DIFFERENCE BETWEEN NEUTROPHIL TO LYMPHOCYTE RATIO (NLR) BETWEEN LUPUS PATIENTS WITH AND WITHOUT NEPHRITIS

Abstract

Neutrophil to lymphocyte ratio (NLR) can be a potential biomarker for disease activity and prognosis in the development of systemic lupus erythematosus (SLE). AIM: to determine if there are difference between NLR value between lupus patient with nephritis and lupus patient without nephritis. METHOD: The subjects of this study were patients with SLE diagnosis in Dr. Hasan Sadikin General Hospital Bandung during the period of January to December 2019. the selected statistical test of difference was non-parametric Mann-Whitney test, The analysis of receiver operating curve (ROC) was conducted to obtain the cut-off value of NLR in predicting lupus nephritis. Data processing was conducted using SPSS® software version 20.0. RESULTS: The total obtained data for lupus patient with and without nephritis was 156 patients. There was significant NLR difference between lupus patients with nephritis and without nephritis (median NLR for lupus patient with nephritis was 4.20, while median NLR for lupus patient without nephritis was 2.82, with p value of <0001, the cut-off value of NLR was >3.52 with sensitivity of 67.6%, specificity of 67.1% in distinguishing between lupus with nephritis and without nephritis. DISCUSSION: Lupus nephritis was marked by deposition of immune complex in the kidney, which would activate complement system and inflammatory cells such as neutrophils, monocytes, eosinophils and T-lymphocytes. CONCLUSIONS: On this study, it was obtained that the difference between NLR on lupus patients with and without nephritis yielded p value of <0.05. However, NLR has not been determined as a biomarker parameter to determine disease activity (flare-ups) and prognosis.