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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: dwiaryani51@gmail.com
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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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