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Updated: Jun 5, 2025
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Published on: June 8, 2022
The Potential Role of Neutrophil Reactivity Intensity and Reactive Lymphocytes as Extended Hematological Parameters
Andri Iskandar Mardia1,2, Laniyati Hamijoyo3, Evan Susandi4
1Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
Objectives:
Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by the presence of autoantibodies against nuclear antigens and immune complex deposition. The pathogenesis of SLE is not fully understood; however, there are alterations in neutrophils and lymphocytes. Recent parameters assessing both neutrophil activations (Neut-RI, Neut-GI, IG) and activated lymphocytes (Re-Lymp, As-Lymp) can be used to assess the activation of immune cells. The aim of this study was to explore the potential role of this parameter in detecting active SLE.
Methods:
Cross-sectional study using secondary data from Hasan Sadikin Lupus Registry. Parameters were examined using Sysmex XN-1500. Lupus activity was determined according to SLEDAI-2K.
Results:
This study included 30 active (SLEDAI 2K ≥ 4) and 30 inactive SLE patients. Compared to inactive SLE, active SLE showed significantly higher Neut-RI (51.5 vs. 49.6 FL, p = 0.004), and lower Re-Lymph (0.09 vs. 0.14 × 103/mm3, p = 0.024). There was no significant difference in Neut-GI (150 vs. 151.6 SI, p = 0.359), As-Lymp (0.02 vs. 0.01 × 103/mm3, p = 0.621), and IG (0.11 vs. 0.06 × 103/mm3, p = 0.384) between active and inactive SLE. Neut-RI/Re-Lymp ratio cutoff > 0.47 could distinguish between active and inactive SLE with AUC 0.689, 66.7% sensitivity, and 70.0% specificity.
Conclusion:
In active SLE, there is an elevation in Neut-RI and a reduction in Re-Lymp. Neut-RI/Re-Lymp ratio exceeding 0.47 could be used to detect active SLE.
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