NLR RATIO TO PREDICT GI BLEED IN HSP

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Abstract

Background

Henoch‐Schönlein purpura (HSP) is a common form of vasculitis in children. It typically involves small vessels of the skin, the gastrointestinal (GI) tract, joints, and kidneys. GI involvement is the most severe short‐term complication and GI bleeding is a major complication of HSP. However, there is no established predictive marker of GI bleeding. Blood neutrophil‐to‐lymphocyte ratio (NLR) has been proposed as a potentially useful marker of clinical outcome in diseases with an inflammatory component. We aimed to determine the association of NLR with HSP and investigate the usefulness of NLR as a marker to predict GI bleeding in children with HSP.

Methods

All patients newly diagnosed as having HSP were reviewed retrospectively. White blood cell count, hemoglobin, platelet counts, mean platelet volume, neutrophil and lymphocyte count were evaluated. NLR and platelet‐to‐lymphocyte ratio (PLR) were calculated using the results from complete blood count tests.

Results

This study included of 141 HSP patients. GI involvement was found in 65 patients (46.1%); of them, 15 patients (10.6%) had GI bleeding. The NLR (P = 0.001) and PLR (P = 0.032) at the time of diagnosis was significantly patients with GI bleeding than in those without GI bleeding. Logistic regression analysis showed that NLR was the only independent predictor of GI bleeding (P = 0.004). The optimal cutoff value of NLR for predicting GI bleeding was 2.86 (sensitivity, 73%; specificity, 68%).

Conclusions

NLR, a simple and easily obtainable parameter, is a potential predictive marker of GI bleeding in children with HSP.