Correlation of haematological markers of systemic inflammation with sickle cell disease severity

Abstract

 Background: Sickle cell disease (SCD) is a common monogenic disorder that presents with several clinical features and complications. Inflammation plays a vital role in the pathobiology. Neutrophil- lymphocyte ratio (NLR), platelet-neutrophil ratio (PNR) and platelet-lymphocyte ratio (PLR) are fairly new but cheap inflammatory markers.

Aim: SCD being an inflammatory disorder, we sought to determine if these markers correlate with SCD severity.

Methods: This is a retrospective multicenter study where the socio-demographic and full blood count (FBC) data were collected. The NLR, PLR and PNR were calculated and then correlated with disease severity. Analysis was done using SPSS version 22.

Results: A total of 482 SCD patients’ data were analyzed. The majority of them (290, 60.2%) had moderate disease while only 66 of them (13.7%) had severe disease. Hb concentration, WBC (p value 0.00), absolute neutrophil count (ANC) (p value 0.00), absolute lymphocyte count (ALC) (p value 0.00) and PNR (p value 0.00) showed a positive correlation with disease severity while platelet count (p value 0.371), PLR (p value 0.124) and NLR (p value 0.105) did not show any significant association with SCD severity score. Hb concentration, PNR and PLR showed significant negative correlation with SCD severity score.

Conclusion: The PNR and PLR values decreased with increasing severity score in SCD. These readily available and cheap parameters which are deduced from routine full blood count can be used to predict severity and risk of developing complications in SCD.