Neutrophil to Lymphocyte Ratio in Diagnosis of Inflammatory Bowel Disease and Correlation with Disease Severity Assessed by Ultrasound and Colonoscopy

Abstract

Abstract Background Inflammatory bowel disease (IBD) is a chronic idiopathic disease affecting author the gastrointestinal tract that is comprised of two separate, but related intestinal disorders; Crohn’ s disease (CD) and ulcerative colitis (UC). The diagnosis of IBD is most commonly made on the basis of clinical features in combination with findings on ultrasonography, endoscopy and histopathology. Patients and Methods This is a crosssectional prospective observational study. This study included 40 IBD patients (19 females and 21 males), presented to Internal Medicine department, El-Demerdash Hospital, Ain Shams University from June 2018 to June 2019. Patients were matched with 10 healthy subjects (7 females and 3 males) as a control group. All patients subjected to the following: Thorough medical history, clinical examination (general and local) and laboratory investigations including complete blood count with calculation of neutrophils to lymphocyte ratio, ESR and CRP on the day of the colonoscopic procedure. US examination and endoscopic examination were done for every patient. Results Mean value of NLR in IBD patients was significantly higher than those in control group representing 3.12±1.87 and 1.88±0.42 respectively but it was statisitically insignificant between active and inactive IBD patients with best cut off >2,01 to differentiate active from inactive patient.THE NLR value was correllating with CRP only with no correlation with ESR,NLR value also has association with US findings that suggesting activity with best cut off >2.5 to detect these findings by US in active patients.US has high sensitivity and specificity in discriminating patients with moderate and severe activity from those with mild activity or those in remission but it was unable to discriminate patient of moderate activity from patients with severe activity with strong assossiation with endoscopic scores of activity. Conclusion NLR values had higher sensitivity and specificity than CRP and ESR with the benefit of being readily available with an affordable price. They are more useful when utilized together with serum laboratory inflammatory indices (CRP and ESR).