E-ISSN: 1305-9327 ISSN: 1305-9319
Value of Lymphocyte: Monocyte Ratio in Predicting Coronary Artery Abnormalities in Kawasaki Disease
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Research
VOLUME: 15 ISSUE: 2
P: 182-186
June 2019

Value of Lymphocyte: Monocyte Ratio in Predicting Coronary Artery Abnormalities in Kawasaki Disease

Med J Bakirkoy 2019;15(2):182-186
DOI: 10.4274/BTDMJB.galenos.2019.20190109073231
Zeynep Gökçe Gayretli Aydın 1
Gönül Tanır 2
1. Karadeniz Teknik Üniveritesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Trabzon, Türkiye
2. Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi, Çocuk Sağlığı ve Hastalıkları Kliniği, Ankara, Türkiye
No information available.
No information available
Received Date: 09.01.2019
Accepted Date: 16.01.2019
Publish Date: 27.05.2019
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ABSTRACT

Objective:

Coronary artery abnormalities (CAA) are critical complication of Kawasaki disease (KD). Several inflammatory biomarkers have been identified for occurrence and progression of KD. Discovering new biomarkers of inflammation becomes important in order to help diagnostic accuracy of CAA and to provide prognostic information for KD. LMR, are simple and inexpensive methods for assessing inflammation, which have been also investigated as predictors of several cancers, cardiovascular and inflammatory diseases. In this study we aimed to investigate whether LMR is a risk factor of CAA of KD.

Methods:

We retrospectively reviewed patients with KD from 2005 to 2016. Demographic features, diagnostic clinical features of KD, laboratory findings, complications were recorded prior to IVIG administration. The patients were divided into two groups according to the development of CAA. The LMR was calculated by dividing the number of lymphocytes by the number of monocytes in the peripheral blood count. To identify CAAs risk factors, and to exclude the possible influence of other variables, multivariate analysis was performed by entering significant variables from the univariate analyses.

Results:

LMR was significantly lower in patients with CAA comparison to the patients without CAA (p<0.05). LMR was found as the only independent variable in multivariate analysis to determine CAA.

Conclusion:

The findings of this study showed a relationship between lower LMR and a high risk of CAA in children with KD. We suppose that LMR can be used as a predictor of coronary arter involvement in KD as a readily available and inexpensive marker in clinical practice.

Keywords: Coronary artery abnormalities, Kawasaki disease, lymphocyte:monocyte ratio, inflammatory biomarkers

References

1
Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children: clinical observations of 50 cases. Jpn J Allerg 1967;16:178-222.
2
Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, et al. Diagnosis,treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Pediatrics 2004;114:1708-33.
3
Cho HJ, Bak SY, Kim SY, Yoo R, Baek HS, Yang S, et al. High neutrophil : lymphocyte ratio is associated with refractory Kawasaki disease. Pediatr Int 2017;59:669-74.
4
Ji H, Li Y, Fan Z, Zuo B, Jian X, Li L, Liu T. Monocyte/lymphocyte ratio predicts the severity of coronary artery disease: a syntax score assessment. BMC Cardiovasc Disord 2017;17:90.
5
Li S, Cao W, Han J, Tang B, Sun X. The diagnostic value of white blood cell, neutrophil, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio in patients with primary angle closure glaucoma. Oncotarget 2017;8:68984-95.
6
Rowley AH. Kawasaki Disease. In: Sarah S. Long MD, Larry K. Pickering MD, Charles G. Prober MD (ed). Principles and Practice of Pediatric Infectious Diseases (4th ed). Elsevier 2012. chapter 199 p: 1003-7.
7
Ha KS, Lee J, Jang GY, Lee J, Lee KC, Son CS, et al. Value of neutrophil-lymphocyte ratio in predicting outcomes in Kawasaki disease. Am J Cardiol 2015;116:301-6.
8
Ha KS, Jang G, Lee J, Lee K, Hong Y, Son C, Lee JW. Incomplete clinical manifestation as a risk factor for coronary artery abnormalities in Kawasaki disease: a meta-analysis. Eur J Pediatr 2013;172:343-9.
9
Bai L, Feng T, Yang L, Zhang Y, Jiang X, Liao J, et al. Retrospective analysis of risk factors associated with Kawasaki disease in China. Oncotarget 2017;8:54357-63.
10
Parthasarathy P, Agarwal A, Chawla K, Tofighi T, Mondal TK. Upcoming biomarkers for the diagnosis of Kawasaki disease: A review. Clin Biochem 2015;48:1188-94.
11
Naranbhai V, Kim S, Fletcher H, Cotton MF, Violari A, Mitchell C, et al. The association between the ratio of monocytes:lymphocytes at age 3 months and risk of tuberculosis (TB) in the first two years of life. BMC Med 2014;12:120.
12
Yayla Ç, Akboğa MK, Gayretli Yayla K, Ertem AG, Efe TH, et al. A novel marker of inflammation in patients with slowcoronary flow: lymphocyte-to-monocyte ratio. Biomark Med 2016;10:485-93.
13
Gary T, Pichler M, Belaj K, Eller P, Hafner F, Gerger A, et al. Lymphocyte-to-monocyte ratio: a novel marker for critical limb ischemia in PAOD patients. Int J Clin Pract 2014;68:1483-7.
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