Department of Dermatology and Venereology, The Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
Department of Rheumatology, The Republic of Turkey, Selçuk University Faculty of Medicine, Selcuklu, Konya, Turkey.
Int J Clin Pract. 2021 Nov;75(11):e14866. doi: 10.1111/ijcp.14866. Epub 2021 Sep 21.
Recurrent oral ulcers (ROUs) are the most common disorder of the oral cavity in the community. The most challenging issue for the clinician to deal with in the diagnosis is to distinguish whether ROUs are associated with primarily Behçet's disease (BD). We aimed to investigate whether hemogram parameters contribute to reinforce BD suspicion in the differential diagnosis of recurrent aphthous stomatitis (RAS) and BD.
A total of 260 participants were recruited from the dermatology department in this single-centre, prospective, case-control study. Participants meeting eligibility criteria were divided into three groups as healthy control (n = 90), RAS (n = 97) and mucocutaneous BD (n = 73). The mean platelet volume (MPV), red cell distribution width (RDW), haemoglobin, neutrophils, monocyte, lymphocytes and platelet counts were evaluated with the complete blood count. Furthermore, the neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio and platelet/lymphocyte ratio were calculated. Erythrocyte sedimentation rate (ESR) and C-reactive protein were recorded. The contribution of hemogram parameters to the differentiation of BD from RAS was analysed.
The healthy control, RAS and BD groups were matched in terms of mean age (29.3 ± 5.8, 28.7 ± 5.6 and 29.9 ± 6.8 years; respectively) and sex distribution (women/men rate: 1.4, 1.6 and 1.7; respectively). ESR, neutrophil count and NLR were significantly higher in BD patients. (P = .032, P = .010, P = .019; respectively). MPV is significantly decreased in BD patients than in healthy control and RAS patients (P < .001). Decreased MPV (≤10 fL) and increased RDW (≥13.0%) were useful in predicting BD in patients evaluated with complaints of ROUs (OR = 9.98, 95% CI: [4.65-21.42], P < .001 and OR = 2.23, 95% CI: [1.14-3.36], P = .019, respectively).
Decreased MPV may be predictive for BD in selected patients with ROUs. We consider that more attention is required in terms of BD especially if MPV ≤10.0 fL.
复发性口腔溃疡（ROU）是社区口腔最常见的疾病。临床医生在诊断中最具挑战性的问题是区分 ROU 是否与主要的贝赫切特病（BD）有关。我们旨在研究血液学参数是否有助于在复发性口疮性口炎（RAS）和 BD 的鉴别诊断中增强对 BD 的怀疑。
这项单中心前瞻性病例对照研究共招募了 260 名来自皮肤科的参与者。符合入选标准的参与者分为三组：健康对照组（n=90）、RAS 组（n=97）和黏膜皮肤 BD 组（n=73）。用全血细胞计数评估平均血小板体积（MPV）、红细胞分布宽度（RDW）、血红蛋白、中性粒细胞、单核细胞、淋巴细胞和血小板计数。此外，计算中性粒细胞/淋巴细胞比值（NLR）、单核细胞/淋巴细胞比值和血小板/淋巴细胞比值。记录红细胞沉降率（ESR）和 C 反应蛋白。分析血液学参数对 BD 与 RAS 鉴别诊断的贡献。
健康对照组、RAS 组和 BD 组的平均年龄（29.3±5.8、28.7±5.6 和 29.9±6.8 岁；分别）和性别分布（女性/男性比例：1.4、1.6 和 1.7；分别）相匹配。BD 患者的 ESR、中性粒细胞计数和 NLR 显著升高（P=.032、P=.010、P=.019；分别）。与健康对照组和 RAS 组相比，BD 患者的 MPV 显著降低（P<0.001）。在评估有 ROU 症状的患者中，MPV 降低（≤10 fL）和 RDW 升高（≥13.0%）可用于预测 BD（OR=9.98，95%CI：[4.65-21.42]，P<0.001 和 OR=2.23，95%CI：[1.14-3.36]，P=0.019，分别）。
在有 ROU 症状的特定患者中，MPV 降低可能预示着 BD。如果 MPV ≤10.0 fL，我们认为需要更加关注 BD。
