The relationship between monocyte-to-lymphocyte ratio and the risk of gastrointestinal system involvement in children with IgA vasculitis: A preliminary report.

BACKGROUND

Immunoglobulin A (IgA) vasculitis is the most common systemic vasculitis of childhood. It can affect the gastrointestinal system (GS) and the renal system.

OBJECTIVES

To evaluate the monocyte-to-lymphocyte ratio (MLR) and other hematological markers in predicting GS and renal system complications of IgA vasculitis in children.

MATERIAL AND METHODS

One hundred and fifteen children with IgA vasculitis and 95 healthy children were included in this study. Demographic characteristics, organ involvement, and laboratory findings, including neutrophil, lymphocyte, monocyte and platelet (Plt) counts, red blood cell volume distribution width (RDW), platelet distribution width (PDW), mean platelet volumes (MPV), monocyte/platelet counts, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR), were evaluated.

RESULTS

Among 115 children with IgA vasculitis, 34 (29.5%) cases had GS involvement, and renal involvement was observed in 12 children (10.4%). Neutrophil, monocyte and Plt count and MLR, NLR and PLR values were higher in the IgA vasculitis group than in control groups. Moreover, the neutrophil count and NLR and MLR levels were significantly higher in children with GS involvement than in those without GS involvement. Logistic regression analysis showed MLR was the sole risk factor for GS involvement among these parameters. Furthermore, a cut-off MLR value of 0.245 differentiated children with IgA vasculitis with GS involvement from those without GS involvement (area under the curve (AUC) 0.694, with a sensitivity of 52.9% and specificity of 77.8%).

CONCLUSIONS

An elevated MLR value could serve as a useful marker in predicting GS involvement in IgA vasculitis in children. Therefore, monitoring the blood MLR value may serve as an important novel indicator to pediatricians regarding the involvement of GS and disease severity of IgA vasculitis.