Immature Granulocytes Research Articles

Association of immature granulocytes (IG) with prognosis in severe COVID-19 patients

Association of immature granulocytes (IG) with prognosis in severe COVID-19 patients

The Optimal Time of Peripheral Blood Hematopoietic Stem Cell Collection for Autologous Transplantation May Be Predicted By Immature Granulocytes and Nucleated Red Blood Cells

The time of initiating stem cell collection is very important for successful transplantation and is determined according to peripheral blood CD34+ cell count analysed by flow cytometry. In this study, we aimed to find the role of new complete blood count parameters to determine the optimal time of stem cell collection. Eighty-six patients who underwent stem cell mobilization were included in the study. Peripheral blood CD34+ cells and complete blood count were analysed on the same day. Patients with peripheral blood CD 34+ cell counts ≤ 20/μL and > 20/μL were determined as Group 1 and Group 2, respectively. The difference of CBC parameters between 2 groups and the relationship of these parameters with peripheral blood CD34+ cell counts were evaluated. It was found that immature granulocytes ratio, nucleated red blood cells ratio and count were positively correlated with peripheral blood CD34+ cell count and these parameters were significantly different between two groups (P< 0.001, P= 0.011 and P= 0.012, respectively). The new index formulated by using immature granulocytes and nucleated red blood cells ratios was significantly different between two groups (P<0.001), and had the highest diagnostic accuracy to determine the time of stem cell collection (AUC= 0.766). Immature granulocytes and nucleated red blood cells can be used to determine the time of peripheral blood stem cell collection faster and cheaper compared to flow cytometry.

The use of 8-diff clinical blood testing of patients to assess the severity of the new coronavirus infection

Introduction. A new coronavirus infection causes a variety of changes in the body of an infected person, which can be monitored using clinical blood analysis. The capabilities of flow cytometry allow to expanding the range of analyzed cell populations, which gives a more complete picture of the patient’s condition and the course of infection process.Aim. To study the extended 8-diff clinical blood analysis in patients with COVID-19 and to identify the parameters characterizing a severe course and an unfavorable outcome.Material and Methods. The study group comprised 282 patients with a confirmed diagnosis of a new coronavirus infection. The following parameters of the extended 8-diff clinical blood test were evaluated: the total content of leukocytes and their populations, the number of reactive and antibody-synthesizing lymphocytes (RE-LYMPH, AS-LYMPH), indicators characterizing the reactivity and granularity of neutrophils (NEUT-RI, NEUT-GI), erythrocyte count, hemoglobin level, normoblast count, and platelet count. Statistical data were processed using the Statistica 10.0 software.Results. The blood picture of patients with a severe course of COVID-19 as well as of those with an unfavorable outcome of disease was characterized by neutrophilia, normoblastemia, and an increase in the number of immature granulocytes. At the same time, there was a significant decrease in the number of lymphocytes and monocytes below the reference interval and a decrease in the number of eosinophils to the extent of complete absence. The performed logistic regression analysis allowed to determine the most significant hematological parameters in predicting the outcome of COVID-19 as follows: the total number of leukocytes (OR 1.3), neutrophils (OR 2.1), reactive neutrophils (OR 1.3), eosinophils (OR 0.05), monocytes (OR 0.2), lymphocytes (OR 0.4), and neutrophil-to-lymphocyte ratio (NLR) (OR 1.4). Also, the threshold values were established for these parameters as follows: the total number of leukocytes > 7.2 × 109/L, neutrophils > 5 × 109/L, reactive neutrophils > 48.6 Fi, eosinophils < 0.05 × 109/L, lymphocytes < 1.3 × 109/L, monocytes < 0.5 × 109/L, and NLR > 2.9 were associated with an unfavorable outcome of the disease.Conclusion. The obtained data may be used for a comprehensive evaluation of COVID-19 patient condition along with other laboratory markers of the severe course of the infection.

Efficacy of blood parameters as indicators of the need for overdue urgent cholecystectomy in elderly patients with acute cholecystitis.

Although early cholecystectomy is recommended for patients with acute cholecystitis, conservative treatment followed by delayed cholecystectomy (DC) is a highly preferred modality, especially in older adult patients. However, some severe cases require overdue urgent cholecystectomy (OC). This study aimed to evaluate the ability of laboratory findings and Tokyo severity classification (TokyoSC) to differentiate those with the need for OC among elderly patients. Laboratory/radiological/clinical findings of geriatric patients with acute cholecystitis on admission and TokyoSC were retrospectively analyzed. The DC and OC groups were compared. The mean age of the 164 patients was 72.3±6.4 years. White blood cell, neutrophil (NEU), immature granulocyte (IG), C-reactive protein, neutrophil-to-lymphocyte ratio (NLR), and TokyoSC parameters were all significant at P<0.001 in differentiation. NLR had a specificity of 98%, and TokyoSC had a sensitivity of 98%. NLR, NEU, IG, and TokyoSC were effective in differentiating patients who needed OC while planning conservative treatment + DC for older adult patients who were followed up due to acute cholecystitis. If the NLR is >9.9 and TokyoSC is moderate/high, early cholecystectomy should be preferred instead of conservative treatment + DC in aged patients.

The Role of Delta Neutrophil Index (Immature Granulocyte) and Hematological Markers in the Diagnosis of Pediatric Acute Appendicitis

The Role of Delta Neutrophil Index (Immature Granulocyte) and Hematological Markers in the Diagnosis of Pediatric Acute Appendicitis

Aberrant myelomonocytic CD56 expression predicts response to cyclosporine therapy in pediatric patients with moderate aplastic anemia.

This study aimed to investigate the expression patterns and clinical significance of neural cell adhesion molecule-positive (CD56+) myelomonocytes in pediatric patients with moderate aplastic anemia (mAA). Fifty-six pediatric patients with mAA were enrolled in this study. The patients' clinical characteristics, laboratory data, and response to cyclosporine therapy were obtained. CD56 expression on bone marrow myelomonocytic cells was investigated using flow cytometry. The association between aberrant CD56 expression and cyclosporine response was evaluated by a multivariate analysis. CD56+ myelomonocytes were detected in 43% of the mAA cases. Aberrant CD56 expression was frequent on immature CD45dimCD16dim granulocytes and mature CD45brightCD14bright monocytes. Compared with patients with CD56- myelomonocytes (CD56- patients), patients with CD56+ myelomonocytes (CD56+ patients) were in moderate hematological condition and had a distinct bone marrow cellular composition profile, which included an increased proportion of myeloid cells and CD56bright natural killer cells and a reduced proportion of CD4+ T cells, CD8+ T cells, and B cells. The multivariate analysis determined that CD56+ myelomonocytes were a favorable factor for achieving response at 6 months after cyclosporine therapy. There was a trend towards a lower 3-year rate of evolution to severe aplastic anemia or relapse among the CD56+ patients (8%) than the CD56- patients (22%). CD56+ patients had an increased myeloid compartment and better prognosis compared with CD56- patients. The findings demonstrated the favorable role of CD56+ myelomonocytes in aplastic anemia progression.

The role of biomarkers in the early diagnosis of acute kidney injury associated with acute pancreatitis: Evidence from 582 cases.

One of the systemic complications of acute pancreatitis (AP) is acute kidney injury (AKI). AKI development in patients with AP increases mortality, morbidity, and the cost of treatment. Therefore, early diagnosis and prevention of AKI is important. The purpose of our study was to present biomarkers and case management of AKI developing in patients with AP. The participants of this retrospective study consisted of 582 patients who were followed up with the diagnosis of AP. Atlanta classification was used for the diagnosis and the identification of severity of AP. The laboratory values of patients at the time of first application to the emergency room were recorded. Blood tests were checked 48 h/l. Their blood tests were monitored daily until the day of discharge. Of the 582 patients who were admitted with the AP diagnosis, 344 were female. AKI was detected in 147 patients (25.2%) of the patients admitted with AP diagnosis. The mean age of patients developing AKI was higher than those who did not develop AKI. The albumin and calcium levels in patients developing AKI were significantly lower than the group without AKI. The C-reactive protein (CRP)/albumin and neutrophil/lymphocyte ratios were statistically significantly higher in the group with AKI than the group without AKI. The increase values in AST and ALT levels between the group with AKI and the group without AKI were not statistically significant. The mean leukocyte, CRP, procalcitonin levels, and immature granulocyte percentage (IG%) ratio were higher in patients with AKI in comparison to the patient group without AKI. The decrease in the lymphocyte, hematocrit, and platelet levels was higher in the patient group with AKI compared to the patient group without AKI. Urea and creatinine levels of the group with AKI at the time of admission were higher than the group without AKI. The clinical picture in 13 of the patients we followed up with AP diagnosis was mortal. The values of hematocrit, platelet, leukocyte, lymphocyte, albumin, CRP, CRP/albumin ratio, neutrophil/lymphocyte ration, IG%, procalcitonin, urea, and creatinine that were examined at the time of hospital admission can be useful biomarkers in predicting the development of AKI in patients with AP. In addition, accompanying diseases and age are among the factors affecting AKI development.

Clinical Applicability of Automated Hematology Analyzer Research Parameters for Disease Diagnosis: a Reference Interval Study.

We established reference intervals for research parameters of complete blood cell count and examined their usefulness for diagnosing certain diseases. Reference intervals for 26 basic and 38 research parameters were established for 3,457 and 1,325 men and 2,742 and 830 women aged 20 - 59 and ≥ 60 years, respectively. Research parameter values for patients with iron deficiency anemia (IDA), appendicitis, sepsis, and myelodysplastic syndromes (MDS) were compared against gender- and age-matched reference values. Seven basic and 10 research parameters among men and one research parameter among women required partitioning by age. No partitioning by gender was required. Further, 67% patients with IDA showed micro red blood cell ratio values above the upper reference limits of their corresponding age and gender subgroups; 3% and 5% patients with appendicitis showed immature granulocyte percentages and counts above the upper reference limits, respectively; 12% - 42% of patients with sepsis showed numerous values exceeded their reference limits, and 67% and 100% patients with MDS showed neutrophil cell complexity and structural dispersion values outside their reference ranges, respectively. Overall, < 60% of research parameter values were outside their reference ranges among most patients, indicating their limited diagnostic usefulness.

Percentage of immature granulocytes in subacute thyroiditis follow-up and differential diagnosis with Graves’ disease

Percentage of immature granulocytes in subacute thyroiditis follow-up and differential diagnosis with Graves’ disease

The Role of Immature Granulocyte in Patients with Complex Appendicitis

The Role of Immature Granulocyte in Patients with Complex Appendicitis

Delta nötrofil indeksi, inkarsere inguinal fıtıklarda barsak rezeksiyonu gereğini öngörmede bir belirteç olarak kullanılabilir mi?

Objective: Delta neutrophil index is a parameter that shows the ratio of immature granulocytes to the neutrophil count. This study aims to determine the power of DNI in predicting the presence of strangulation in incarcerated inguinal hernias.&#x0D; Methods: The files of the patients who were admitted to our clinic and operated due to incarcerated inguinal hernia between May 2021 and May 2022 were reviewed retrospectively. The patients' age, gender, hernia type, leukocyte, lymphocyte, neutrophil, platelet, monocyte values, delta neuthrophil index, the surgical method applied, and whether bowel resection was performed were extracted from the patient files. The patients were divided into two groups patients who underwent bowel resection because of bowel ischemia (group 1) and those who did not (group 2).&#x0D; Results: Eighty-one patients were included in the study. It was determined that 70 (86.4%) patients did not undergo bowel resection, and 11 (13.6%) underwent bowel resection. The median DNI value of the patients in Group 1 was 0.30 (0.10 - 1.20), and the median DNI value of the patients in Group 2 was 0.30 (0.10 - 1.30), and the difference was not statistically significant (p=0.77)&#x0D; Conclusion: Delta neutrophil index may not be an accurate predictive value to predict the presence of ischemia in the incarcerated bowel segment in patients with incarcerated inguinal hernia.

Predictive value of immature granulocyte in the diagnosis of acute complicated appendicitis.

The goal in appendicitis is early diagnosis and early treatment. Complications develop as treatment is delayed. Therefore, there is a need for fast, low-cost markers that can be diagnosed earlier. The aim of this study is to show the effectiveness of immature granulocyte (IG) level in determining the complication of acute appendicitis. In this retrospective cross-sectional study, 99 patients with acute appendicitis and 41 control groups were included in the study. Acute appendicitis patients were divided into two groups as acute simple appendicitis(n = 65) and acute complicated appendicitis(n = 34). In all groups, demographic data, immature granulocyte (IG) count(x103/μL), IG ratio (IG%), white blood cell (WBC), polymorphonuclear leukocytes (PNL), lymphocyte, monocyte, platelet, mean platelet volume (MPV), ferritin levels were recorded. The blood analyses were performed the Mindray BC6800 automated hematology analyzer using standard laboratory protocols. All statistical testing was undertaken using IBM SPSS Statistics for Mac. Compared to the acute simple appendicitis, acute complicated appendicitis patients had significantly higher levels WBC, PNL, monocyte, IG count, and IG% (p = 0.009, p = 0047, p = 0.001, p = 0.018; respectively) while there was no significant difference in ferritin between groups (p = 0.49). In the ROC analysis, AUC value was found for IG count and IG% (0.893 and 0.725, cut-off 0.005 and 0.05; respectively) for acute appendicitis. The negative predictive value of IG for Acute Appendicitis was 85% and was the same as that of WBC. In acute complicated appendicitis, the AUC for IG and IG% was 0.796 (cut-off 0.02) and 0.693 (cut-off 0.2), respectively. Positive Likelihood Ratio (+LR; 2.1) value of IG was found higher than other complete blood count (CBC) tests. The IG count is test with fast, more predictive value than another CBC tests, and without cost in the early diagnosis of acute complicated appendicitis. It is strong negative predictive test for Acute Appendicitis disease.

1072. SARS-CoV-2 Antibody Levels Associate with Neutrophil Activation

Abstract Background COVID-19 disease severity and outcomes have been linked to high antibody titers and a dysregulated neutrophil immune response. Here we query associations and connections between the endogenous SARS-CoV-2 antibody response and neutrophil activation in COVID-19. Methods Baseline serum or plasma samples from 57 patients hospitalized on oxygen with COVID-19 were used to perform; 1) quantitative measurements of SARS-CoV-2 specific antibodies using a luciferase-based immunoprecipitation system assay, 2) quantitative measurements of neutrophil specific biomarkers using Luminex technology, and 3) neutrophil extracellular traps (NETs) as measured by myeloperoxidase-DNA (MPO-DNA) complexes by ELISA. Absolute neutrophil count (ANC) and immature granulocyte count (IGC) were measured from complete blood counts (CBC). Antibody levels were compared by disease severity using Wilcoxon rank-sum test and correlations were generated between antibody levels and neutrophil activation markers using Spearman’s correlation (SC). Results In a cohort of hospitalized patients, severe/critical COVID-19 was associated with higher levels of nucleocapsid-IgA (p=0.011) as well as spike-IgG (p= 0.0007) compared to moderate disease, while spike-IgA and nucleocapsid-IgG showed similar associations, trending towards significance (Figure 1A). Levels of IgG-spike and IgG-nucleocapsid both had significant correlations with the ANC (SC 0.33, p = 0.029; SC 0.38 p = 0.012). All four antibody titers showed strong correlations with IGC, lactoferrin and lipocalin-2, evidence of emergency granulopoiesis. Further, S100A9, a component calprotectin correlated with spike-IgG and nucleocapsid-IgA levels (SC 0.29, p = 0.030, SC 0.29 p = 0.029). Lastly, we found circulating NETs correlated with spike IgA levels (SC 0.38 p = 0.006), and its correlations with IgG-spike and IgA-nucleocapsid additionally approached significance with NETs levels as well (Figure 1B). Antibody Levels Correlate with Disease Severity and Neutrophil Activation Markers Figure 1: A) Levels of anti-Spike and anti-Nucleocapsid IgA and IgG levels measured in the serum of 57 unvaccinated hospitalized COVID-19 patients. Moderate illness represents ordinal scale 5 requiring low flow oxygen, while severe/critical patients represent ordinal scale 6 and 7, requiring high flow oxygen, non-invasive or mechanical ventilation, respectively. P values are compared by a Wilcoxon ranked sum test. B) Heatmap showing Spearman correlations between levels of anti-Spike and anti-Nucleocapsid IgA and IgG and markers of neutrophil activation. P values for individual correlations are represented in parentheses. MPO (myeloperoxidase), ANC (absolute neutrophil count), S100A9 (S100 calcium binding protein A9). Conclusion Higher anti-spike and anti-nucleocapsid IgG and IgA levels associate with more severe COVID-19 illness. Further, endogenous SARS-CoV-2 specific antibody levels associate with markers of emergency granulopoiesis and neutrophil activation. Inhibiting antibody mediated neutrophil activation may improve outcomes in COVID-19. Disclosures All Authors: No reported disclosures.

The Effectiveness of Immature Granulocyte Count for Predicting COVID-19 Severity and Poor Outcomes

The Effectiveness of Immature Granulocyte Count for Predicting COVID-19 Severity and Poor Outcomes

Assessment of Micro-R/Macro-R values and other hemogram parameters for the diagnosis of early neonatal sepsis

Aims: Neonatal sepsis is a systemic condition that results in hemodynamic and clinical findings. We aimed to determine the role of hemogram parameters in the diagnosis of early neonatal sepsis.&#x0D; Methodology: This retrospective study was conducted with 126 neonates hospitalized in Kastamonu Training and Research Hospital Neonatal Intensive Care Unit between March 2018 to March 2022. There were 65 term neonates diagnosed with early neonatal sepsis in the patient group. In the control group, there were 61 term neonates who underwent hemogram within the first 72 hours (postnatal period) due to physiological jaundice and did not receive any antibiotic treatment. The assessment was made by comparing the hemogram parameters of these groups.&#x0D; Results: The Macro-R value, white blood cell count, absolute neutrophil count, monocyte count, immature erythrocyte count and percentage, immature granulocyte count and percentage and neutrophil-lymphocyte ratio were found to be significantly higher in the patient group than in the control group (p&lt;0.05). Macro R, white blood cell count, absolute neutrophil count, immature erythrocyte count and percentage, immature granulocyte count and neutrophil/lymphocyte ratio had high sensitivity and specificity for the diagnosis of early neonatal sepsis.&#x0D; Conclusion: We think that these simple and easily accessible parameters have potential value in the diagnosis of ENS if they are used together with the clinical symptoms of ENS.

Determining the effectiveness of the immature granulocyte percentage and systemic immune-inflammation index in predicting acute pyelonephritis

ABSTRACT Aim The most serious form of urinary tract infection (UTI) is acute pyelonephritis (APN), which can result in bacteremia and renal scarring. This study aims to show the roles that the systemic immune-inflammation index (SII) and the immature granulocyte (IG) percentage play in predicting APN in pediatric patients by comparing them with traditional infection markers. By illustrating a significant relationship between APN, the IG percentage, and the SII, the study’s contributions to the differential diagnosis of UTI can promote a rapid and appropriate treatment of APN. Material and Methods The present study included 522 pediatric patients. The patients were divided into two groups: (I) an APN group (n = 236) and (II) a lower UTI group (n = 286). Results The mean age of the sample was 5.05 ± 4.7 years. According to the most appropriate cutoff values, the findings showed that among all the parameters, C-reactive protein (CRP) and the IG percentage had the highest sensitivities, specificities, and predictive values for predicting APN. Conclusion This study emphasizes the support features of the IG percentage and the SII in the diagnosis of APN in pediatric patients, a topic that has recently attracted attention. The findings indicated that among all of the parameters behind CRP, the IG percentage and the SII had the highest sensitivities, specificities, and predictive values for forecasting APN. It is worth noting that these methods can be applied without additional costs or burdens to the patient.

Does the Percentage of Immature Granulocytes Predict the Severity and Mortality of the Disease in Patients with Acute Pancreatitis Presenting to the Emergency Department?

Does the Percentage of Immature Granulocytes Predict the Severity and Mortality of the Disease in Patients with Acute Pancreatitis Presenting to the Emergency Department?

The effect of full blood count and cardiac biomarkers on prognosis in carbon monoxide poisoning in children.

In this study, cardiac biomarkers, blood parameters, electrocardiography (ECG), and echocardiography were investigated in children with carbon monoxide (CO) poisoning, and the diagnostic value of these parameters was investigated. The demographical, clinical, and laboratory data of children aged 0-18years who were admitted to the pediatric emergency department due to CO poisoning between January 2019 and January 2022 were retrospectively scanned from medical records. The patients were divided into two groups as troponin-I positive and troponin-I negative. There were 107 children aged 0-18years (average age, 10.46 ± 5.77years; 51% female) with CO poisoning. There were 13 patients with troponin-I positive myocardial injury. Troponin-I was positive in 3 patients whose carboxyhemoglobin (COHb) level was below 2% at the time of admission. In one patient, troponin-I, which was normal at admission, increased by the 24th hour of hospitalization. Hyperbaric oxygen therapy was given due to headache in one patient, although the COHb level of that patient was below 25%. An NT-proBNP level of ≥ 219.5ng/L predicted the development of troponin-I positivity with a sensitivity of 70% and a specificity of 86.7% (AUC, 0.967 (0.58-0.994); p = 0.017). White blood cell (WBC), neutrophil, neutrophil-to-lymphocyte ratio (NLR), immature granulocyte (IG), and IG% levels were found to be significantly higher in the troponin-positive patient group. DISCUSSIONAND CONCLUSION: NT-proBNP has been shown to be an early diagnostic marker for myocardial dysfunction. Additionally, when cardiac markers are not available, full blood parameters may assist clinicians for patient treatment and referral.

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.

Diagnostic test of Immature Granulocyte Ratio (IG Ratio) to detect Early-Onset Neonatal Sepsis (EONS)

Background: Based on the onset of events, the most common neonatal sepsis is early-onset neonatal sepsis (EONS), which occurs within the first 72 hours of life. Blood culture is the gold standard for EONS, but this examination takes a long time to provide the results. However, the latest method is obtained to determine the shift to the left granulocytic image by counting Immature Granulocyte (IG). This study aims to evaluate the accuracy of the IG Ratio for diagnosing EONS in neonates suspected of having sepsis. Methods: A cross-sectional observational study was conducted among 60 EONS patients consecutively, who met the inclusion criteria from January to June 2022 at Prof. dr. I.G.N.G Ngoerah Hospital, Bali. Variables assessed in this study included age, gender, delivery methods, birth status, birthweight, blood culture, complete blood count (CBC), I/T ratio, and IG ratio. Data were analyzed using SPSS version 23 for Windows. Results: The cut-off point of the IG Ratio was 2.21 (AUC=0.670 (0,490-0,851); p=0.041; OR: 8.021 (2.283-28.185); p=0.001), which had a sensitivity of 64.7% and a specificity of 81.4% for diagnosing EONS in neonates suspected of having sepsis. The results also obtained a Negative Predictive Value (NPV) of 85.35 and a Positive Predictive Value (PPV) of 57.89. Conclusion: The cut-off point of the IG Ratio of 2.21 has a risk factor of 8.021 times higher for diagnosing EONS in neonates with sepsis.