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. 2024 Jul-Sep;50(3):421-427.
doi: 10.12865/CHSJ.50.03.09. Epub 2024 Sep 30.

Assessment of Neutrophil-Lymphocyte Ratio and Systemic Immune-Inflammation Index in Systemic Scleroderma Patients with Focus on Cardiopulmonary Manifestations

Camelia Palici  1 , Stefan Cristian Dinescu  2 , Cristina Elena Bita  2 , Alesandra Florescu  2 , Anca Emanuela Musetescu  2 , Florentin Vreju  2 , Paulina Lucia Ciurea  2
Affiliations

Assessment of Neutrophil-Lymphocyte Ratio and Systemic Immune-Inflammation Index in Systemic Scleroderma Patients with Focus on Cardiopulmonary Manifestations

Camelia Palici et al. Curr Health Sci J. 2024 Jul-Sep.

Abstract

Objectives: To quantify levels of two inflammation-related indexes, namely neutrophil-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) in systemic scleroderma patients and determine the association with clinical manifestations and features of heart ultrasound.

Methods: The study group consisted of 34 patients with diagnosis of systemic scleroderma which were admitted to the hospital during 2015-2019. Patient data included the presence and type of clinical manifestations of systemic scleroderma, chest imaging to screen for lung disease, heart ultrasound reports and the laboratory investigations needed to quantify inflammatory indexes. We analysed the levels of inflammatory indexes and compared results based on the prevalence of systemic manifestations.

Results: Higher serum levels of NLR and SII are associated with the presence of joint, lung and pericardial involvement. Statistical significance was observed only for NLR levels with regard to the presence of articular involvement and ILD. Low ejection fraction was also associated with higher levels of both inflammatory indexes, without statistical significance.

Conclusion: Inflammatory indexes are cost-effective markers that reflect active disease manifestations of systemic scleroderma and can thus be a useful tool to include in the regular follow-up of patients in order to better inform organ-specific assessments.

Keywords: Systemic scleroderma; biomarkers; inflammation; neutrophils.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

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Table 1. Study population characteristics
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Table 2. Summary of ultrasound measurements
Figure 3
Figure 3
Serum levels of inflammatory indexes in relation to clinical manifestations; NLR-neutrophil-lymphocyte ratio, SII-systemic immune-inflammation index, GI-gastrointestinal, ILD-interstitial lung disease, PAH-pulmonary arterial hypertension
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Table 3. Inflammatory indexes values in relation to pathologic heart ultrasound findings
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Table 4. Ultrasound measurements with regard to the presence of low ejection fraction
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