Can Neutrophil/Lymphocyte Ratio Assess Inflammatory Bowel Disease Activity and Severity in Children?

Area of Science:

• Pediatric Gastroenterology
• Inflammatory Bowel Disease Research
• Biomarker Discovery

Background:

• Current inflammatory bowel disease (IBD) markers like white blood cells, C-reactive protein, and erythrocyte sedimentation rate lack diagnostic precision.
• Fecal calprotectin offers better sensitivity and specificity but is costly.
• Endoscopic procedures, while definitive, are invasive and carry risks.

Purpose of the Study:

• To evaluate the neutrophil/lymphocyte ratio (NLR) as a potential laboratory marker for assessing IBD activity and severity in pediatric patients.
• To address the lack of research on NLR in pediatric IBD populations.

Main Methods:

• A prospective study involving 50 pediatric patients (2 months to 16 years) with endoscopically and histopathologically confirmed IBD.
• Collected clinical data including activity scores and endoscopic subscores.
• Performed laboratory tests: white blood cells, C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, and calculated the neutrophil/lymphocyte ratio.

Main Results:

• The mean NLR varied among IBD subtypes: 1.76 ± 0.36 in ulcerative colitis, 1.50 ± 0.41 in Crohn's disease, and 1.47 ± 0.14 in indeterminate colitis.
• Significant correlations were observed between NLR and established markers: erythrocyte sedimentation rate, C-reactive protein, fecal calprotectin, clinical activity score, and Mayo endoscopic subscore.

Conclusions:

• The neutrophil/lymphocyte ratio demonstrates potential as a reliable and accessible biomarker for monitoring inflammatory bowel disease activity and severity in children.
• NLR offers a promising, less invasive alternative for pediatric IBD management.