Abstract
Introduction: Granulomatosis with polyangiitis (GPA) is a rare necrotizing vasculitis, which usually involves the upper and lower respiratory systems and kidneys and often have a relapsing course. Neutrophil/lymphocyte ratio (NLR) has been shown to be a useful marker predicting not only progressive disease, but also mortality in various inflammatory diseases. We aimed to investigate the roles of NLR in predicting the extend of clinical involvement and prognosis of patients with GPA.Materials and methods: Consecutive newly diagnosed GPA patients who had follow-up for at least 6 months between 2010 and 2016 at Gazi University Internal Medicine-Rheumatology clinic were retrospectively analyzed.Results: Fifty-three newly diagnosed GPA patients were studied. NLR was significantly higher in the GPA group compared with the control group (4.50 [min–max: 0.07–34.81] vs 1.77 [min–max: 1.04–2.90], respectively, p < .001). NLR significantly correlated with ESR and CRP levels (r = .40 and r = .48, respectively, p < .001 for both).Discussion: GPA is a vasculitis with a significant morbidity and mortality (REF). Renal involvement usually presents with crescentric glomerulonephritis, resulting in significant and permanent loss of renal functions and end-stage kidney disease. Higher NLR at baseline is associated with worse renal outcome. Our findings suggest that baseline NLR could have a predictive value for renal prognosis. We have also demonstrated a significant correlation between NLR and BVAS activity scores. Our data suggest that GPA patients with a significantly high NLR at baseline might need closer follow-up for persistent disease activity.
Highlights
Granulomatosis with polyangiitis (GPA) is a rare necrotizing vasculitis, which usually involves the upper and lower respiratory systems and kidneys and often have a relapsing course
We aimed to investigate the roles of Neutrophil/lymphocyte ratio (NLR) in predicting the extend of clinical involvement and prognosis of patients with GPA
NLR significantly correlated with Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels (r 1⁄4 .40 and r 1⁄4 .48, respectively, p < .001 for both)
Summary
Granulomatosis with polyangiitis (GPA) is a rare necrotizing vasculitis, which usually involves the upper and lower respiratory systems and kidneys and often have a relapsing course. Granulomatosis with polyangiitis (GPA) is a rare necrotizing vasculitis of small-to-medium-sized vessels, which usually involves the upper and lower respiratory systems and kidneys and often have a relapsing course.[1] Its clinical presentation varies from a limited non-vital organ involvement to a life threatening systemic vasculitis.[2] Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are the acute phase reactants used in the clinical evaluation of disease activity, their roles in predicting the extend of disease involvement or prognosis are limited.[3] Neutrophil/lymphocyte ratio (NLR) has been shown to be a useful marker predicting progressive disease, and mortality in various inflammatory diseases.[4] To the best of our knowledge, its role in GPA has not been previously reported.
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