei University College of Medicine (6-2016-0145) and by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (HI14C1324).

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Authors and Affiliations

  1. Division of Rheumatology, Department of Internal Medicine, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea

    Hee Jin Park

  2. Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

    Seung Min Jung, Jason Jungsik Song, Yong-Beom Park & Sang-Won Lee

  3. Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea

    Jason Jungsik Song, Yong-Beom Park & Sang-Won Lee

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  1. Hee Jin Park
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Correspondence to Sang-Won Lee.

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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.

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Park, H.J., Jung, S.M., Song, J.J. et al. Platelet to lymphocyte ratio is associated with the current activity of ANCA-associated vasculitis at diagnosis: a retrospective monocentric study. Rheumatol Int 38, 1865–1871 (2018). https://doi.org/10.1007/s00296-018-4125-y

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