Nötrofil/Lenfosit Oranı, RDW, RPR, MPV ve MPR Hemogram İndekslerinin Febril Nöbet Tanısına Katkısı

Year 2020, Volume: 18 Issue: 3, 346 - 357, 18.12.2020

Turgay Çokyaman , Tolga Kasap

Abstract

GİRİŞ ve AMAÇ: Bu çalışmada nötrofil/lenfosit oranı (NLR), kırmızı kan hücresi dağılım genişliği (RDW), RPR, MPR, ortalama trombosit hacmi (MPV), trombosit sayısı (PLT) gibi hemogram indekslerinin febril nöbet (FS) tanısına katkısının ayrıntılı olarak araştırılması amaçlandı.

YÖNTEM ve GEREÇLER: Çalışmaya 91 FS, 116 ateşli hastalık ve 100 sağlıklı kontrol olgusu dahil edildi. Yerine göre uygun istatistiksel analizlerle ikili ve üçlü grup karşılaştırmaları sonucu FS lehine anlamlı hemogram indeksleri tespit edildi ve ROC eğrisi analizine göre FS tanısı için tanı koydurucu sınır değerleri, duyarlılık ve özgüllükleri hesaplandı.

BULGULAR: NLR indeks FK grubunda anlamlı düzeyde yüksekti. FK grubunda median 2,6, ateşli hastalık ve sağlıklı kontrol grubunda sırasıyla 1,6 ve 0,7 bulundu (p<0,001). ROC eğrisi analizinde FK tanısı için NLR indeksinin sınır değerleri, duyarlılık ve özgüllükleri belirlendi. 1/RPR indeksi FK vakalarında istatistiksel olarak anlamlı düzeyde düşük bulundu. FK grubunda 20,5, ateşli hastalık ve sağlıklı kontrol gruplarında sırasıyla 23,3 ve 23,2 bulundu (p=0,003). NLR’ye benzer şekilde RPR indeks içinde ROC eğrisi analizinde FK tanısı için sınır değerleri, duyarlılık ve özgüllükleri hesaplandı.

TARTIŞMA ve SONUÇ: NLR ve 1/RPR indeksleri, FS tanısına katkıda bulunabilecek ucuz ve kolay erişilebilir hemogram parametreleridir. Acil servislerde ve ayaktan tedavi kliniklerinde pratisyen hekim ve pedyiatristler tarafından kolayca kullanılabilirler.

Keywords

febril nöbet,, hemogram,, çocuk

Contribution of Neutrophil/Lymphocyte Ratio, RDW, RPR, MPV and MPR Indexes to Febrile Seizure Diagnosis

Abstract

INTRODUCTION: In this study, it was aimed to investigate in detail the contribution of hemogram indices such as neutrophil/lymphocyteratio (NLR), red blood cell distribution width (RDW), RPR, MPR, mean platelet volume (MPV), and platelet count (PLT) to the diagnosis of febrile seizure (FS).

MATERIALS and METHODS: 91 FS, 116 febrile disease and 100 healthy control cases were included in the study. Significant hemogram indices in favor of FS were determined as a result of double and triple group comparisons with appropriate statistical analyzes, and diagnostic cut-off values, sensitivity and specificity were calculated for FS diagnosis according to receiever operating characteristic (ROC) curve analysis.

RESULTS: NLR index was significantly higher in the FS group. The median was 2.6 in the FS group, 1.6 and 0.7 in the febrile disease and healthy control groups, respectively (p<0.001). In the ROC curve analysis, thecut-off values, sensitivity and specificities of the NLR index for FS diagnosis were determined. The 1/RPR index was found to be statistically significantly lower in FS group. It was found to be 20.5 in the FS group, 23.3 and 23.2 in the febrile disease and healthy control groups, respectively (p=0.003). Similar to the NLR, cut-off values, sensitivity and specificities were calculated for FS diagnosis in the ROC curve analysis within the 1/RPR index.

CONCLUSIONS: NLR and 1/RPR indexes are cheap and easily accessible hemogram parameters that can contribute to the diagnosis of FS. They can be used simply by practitioners and pediatricians in emergency rooms and out patient clinics

Keywords

febrile seizure,, hemogram,, children

References

• REFERENCES 1. .Jones T, Jacobsen SJ. Childhoodfebrile seizures: overviewandimplications. Int J MedSci. 2007;4:110-4.
• 2. [No authorslisted]. Practiceparameter: longtermtreatment of thechildwithsimple febrile seizures. American Academy of Pediatrics. Commitee on Quality Improvement, Subcommitee on Febrile Seizures. Pediatrics. 1999;103(6):1307-9.
• 3. Virta M, Hurme M, Helminen M. Increasedplasmalevels of pro‐and anti‐inflammatorycytokines in patients with febrile seizures. Epilepsia. 2002;43(8):920-3.
• 4. Chiba Y, Mizoguchi I, Hasegawa H, et al. Regulation of myelopoiesisbyproinflammatorycytokines in infectious diseases. Cell Mol Life Sci. 2018;75(8):1363-76.
• 5. Lappé JM, Horne BD, Shah SH, May HT, Muhlestein JB, Lappé DL, et al. Redcelldistribution width, C-reactive protein, thecompletebloodcount, andmortality in patientswithcoronarydiseaseand a normal comparisonpopulation. ClinChimActa. 2011;412(23-24):2094–9.
• 6. Yildirim Cetin G, Gul O, Kesici-Metin F, Gokalp İ, Sayarlıoglu M. Evaluation of the mean platelet volume and red cell distribution width in FMF: Aretheyrelatedtosubclinicalinflammationor not? Int J Chronic Dis. 2014;2014:127426.
• 7. Dogan I, Karaman K, Sonmez B, Celik S, Turker O. Relationshipbetween serum neutrophil count and infarct size in patients with acute myocardialinfarction. NuclMedCommun. 2009;30(10):797-801.
• 8. Yeşil A, Senateş E, Bayoğlu IB, Erdem ED, Demirtunç R, Kurdaş Övünç AO. Red cell distribution width: a novel marker of activity in inflammatoryboweldisease. Gut Liver. 2011;5(4):460-7.
• 9. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Meanplateletvolume: a link between thrombosis and inflammation? CurrPharmDes. 2011;17(1):47-58.
• 10. Chiou HH, Hsieh LP. Parentingstress in parents of childrenwithepilepsyandasthma. J Child Neurol. 2008; 23(3):301-6.
• 11. Kolahi AA, Tahmooreszadeh S. First febrileconvulsions: inquiryabouttheknowledge, attitudes and concerns of thepatients' mothers. Eur J Pediatr 2009;168(2):167-71.
• 12. Nass RD, Hampel KG, Elger CE, Surges R. Blood pressure in seizuresandepilepsy. Front Neurol. 2019;10:501.
• 13. Parks KR, Davis JM. Epinephrine, cortisol, endotoxin, nutrition, andtheneutrophil. SurgInfect (Larchmt). 2012;13(5):300-6.
• 14. Goksugur SB, Kabakus N, Bekdas M, Demircioglu F. Neutrophil-to-lymphocyte ratio and red blood cell distribution width is a practicalpredictorfordifferentiation of febrile seizure types. EurRevMedPharmacolSci. 2014;18(22):3380-5.
• 15. Yigit Y, Yilmaz S, Akdogan A, Halhalli HC, Ozbek AE, Gencer EG. The role of neutrophil-lymphocyte ratio and red blood cell distribution width in the classification of febrile seizures. EurRevMedPharmacolSci. 2017;21(3):554-9.
• 16. Esmaili Gourabi H, Bidabadi E, Cheraghalipour F, Aarabi Y, Salamat F. Febrileseizure: demographic features and causativefactors. Iran J Child Neurol. 2012;6(4):33-7.
• 17. Liu Z, Li X, Zhang M, et al. The role of mean platelet volume/platelet count ratio and neutrophil to lymphocyte ratio on the risk of febrileseizure. SciRep. 2018;8(1):15123.
• 18. Gontko-Romanowska K, Żaba Z, Panieński P, et al. Theassessment of laboratoryparameters in children with feverandfebrileseizures. Brain Behav. 2017;7(7):e00720.
• 19. Miri-Moghaddam E, Sargolzaie N. Cutoffdetermination of discriminationindices in differential diagnosis between irondeficiencyanemiaand β- thalassemiaminor. Int J HematolOncolStem Cell Res. 2014;8(2):27–32.
• 20. de Gonzalo-Calvo D, de Luxán-Delgado B, Rodríguez-González S, et al. Interleukin 6, soluble tumor necrosis factorreceptor I andredbloodcelldistributionwidth as biologicalmarkers of functional dependence in an elderlypopulation: a translationalapproach. Cytokine. 2012;58(2):193-8.
• 21. Yohannan MD, Higgy KE, al-Mashhadani SA, Santhosh-Kumar CR. Thrombocytosis. Etiologi canalysis of 663 patients. Clin Pediatr (Phila). 1994;33(6):340-3.
• 22. Kaser A, Brandacher G, Steurer W, Ohashi M, Orii N, Nagai T, et al. Interleukin-6 stimulates thrombopoiesis throughthrombopoietin: role in inflammatorythrombocytosis. Blood. 2001;98(9):2720-5.
• 23.Şahin F, Koşar AF, Aslan AF, Yiğitbaş B, Uslu B. Serum Biomarkers in Patients with Stable and Acute Exacerbation of ChronicObstructivePulmonaryDisease: A ComparativeStudy. J MedBiochem. 2019;38(4):503-11