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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
Diagnostic role of inflammatory markers in pediatric Brucella arthritis
Fesih Aktar1, Recep Tekin2, Mehmet Selçuk Bektaş3
1Department of Pediatric Infectious Disease, Dicle University School of Medicine, 21280, Diyarbakir, Turkey. fesihaktar@yahoo.com.
Insights
Inflammatory markers like neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were elevated in children with brucella arthritis (BA). These findings suggest NLR and PLR may serve as indirect indicators of inflammation in BA cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Rheumatology
Background:
- Brucellosis is a multisystem infectious disease characterized by inflammation and elevated acute-phase reactants.
- Biomarkers such as mean platelet volume (MPV), platelet distribution width (PDW), red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) are recognized indicators of inflammation.
Purpose of the Study:
- To evaluate the diagnostic utility of MPV, PDW, RDW, NLR, and PLR as inflammatory biomarkers in pediatric brucella arthritis (BA).
Main Methods:
- A retrospective study involving 64 children diagnosed with BA and 66 healthy controls.
- Collected demographic data, joint involvement details, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and hematological parameters.
- Analyzed synovial fluid and serum tube agglutination test results for Brucella, alongside treatment regimens.
Main Results:
- Children with BA showed significantly higher mean values for PDW, RDW, MPV, NLR, and PLR compared to controls (p < 0.05).
- A positive correlation was observed between MPV and NLR (R² = 0.192, p < 0.001).
- The ankle was the most frequently affected joint (53.1%).
Conclusions:
- Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) appear to be elevated in children with brucella arthritis, serving as indirect markers of inflammation.
- Further longitudinal research is recommended to solidify the association between these biomarkers and BA.
Background:
As a multisystem infectious disease, there is an inflammation, which causes increase in acute phase reactants in brucellosis. The mean platelet volume (MPV), platelet distribution width (PDW), red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been identified as markers of inflammation. The present study aimed to evaluate diagnostic values of these biomarkers in brucella arthritis (BA).
Methods:
The study included 64 children with BA and 66 healthy control subjects. Demographic features, joint involvement, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and hematological variables were retrospectively recorded. In addition, results of synovial fluid and serum tube agglutination test for brucella together with treatment regimens were recorded.
Results:
The mean age of the patients (53.1 % male) was 92.3 ± 41.2 months. The most commonly affected joint was ankle (53.1 %). Synovial fluid puncture-brucella agglutination test was positive in 22 (34.3 %) patients. Puncture culture was positive in 9 patients. Most of the patients (57.8 %) were treated with a combination of rifampicin plus sulfamethoxazole/trimethoprim and gentamicin. Significantly higher mean PDW, RDW, MPV, NLR and PLR values were found in children with BA compared to control subjects (p < 0.05). A positive correlation was found between MPV and NLR values (R (2) = 0.192, p < 0.001).
Conclusion:
Our findings indicated that NLR and PLR are indirect markers of inflammation that may be observed abnormally increased in children with brucella arthritis. Further longitudinal studies are needed to investigate this topic to establish the more clear associations.
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