A novel approach in the diagnosis and follow-up of sarcoidosis
Keywords:Sarcoidosis, Lymphadenopathy, Monocyte, Lymphocyte, Lung
Aim: Sarcoidosis is characterized by the presence of non-caseous granulomas that can involve all organs, especially the lungs and mediastinal lymph nodes. No biomarker investigated in recent years appears to be specific for sarcoidosis. We aimed to investigate and evaluate the relationship between neutrophil-lymphocyte ratios (NLR), platelet-lymphocyte ratios (PLR), monocyte-lymphocyte ratios (MLR), eosinophil-lymphocyte ratios (ELR), and blood count parameters in sarcoidosis patients. Methods: A total of 150 individuals comprising 97 sarcoidosis patients, and 53 controls, were included in the study. The data were recorded retrospectively. Chest X-ray findings were analyzed with regards to age, gender, body mass index, modified medical research concept (MMRC) dyspnea scale and respiratory function parameters. Blood count, NLR, PLR, MLR, eosinophil/basophil ratio (EBR) were evaluated in patients with sarcoidosis. Results: Hemoglobin (g/dl) and lymphocyte count (103 /UL) values were significantly lower in sarcoidosis patients, while red blood cell distribution width standard deviation (RDW SD) (fl), neutrophil count (103 /UL), monocyte count (103 /UL), basophil count (103 /UL), NLR, PLR, MLR values were significantly higher compared to the control group. However, platelet (103 /UL), MPV and EBR values were similar. Conclusion: Our study showed that MLR value, which was not previously used in sarcoidosis patients, is an important biomarker in the diagnosis of sarcoidosis, just as NLR.
Soto-Gomez N, Peters JI, Nambiar AM. Diagnosis and Management of Sarcoidosis. Am Fam Physician. 2016;93(10):840-8.
Hunninghake GW, Costabel U, Ando M, Baughtman R, Cordier JF, du Bois R et al. ATS/ERS/WASOG statement on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and other Granulomatous Disorders. Sarcoidosis, Vasc Diffus lung Dis Off J WASOG. 1999;16(2):149-73.
Baughman RP, Culver DA, Judson MA. A concise review of pulmonary sarcoidosis. Am J Respir Crit Care Med. 2011;183(5):573-81. doi: 10.1164/rccm.201006-0865CI
Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the E. Am J Respir Crit Care Med. 1999;160(2):736-55. doi: 10.1164/ajrccm.160.2.ats4-99
Jain R, Yadav D, Puranik N, Guleria R, Jin J-O. Sarcoidosis: Causes, Diagnosis, Clinical Features, and Treatments. J Clin Med. 2020;9(4). doi: 10.3390/jcm9041081
Sulica R, Teirstein AS, Kakarla S, Nemani N, Behnegar A, Padilla ML. Distinctive clinical, radiographic, and functional characteristics of patients with sarcoidosis-related pulmonary hypertension. Chest. 2005;128(3):1483-9. doi: 10.1378/chest.128.3.1483
Baughman RP, Lower EE, Drent M. Inhibitors of tumor necrosis factor (TNF) in sarcoidosis: who, what, and how to use them. Sarcoidosis, Vasc Diffus lung Dis Off J WASOG. 2008;25(2):76-89.
Ocal N, Dogan D, Ocal R, Tozkoparan E, Deniz O, Ucar E et al. Effects of radiological extent on neutrophil/lymphocyte ratio in pulmonary sarcoidosis. Eur Rev Med Pharmacol Sci. 2016;20(4):709-14.
Yalnız E, Karadeniz G, Üçsular FD, Erbay Polat G, Şahin GV. Predictive value of platelet-to-lymphocyte ratio in patients with sarcoidosis. Biomark Med. 2019;13(3):197-204. doi: 10.2217/bmm-2018-0252
Akboga MK, Canpolat U, Yuksel M, Yayla C, Yılmaz S, Turak O et al. Platelet to lymphocyte ratio as a novel indicator of inflammation is correlated with the severity of metabolic syndrome: A single center large-scale study. Platelets. 2016;27(2):178-83. doi: 10.3109/09537104.2015.1064518
Liu D, Jin J, Zhang L, Li L, Song J, Li W. The Neutrophil to Lymphocyte Ratio May Predict Benefit from Chemotherapy in Lung Cancer. Cell Physiol Biochem Int J Exp Cell Physiol Biochem Pharmacol. 2018;46(4):1595-605. doi: 10.1159/000489207
Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeanger JRH, Brenıtz EA et al. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med. 2001;164(10 Pt 1):1885-9. doi: 10.1164/ajrccm.164.10.2104046
Gupta D, Rao VM, Aggarwal AN, Garewal G, Jindal SK. Haematological abnormalities in patients of sarcoidosis. Indian J Chest Dis Allied Sci. 2002;44(4):233-6.
Silverstein E, Pertschuk LP, Friedland J. Immunofluorescent localization of angiotensin converting enzyme in epithelioid and giant cells of sarcoidosis granulomas. Proc Natl Acad Sci U S A. 1979;76(12):6646-8. doi: 10.1073/pnas.76.12.6646
Lieberman J, Nosal A, Schlessner A, Sastre-Foken A. Serum angiotensin-converting enzyme for diagnosis and therapeutic evaluation of sarcoidosis. Am Rev Respir Dis. 1979;120(2):329-35. doi: 10.1164/arrd.19184.108.40.2069
Loke WSJ, Herbert C, Thomas PS. Sarcoidosis: Immunopathogenesis and Immunological Markers. Int J chronic Dis. 2013;2013:928601. doi: 10.1155/2013/928601
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