Prognostic Value of Hematological Parameters in Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis

Abstract

Objective: Hematological parameters including neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and monocyte–lymphocyte ratio (MLR) have been demonstrated as new predictors of prognosis and activity in various diseases. In this study, we aimed to investigate the associations of NLR, PLR and MLR with disease severity and prognosis in patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). 
 Materials and Methods: Medical records of 92 AAV patients were investigated retrospectively. The clinical and laboratory data, and disease outcomes were recorded. The patients having five factor score (FFS) ≥ 2 were categorized as severe disease.
 Results: 92 patients with a median age of 60 years were included. Patients with NLR≥4.8 (RR 1.83), PLR≥151.8 (RR 2.02) and MLR≥0.38 (RR 1.85) had higher risk of severe disease. In correlation analysis, NLR, PLR and MLR were positively correlated with C reactive protein and erythrocyte sedimentation rate (ESR). NLR, PLR and MLR were associated with remission. 
 Conclusion: Only the patients with high PLR had higher relapse rate. MLR was also correlated with development of end-stage renal disease (ESRD). Renal involvement was more frequent in patients with high levels of NLR, PLR and MLR. 
 Conclusions: We showed that NLR, PLR and MLR at diagnosis were associated with the severity and prognosis of AAV. This is the first study, showing the correlation of MLR with disease severity and ESRD in patients with AAV.