Immature Granulocyte Percentage Research Articles

Role of immature granulocytes and total bilirubin values in the diagnosis of perforated appendicitis in patients over 65 years.

The aim of this study was to investigate the effectiveness of immature granulocyte count, immature granulocyte percentage, and total bilirubin value in predicting complicated and perforated appendicitis in patients aged 65 years and older with a diagnosis of appendicitis. In this study, 84 patients, aged 65 years and older, who had appendectomy demographic information, preoperative white blood cell count, neutrophil/lymphocyte ratio, immature granulocyte count and immature granulocyte percentage, operation findings, and pathology results were collected retrospectively. They were grouped into 4 categories: complicated, non-complicated, perforated, and non-perforated, according to the data and surgical findings. Total bilirubin and immature granulocyte count were found to be statistically significant in predicting complicated and perforated appendicitis in patients aged 65 years and older with a diagnosis of appendicitis. The total bilirubin was found to have the following values in differentiating complicated appendicitis: area under the curve=0.883, sensitivity=78.3%, and specificity=88.5%. Total bilirubin had the highest discrimination power with area under the curve=0.804 in differentiating perforation. The immature granulocyte percentage and total bilirubin count are the fast, inexpensive, and reliable parameters that can be used to predict complicated and perforated appendicitis in patients aged 65 years and older.

Could an Increased Percentage of Immature Granulocytes Accompanying Dyspepsia Predict COVID-19?

Background and Aim: Although vaccination practices continue at a fast pace around the world, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) still threatens people’s lives. In this study, we aimed to determine the presence of SARS-CoV-2 in patients who do not have the typical symptoms of the novel coronavirus disease 2019 (COVID-19), but only present with dyspepsia, and to investigate the role of immature granulocytes in the early diagnosis of these patients. Material and Methods: Adult and pediatric patients suffering from dyspepsia were included in the study. The patients were divided into two groups, ‘‘positive’’ and ‘‘negative’’, based on their SARS-CoV-2 polymerase chain reaction test results. Immature granulocyte count (IG), immature granulocyte percentage (IG%), C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR) values were recorded. Results: A total of 238 patients, including 25 (10.5%) pediatric and 213 (89.5%) adult patients, were included in the study. A total of 2 (8%) pediatric patients and 17 (7.9%) adult patients tested positive for SARS-CoV-2. The IG, IG%, and CRP parameters were significantly higher in the SARS-CoV-2-positive patients compared to the SARS-CoV-2-negative patients. The optimal cut-off value predictive of COVID-19 infection was determined to be ≥0.650 (sensitivity: 52.6% and specificity: 95.5%, p = 0.001) for IG%. Conclusions: It should be noted that dyspepsia may also be a COVID-19 symptom. IG% values, which can be determined with a hemogram test, a cheap and easily accessible test, may be a warning in the early detection of patients who do not have the typical symptoms of COVID-19.

The Utility of Immature Granulocyte Count and Percentage on the Prediction of Acute Appendicitis in the Suspected Acute Appendicitis According to the Alvarado Scoring System: A Retrospective Cohort Study.

This study aimed to investigate the utility of immature granulocyte count and percentage on the prediction of suspected acute appendicitis according to the Alvarado scoring system and its effect on the need for computed tomography scanning. Adult patients who had an Alvarado scoring system between 4 and 7 with the first imaging technique computed tomography were included and retrospectively analyzed. The immature granulocyte count and granulocyte percentage were obtained from the blood samples taken at the time of the patient's first admission to the hospital. A total of 652 patients were evaluated and 186 patients were included in the study. Acute appendicitis was not detected in computed tomography imaging of 121 (65%) patients (group N) and detected in 65 (35%) patients (group P). The mean immature granulocyte percentage in group N and group P were 0.314 ± 0.188 (0.00-1.40) and 0.364 ± 0.205 (0.05-1.00), respectively. The mean immature granulocyte percentage was similar between groups (P = .095). The mean immature granulocyte count was 33 ± 46/μL (0-50) in group N and 60 ± 85/μL (10-690) in group P. Immature granulocyte count was significantly higher in group P (P = .005). Univariate analysis results revealed that age and immature granulocyte percentage were not predictive factors for the presence of acute appen- dicitis in suspected cases (P > .05). On the other hand white blood cell, neutrophil-lymphocyte ratio, C-reactive protein, and immature granulocyte count were determined as predictive factors in univariate analysis and multivariate analysis. Receiver operating character- istic curve analysis of preoperative immature granulocyte percentage and immature granulocyte count values in the diagnosis of acute appendicitis: the cut-off value of immature granulocyte percentage was ≥0.35 and its sensitivity, specificity, positive predictive value, and negative predictive value were 44.1%, 72.1%, 71.1%, and 41.5%, respectively (area under the curve: 0.588; CI: 0.484-0.682). The cut-off value of immature granulocyte count was ≥35/μL and its sensitivity, specificity, positive predictive value, and negative predictive value were 66.1%, 73.6%, 71.9%, and 67.7%, respectively (area under the curve: 0.743; CI: 0.659-0.827) Conclusion: Immature granulocyte count is a predictive factor for acute appendicitis in patients with the middle-risk group according to the Alvarado score and may be useful for the selective use of tomography.

Diagnostic value of delta neutrophil index in determining axillary metastases in breast cancer

Aim: The delta neutrophil index (DNI), which shows the percentage of immature granulocytes (IG) in peripheral blood in inflammatory conditions, is an indicator of increased bone marrow activation. Its ability to predict prognosis has been demonstrated in many cancer studies. This study aims to investigate the value of DNI in predicting axillary metastases in breast cancer.
 Material and Method: Patients diagnosed with breast cancer and operated on axillary lymph node dissection were screened and 127 patients were included in the study. The patient’s age, gender, operation time, length of hospital stay, immature granulocyte (IG) percentages (IG#), and axillary lymph node pathology results were retrospectively scanned from the archive system.
 Results: DNI and IG were statistically higher in the group with lymph node metastasis. When examined for IG#, the mean of the group with reactive lymph nodes was 0.02±0.02, while the mean of the metastatic group was 0.04±0.05. This statistically significant difference was high (p

Can immature granulocyte count be a practical marker for evaluating bone marrow activation in beta thalassemia patients?

Amaç: Çalışmamızda çocuk ve erişkin beta talasemi major ve intermedia hastalarımızın immatür granülosit ve immatür granülosit yüzdelerinin kemik iliği aktivasyonlarını değerlendirmede pratik bir belirteç olarak kullanılıp kullanılamayacağını araştırmayı amaçladık. Yöntem: Ocak 2017-Aralık 2021 tarihleri arasında Mersin Üniversitesi Tıp Fakültesi Çocuk ve Erişkin Hematoloji kliniğinde takipli 38 Beta talasemi major ve 12 Beta talasemi intermedia hastasının yaş, hemoglobin (gr/dl), hematokrit, beyaz küre sayısı (x103/µL), trombosit değeri (x103/µL), immatür granülosit sayısı ( x103/µL) , immatür granülosit yüzdesi (%), ferritin değeri (ng/mL), şelasyon durumu, transfüzyon sıklığı ve düzeni, son bir yıldaki ortalama hemoglobin düzeyi gibi parametreleri incelendi. Düzenli transfüzyon alan ve almayan hastalar immatür granülosit sayısı, yüzdesi ve diğer parametreler açısından karşılaştırıldı. Bulgular: Hastalar çocuk ve erişkin olarak gruplandığında; çocuk hastalarda son bir yıldaki hemoglobin düzeyi daha yüksek iken erişkinlerde beyaz kan hücresi, immatür granülosit ve trombosit sayısının anlamlı olarak daha yüksek olduğu görüldü (p<0.05). Çocuk hastaların daha düzenli transfüzyon aldığı gözlendi. Düzensiz transfüzyon alan hastalarda son bir yıldaki ortalama hemoglobin düzeyinin anlamlı oranda daha düşük ancak immatür granülosit düzeyi, trombosit ve beyaz küre sayısının daha yüksek olduğu görüldü (p<0.05). Son bir yıldaki ortalama hemoglobin düzeyi arttıkça ortalama immatür granülosit sayısı ve yüzdesinin azaldığı saptandı. Sonuç: Çalışmamızda immatür granülosit sayısı ve yüzdesi, total beyaz küre ve trombosit sayısının düzensiz transfüzyon alan hastalarda istatistiksel açıdan anlamlı olacak şekilde yüksek olması ve son bir yıldaki ortalama hemoglobin düzeyi azaldıkça immatür granülosit ve immatür granülosit yüzdesinin artması bu hastalarda kemik iliğindeki hematopoezin aktif olduğunu düşündürdü. Bu nedenle beta talasemili hastalarda inflamatuvar aktivitenin derecesini ve transfüzyon etkinliğini değerlendirmede hemen her merkezde bakılabilen immatür granülosit ve immatür granülosit yüzde parametrelerinin kullanılabileceğini düşünmekteyiz.

Can immature granulocytes be used as a predictive new marker in the diagnosis of acute cholecystitis?

Aim: Acute cholecystitis (AC) is one of the most common acute surgical diseases in the emergency department (ED). The aim of this study was to investigate the efficacy of inflammatory parameters as immature granulocyte count (IGC) and immature granulocyte percentage (IG%) in the diagnosis of AC. Material and methods: This retrospective and observational study consisted of patients, diagnosed with AC, who were admitted to a tertiary ED with abdominal pain between March 2019 and April 2021. The effectiveness of IGC and IG% in the diagnosis of AC was examined by comparing the results with the control group (CG). Results: A total of 493 patients were included in the study. 270 patients were in the AC group, 223 patients were in the CG. IG% and IGC were found to be significantly higher in the AC group than in the CG (0.5 (0.32) vs. 0.4 (0.2); 0.06 (0.08) vs. 0.03 (0.03); p<0.001, p<0.001 respectively). It has been shown that IGC, at a cut-off value of 0.03, predicts the diagnosis of AC with 72.1% sensitivity and 55.5% specificity. On the other hand, IG%, at a cut-off value of 0.45, predicts the diagnosis of AC with 53.2% sensitivity and 72.7% specificity (AUC [0.717 (0.672-0.762); 0.692 (0.645-0.738)], respectively p<0.001, p<0.001). Conclusions: In conclusion, IGC and IG% can be used as a useful inflammatory parameter in the diagnosis of AC in patients admitted to the emergency department.

The importance of immature granulocyte and immature reticulocyte fraction for the severity of acute bronchiolitis

The immature granulocyte (IG) and immature reticulocyte fraction (IRF) are new analytical parameters of the complete blood count, that have been studied as biomarkers of several inflammatory conditions. Here, our aim is to determine the effectiveness of IG and IRF percentages for the severity of acute bronchiolitis (AB). A single-center, prospective study was performed in patients who were hospitalized for acute bronchiolitis and healthy children were included as a control group. The demographic characteristics, white blood cell (WBC) count, platelet (PLT) count, eosinophil%, IG%, and IRF% values were analysed. Receiver operating characteristics (ROC) analysis was used to compare the diagnostic accuracies and predictive performances. We enrolled 168 infants in the acute bronchiolitis group and 80 in the control group. The Clinical Severity Score (CSS) showed that 48, 93, and 27 patients had mild, moderate, and severe bronchiolitis, respectively. The WBC, PLT, and IRF value were significantly higher in patients (p &lt; 0.001). There was no difference between the patients and control group in terms of IG and eosinophil percentage. Only a positive correlation was observed between the clinical severity of the AB and IRF (p=0.003).The ROC curve analysis indicated that the IRF% cut-off point for predicting severity AB was &gt;12.4, with a sensitivity of 53% and specificity of 88% (Areas under the curves (AUC):0.701,p&lt;0.001). The WBC count, PLT count, and IRF value increased in the AB group. The IRF percentage can be used to predict the clinical severity of AB in children.

Immature granulocytes as biomarkers of inflammation in children with predialysis chronic kidney disease.

Chronic inflammation in patients with predialysis chronic kidney disease (CKD) is quite common. We aimed to investigate the relationship of the percentage of immature granulocytes (IG%) and immature granulocyte count (IGC) with inflammation in children with predialysis CKD. The data from children with stage 2-4 CKD and a control group of healthy children were evaluated retrospectively. A highly-sensitive C-reactive protein (hs-CRP) level above 5mg/dL was considered the presence of inflammation. The IGCs were calculated in the white cell differential channel of the Sysmex XN-9000 using the fluorescent flow cytometry method. The IG% was expressed as percentage of total leucocyte concentration. The data from 57 patients (30 stage 2 CKD, 15 stage 3 CKD, 12 stage 4 CKD) and 46 controls were analyzed. hs-CRP levels, IG%, IGC, white blood cell (WBC) and neutrophil counts, and neutrophil-to-lymphocyte ratio (NLR) were higher in patients than the control group (p < 0.000, p < 0.000, p < 0.000, p = 0.001, p = 0.002, p < 0.000, respectively). Both IG% and IGC were positively correlated with hs-CRP, WBC and neutrophil counts, and NLR (r = 0.485, p < 0.000; r = 0.379, p = 0.004; r = 0.543, p < 0.000; r = 0.628, p < 0.000 for IG%; r = 0.379, p = 0.004; r = 0.351, p = 0.007; r = 0.525, p < 0.000; r = 0.601, p < 0.000 for IGC, respectively). A ROC analysis of the relationship between IGC, IG%, and inflammation showed IGC and IG% had predictive value for the presence of inflammation (cut-off value: 0.035 × 106/mL, AUC: 0.799 ± 0.061, sensitivity: 74.2%, specifity: 63%, p < 0.001 for IGC; cut-off value: 0.45%, AUC: 0.838 ± 0.056, sensitivity: 70.8%, specifity: 67.3%, p = 0.001 for IG%). Immature granulocytes may be used as a biomarker of inflammation in children with predialysis CKD. A higher resolution version of the Graphical abstract is available as Supplementary information.

Contribution of immature granulocyte level to diagnosis in pleural effusion.

Background In this study, we aimed to evaluate the diagnostic value of neutrophil and immature granulocyte levels in peripheral blood in cases with pleural effusion. Methods Between May 2019 and May 2020, a total of 117 patients (43 males, 74 females; mean age: 63.1±18.1 years; range, 18 to 93 years) who had pleural effusion and analysis of pleural fluid were retrospectively analyzed. All patients were evaluated in terms of age, sex, presence of comorbid diseases, approach to the pleural fluid, biochemical values of peripheral blood and pleural fluid, hemogram series of peripheral blood, diagnosis of pleural fluid, and mortality. Results Of the patients, 66 (54.5%) were diagnosed with benign pleural effusion and 51 (43.5%) were diagnosed with malignant pleural effusion. Number of cases with known primary malignancy was 54 (46.1%). Immature granulocyte count number and percentage of venous blood in the malignant pleural effusion group was significantly higher than the group with benign pleural effusion (p<0.05). Conclusion As a hemogram parameter, immature granulocyte level is an easily applicable, cheap, and a non-invasive method in the outpatient settings.

The Prognostic Value of Inflammatory Markers to Predict Adverse Clinical Course of Acute Pancreatitis

Background/Aim: Prognosis of complications is important in patients with acute pancreatitis (AP). The aim was to determine the severity of AP based on changes of inflammatory markers (IM). Material and Methods: WBC, immature granulocytes (IG), neutrophil-lymphocytes ratio (NLR) and the C-reactive protein (CRP) were compared in 243 patients with moderately severe pancreatitis (MSP) and in 59 patients with acute severe pancreatitis (ASP). Results: WBC count was significantly more in ASP compare to MSP group (15.4±2.3×109/l. vs. 12.7±1.2×109/l.). IG percentage was high in ASP group; however, lymphocytes count was lower in ASP. NLR during early 48 hours decreased in MSP; but significantly increased in ASP group. The “cut off” for NLR was determined as 10.5. 3-weeks survival in patients with NLI&lt;10.5 was 95.9%. In patients with NLI&gt;10.5 the survival was 79.2% and mortality raised up to 21.8%. IG in MSP group was 0.39±0.21% and 1.7±0.51% in ASP.CRP on admission was not differ between groups, but increased in ASP in 2nd day and was significantly higher compare to MSP. Conclusion: NLR can predict the survival on admission, but CRP only 2nd day achieve the predictive value. Rational evaluating of IM during early 2 days can predict the further clinical course of AP.

Is immature granulocyte a new predictor in the diagnosis of peptic ulcer perforation?

&lt;b&gt;Introduction:&lt;/b&gt; Peptic ulcer perforation (PUP) requires immediate treatment. Immature granulocyte (IG) takes part in the inflammation process and is a biomarker which can be easily tested in peripheral venous blood. &lt;/br&gt;&lt;/br&gt; &lt;b&gt;Aim:&lt;/b&gt; This study demonstrates that IG is a convenient biomarker in the diagnosis of PUP. &lt;/br&gt;&lt;/br&gt; &lt;b&gt; Material and methods: &lt;/b&gt; Medical records of patients treated in the years 2018–2020 were analysed retrospectively. The study recognized three groups of patients: 42 PUD patients (Group 1), 42 PUP patients (Group 2) and 45 individuals acting as a healthy control (HC, Group 3). Surgical repair was performed in all patients from the PUP group. Differences between the groups were analysed statistically. The receiver operating characteristic curve (ROC) was calculated in order to predict the likelihood of PUP diagnosis based on the immature granulocyte count (IGC) and immature granulocyte percentage (IG%). &lt;/br&gt;&lt;/br&gt; &lt;b&gt; Results:&lt;/b&gt; The average IGC was high in group 1 and group 2, while the IG levels remained low in the HC group A statistically significant difference between the groups was confirmed (mean values, respectively; 0.05 [0.12], 0.04 [0.06], 0.03 [0.03], and P = 0.001). The average value of IG% was high in group 1 and group 2 but remained low in the HC group A statistically significant difference between the groups was confirmed (mean values, respectively; 1.62 ± 0.41, 0.68 ± 0.22, 0.37 ± 0.55, and P = 0.003). The following parameters were calculated for IGC and IG%: AUC: 0.637; sensitivity: 61.9%; specificity: 57.1%; P = 0.031, AUC: 0.693; sensitivity: 61.9%; specificity: 64.3%; P = 0.02), respectively. &lt;/br&gt;&lt;/br&gt; &lt;b&gt;Results:&lt;/b&gt; IG is convenient as a diagnostic biomarker in PUP patients admitted to the emergency department.

Evaluation of Immature Granulocyte Count as the Earliest Biomarker for Sepsis

ABSTRACTBackgroundDiagnosing sepsis early is important for its successful management. Various biomarkers are being used currently, but mostly they are either expensive or not readily available. This study aims to evaluate usefulness of automated immature granulocyte count (IG#) and immature granulocyte percentage (IG%) as early diagnostic markers of sepsis and compares it to other established predictive markers.Patients and methodsIn this prospective observational study, 137 eligible, critically ill, nonseptic intensive care unit patients were analyzed for automated IG#, IG%, serum procalcitonin (PCT), and blood lactate (Lac), daily for 7 days after recruitment. Patients were followed for the development of sepsis, defined by the new Sepsis-3 criteria. The study was divided into four time periods of 24 hours each with respect to the day of developing organ dysfunction. Using area under receiver operator characteristic and diagnostic odds ratio (DOR) methods, the best biomarker for the prediction of sepsis in each time period was calculated.ResultsIG# and IG% were the earliest biomarkers to have a significant discriminating value with area under the curve of 0.81 and 0.82, respectively, as early as 24 hours before clinical sepsis is diagnosed by Sepsis-3 criteria. Both IG# and IG% have a high DOR of 34.91 and 18.11, respectively, when compared to others like PCT and Lac having a DOR of 27.06 and 4.78, respectively.ConclusionIG# and IG% are easily available, rapid, and inexpensive tools to differentiate between septic and nonseptic patients with high specificity and sensitivity. It is the earliest biomarker to show a significant rise in patients developing sepsis.How to cite this articleBhansaly P, Mehta S, Sharma N, Gupta E, Mehta S, Gupta S. Evaluation of Immature Granulocyte Count as the Earliest Biomarker for Sepsis. Indian J Crit Care Med 2022;26(2):216–223.

The role of immature granulocyte percentage in predicting acute chest syndrome and the severity of the vaso-occlusive crisis in sickle cell disease.

Sickle cell disease (SCD) is an inflammatory disease that can result in both chronic and acute inflammation. Immature granulocytes (IG) are not-yet-mature white blood cells that can be easily detected in complete blood count (CBC) tests. In recent studies it has been suggested that IG may play a role in determining the prognosis of inflammatory diseases. The aim of our study was to investigate the role of IG percentage on predicting acute chest syndrome (ACS) and the severity of vaso-occlusive crisis (VOC) in patients with SCD. The study cohort consisted of 49 SCD patients admitted to the emergency department for VOC. If symptoms did not regress despite appropriate treatment including hydration and analgesia, they were hospitalized. Patients whose symptoms regressed were discharged from the emergency department within 24 hours. Blood samples, including CBC and C-reactive protein (CRP), a marker of inflammation, were taken within the first hour of admission. Steady state laboratory parameters from the previous visit in the last three months were collected from patient files. The mean age was 18±4 (range 8-25) years. Most were hospitalized (41/49; 83.7%) and 8 of 49 were discharged from the emergency department after their treatment for VOC. ACS developed in 13 of 49 (26.5%). White blood cell, neutrophil and nucleated red blood cell counts, percentage of IG (IG%) and CRP levels were significantly increased in patients with VOC. IG% of patients with ACS was significantly higher than patients without ACS. However, ROC analysis showed that IG% was not associated with the development of ACS or hospitalization for VOC. Despite a small SCD cohort, the significant increase in the IG% in patients with VOC compared to their baseline values has suggested a role for IG% in predicting VOC. Although IG% was higher in ACS, its utility in predicting ACS was poor.

Utility of immature granulocyte in severity of helicobacter pylori infection

Helicobacter pylori infection is a chronic bacterial infection associated with some extragastric diseases as well as gastric involvements that occur most commonly worldwide. In our study, we aimed to investigate the usability of immature granulocytes as a basic indicator that can reflect the severity of helicobacter pylori inflammation, to the best of our knowledge, for the first time. Patients who underwent upper gastrointestinal endoscopy between April 2019 and April 2020 and were diagnosed with antral gastritis were included in this study. The relationship between helicobacter infection and its severity detected in gastric biopsies of patients and immature granulocyte count (IGC), immature granulocyte percentage (IG%), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume (MPV) were investigated. Of the 868 patients, 210 were HP negative, 658 were HP positive (218 mild HP positive, 293 moderate HP positive, and 147 severe HP positive). There were statistically significant differences between the HP negative and HP positive groups in terms of IGC, IG%, NLR, and PLR. However, IG% and IGC were not clinically useful because the median IG% (0.3 vs 0.3) and IGC (0.02 vs 0.02) were the same in the HP negative and total HP positive groups. In our study, IGC and IG% were not found useful to detect H. pylori intensity and severity of inflammation.

An effective and reliable marker in gradıng the severity of acute cholecystitis: Increased immature granulocyte percentage.

Acute cholecystitis (AC) is an acute inflammatory disease of gallbladder and it is one of the most common causes of acute abdominal pain. Determining the severity of AC at hospital admission is extremely important to choose the most effective treatment method and predict vital prognosis. The aim of this study was to investigate the effectiveness of immature granulocyte percentage (IG%) in grading AC severity. This retrospective study was carried out on 528 patients hospitalized due to AC diagnosis. Demographic data, white blood cell (WBC) count, neutrophil lymphocyte ratio (NLR), IG%, C-reactive protein (CRP) levels, and imaging results of patients were recorded. Furthermore, patients' length of hospital stay was determined. Tokyo Guidelines were used to grade AC severity. According to this grading, patients were classified into three groups as grade 1 (mild), grade 2 (moderate), and grade 3 (severe) AC. Differences among groups were analyzed statistically. There were 386 patients (73.1%) in the mild AC group, 102 patients (19.3%) in the moderate AC group, and 40 patients (7.6%) in the severe AC group. WBC, NLR, CRP and IG% were significant parameters in discriminating mild AC from moderate and severe AC. However, only IG% was a significant parameter in discriminating moderate AC from severe AC. Moreover, the power of IG% to discriminate between patients with mild and moderate AC and those with severe AC was dramatically higher than the other parameters. Increased IG% is seen as an effective and reliable predictor in the early determination of AC severity.

MONOCYTE DISTRIBUTION WIDTH; CAN IT BE USED AS AN EARLY DIAGNOSIS MARKER IN CASES OF ACUTE COMPLICATED APPENDICITIS? A PRELIMINARY STUDY

AİM : The aim of this study was to investigate the effectiveness of monocyte distribution width in both the diagnosis of acute appendicitis (AA) and in differentiating between simple appendicitis (SA) and complicated appendicitis (CA).&#x0D; &#x0D; METHODS: This study was conducted using data from 107 adult patients who underwent appendectomy. Demographic details, preoperative white blood cell (WBC) count, immature granulocyte count (IG) and percentage (IG %), monocyte distribution width (MDW), neutrophil-lymphocyte ratio (NLR) and pathology results were evaluated retrospectively. Patients were grouped as AA and normal appendix (NA) according to the pathology reports, and the AA cases were divided into SA and CA groups according to the intraoperative findings.&#x0D; &#x0D; RESULTS: WBC, IG, IG%, NLR and MDW values were found to be statistically significant for the differentiation of acute appendicitis from normal appendicitis cases (p &lt; 0.05). Of these parameters, the strongest parameter for the diagnosis of AA was NLR (sensitivity: 76%, specificity: 89%, p&lt; 0.001). The IG value was found to be statistically significant in the diagnosis of complicated appendicitis cases (p &lt; 0.05)&#x0D; &#x0D; CONCLUSION: The MDW value is a fast, reliable and easily accessible parameter in the diagnosis of AA. However, although MDW values were found to be high in CA cases in the differentiation of SA and CA, they were not statistically significant. More comprehensive studies are needed for a clearer assessment.

Immature granulocyte percentage for prediction of sepsis in severe burn patients: a machine leaning-based approach

BackgroundOf the existing sepsis markers, immature granulocytes (IG) most frequently reflect the presence of an infection. The importance of IG as an early predictor of sepsis and bacteremia is evaluated differently for each study. This study aimed to evaluate the effectiveness of the Sysmex XN series’ IG% as an independent prognostic indicator of sepsis using machine learning.MethodsA total of 2465 IG% results from 117 severe burn patients in the intensive care unit of one institution were retrospectively analyzed. We evaluated the IG% for sepsis using the receiver operating characteristic, logistic regression, and partial dependence plot analyses. Clinical characteristics and other laboratory markers associated with sepsis, including WBC, procalcitonin, and C-reactive protein, were compared with the IG% values.ResultsTwenty-six of the 117 patients were diagnosed with sepsis. The median IG% value was 2.6% (95% CI: 1.4–3.1). The area under the receiver operating characteristic curve was 0.77 (95% CI: 0.78–0.84) and the optimal cut-off value was 3%, with a sensitivity of 76.9% and specificity of 68.1%. The partial dependence plot of IG% on predicting sepsis showed that an IG% < 4% had low predictability, but increased thereafter. The interaction plot of IG% and C-reactive protein showed an increase in sepsis probability at an IG% of 6% and C-reactive protein of 160 mg/L.ConclusionsIG% is moderately useful for predicting sepsis. However, since it can be determined from routine laboratory test results and requires no additional intervention or cost, it could be particularly useful as an auxiliary marker.

Immature Granulocyte Percentage in Early Chronic Myeloid Leukemia

A 38-year-old man presented with mild fatigue of recent onset to the medical outpatient department (OPD). Clinical examination showed an absence of fever, pallor, and no organomegaly. Routine complete blood count (CBC) showed mild leukocytosis (total leukocyte count 22.93 × 109/L), absence of features of sepsis but with immature granulocyte (IG) fraction of 26.6% on peripheral blood film without basophilia or eosinophilia. A diagnosis of chronic myeloid leukemia (CML) was suspected which was confirmed by conventional karyotyping and quantitative reverse transcription − polymerase chain reaction (QPCR). Following administration of imatinib for 2 weeks, a follow-up CBC showed a reduction in IG fraction to 1.5%. The patient is under follow-up in OPD for 4 months and is responding well as substantiated by follow-up QPCR. To the best of our knowledge, this is the first ever report where CML was first suspected on the basis of IG fraction and the same parameter proved useful for follow-up.

Accuracy of Sysmex XN immature granulocyte percentage compared to manual microscopy

Accuracy of Sysmex XN immature granulocyte percentage compared to manual microscopy

An Assessment on the Effectiveness of the Immature Granulocyte Percentage in Predicting Internal Organ Involvement Among Children With Henoch-Schönlein Purpura.

Henoch-Schönlein purpura (HSP) is the most common childhood systemic vasculitis. The present study aims to investigate the effectiveness of the immature granulocyte (IG) percentage as a new marker for predicting internal organ involvement in HSP. This study included 75 patients below 18 years old who were diagnosed with HSP. The mean age was 7.48±2.77 years. The male/female ratio was 1.14. The findings showed that 35 (46.7%) of the patients had an internal organ involvement. The mean IG percentage was 0.88±0.68 among the patient group with HSP internal organ involvement, while it was 0.31±0.15 in the group without internal organ involvement, and a significant difference was determined between the 2 groups (P=0.000). The findings showed that the patients with renal involvement had the highest mean IG percentage (IG; 1.00±0.21). When the cutoff value for the IG percentage was specified as 0.45 to predict internal organ involvement, the sensitivity was 77.1%, and the specificity was 85%. In this study, the findings showed that IG percentage increased among patients with internal organ involvement in HSP and that its sensitivity, specificity, and predictive values were higher in predicting internal organ involvement compared with other markers.