Pb2490: neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in patients with systemic lupus erythematosus: a monocentric study

Topic: 23. Hematopoiesis, stem cells and microenvironment Background: The systemic lupus erythematosus (SLE) is an auto-immune pathology whose clinical manifestations are highly polymorphic. Inflammatory markers like neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been used in the assessment of inflammatory diseases. Aims: The aim of this study was to evaluate the role of NLR and PLR in SLE patients, and their relation with disease features. Methods: This is a retrospective study conducted in Mohamed Tahar Maamouri hospital in Tunisia. It included 34 patients with established SLE according to the EULAR/ACR 2019 classification. The NLR and PLR were calculated in each observation at the initial consultation. The correlation between these biomarkers and the SLE manifestations were analyzed. Results: Among the 34 patients included there was only one male. The median age was 37 years with extremes ranging from 16 to 75 years. Neutropenia, Lymphopenia and thrombopenia were found respectively in 3%, 44% and 41% of cases. The median NLR and the median PLR were respectively 2.88 and 148. NLR>2 and PLR>140 accounted for 82% and 56% respectively. In univariate analysis, elevated NLR and elevated PLR were significantly associated with C-reactive protein (CRP). Patients with Lupus Nephritis had higher level of PLR, proteinuria>2g/24 hours was found to be correlated with PLR>140. Severe disease flares and hospitalization in intensive care (HIC) were significantly associated with elevated PRL. The two biomarkers found did not relate significantly towards antinuclear antibodies (ANA) level, neurologic involvement or severe infectious complications (Table 1). Table 1: Univariate analysis - NLR>2 PLR>140 N % P N % P CRP>20mg/l 13 46% 0.016 14 74% 0.007 Proteinuria>2g/24h 10 36% 0.37 3 16% 0.046 ANA>1/640 11 39% 0.22 10 53% 0.26 Severe flares 15 54% 0.28 2 11% 0.007 HIC 13 46% 0.43 5 26% 0.016 Neurolupus 11 39% 0.3 7 37% 0.8 Infections 11 39% 0.23 9 47% 0.44 Summary/Conclusion: The elevation of the PRL and NRL deserve consideration in evaluating SLE activity and severity. Given the small sample size of our population, more studies are needed to complete this aspect. Keywords: Autoimmune disease, Autoantibody, Systemic lupus erythematosus