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Predictive role of inflammatory indexes in systemic manifestations of pediatric Behçet's disease
Zeynel Abidin Akar1, Ömer Karakoyun2, Kadir Kaya3
1Division of Rheumatology, Department of Physical Therapy and Rehabilitation, Dicle University, Diyarbakır, Turkey.
Insights
Systemic inflammatory biomarkers like NLR, SII, PIV, and CRP/albumin ratio can indicate organ involvement in pediatric Behçet
Area of Science:
- Pediatric Rheumatology
- Autoinflammatory Diseases
- Biomarker Research
Background:
- Pediatric Behçet's disease (BD) diagnosis is challenging due to varied symptoms and lack of specific criteria.
- Systemic inflammatory biomarkers are not well-established for assessing organ involvement in pediatric BD.
Purpose of the Study:
- To evaluate the association between systemic inflammatory biomarkers and organ involvement in pediatric BD.
- To investigate neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and CRP/albumin ratio in pediatric BD patients.
Main Methods:
- Retrospective study of 41 pediatric BD patients and 41 healthy controls.
- Calculation of inflammatory indices (NLR, SII, PIV, CRP/albumin) from pre-treatment blood samples.
- ROC analysis to determine cut-off values for systemic involvement.
Main Results:
- 68.3% of pediatric BD patients had systemic involvement, including neurological and vascular.
- Elevated PIV, SII, NLR, and CRP/albumin ratios were significantly associated with systemic, neurological, and vascular involvement (p < 0.05).
Conclusions:
- Systemic inflammatory biomarkers (NLR, SII, PIV, CRP/albumin) may indicate organ involvement in pediatric BD.
- Routine assessment of these markers can aid in early recognition and management of systemic manifestations.
Purpose:
Behçet's disease (BD) is a multisystem autoinflammatory disorder that may present during childhood. Pediatric BD is challenging to diagnose due to heterogeneous clinical manifestations and the lack of standardised pediatric classification criteria. This study aimed to evaluate the association between systemic inflammatory biomarkers-including the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and C-reactive protein (CRP)/albumin ratio-and systemic organ involvement in children with BD. To our knowledge, no prior study has investigated these markers in pediatric BD.
Methods:
In this retrospective study, 41 pediatric patients diagnosed with BD according to the 2015 PEDBD criteria and followed jointly by dermatology and rheumatology departments were included. Age- and sex-matched healthy controls (n = 41) undergoing elective surgery were also enrolled. Inflammatory indices (NLR, SII, PIV, CRP/albumin) were calculated from pre-treatment blood samples. Cut-off values for systemic involvement were determined via ROC analysis. Statistical analyses included the Kolmogorov-Smirnov test, independent t-test or Wilcoxon test, Chi-square and McNemar tests, correlation analysis, logistic regression, and ROC analysis.
Results:
Systemic involvement was observed in 28 (68.3%) patients, including neurological involvement in 4 (9.8%), vascular involvement in 5 (12.2%), and other major organ involvement in 19 (46.3%). Inflammatory indices-PIV, SII, NLR, and CRP/albumin-were significantly higher in patients with systemic, neurological, and vascular involvement (all p < 0.05). Optimal cut-off values for each index were established based on systemic involvement.
Conclusion:
Systemic inflammatory biomarkers such as NLR, SII, PIV, and CRP/albumin ratio may serve as useful indicators of systemic organ involvement in pediatric BD. Routine assessment of these markers could facilitate earlier recognition and more targeted management of systemic manifestations in this population.
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