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Evaluation of hematologic parameters in children with Down syndrome

Year 2022, Volume: 32 Issue: 5, 605 - 609, 29.10.2022
https://doi.org/10.54005/geneltip.1189081

Abstract

Objective: Congenital hematological disorders are frequently observed in Down syndrome (DS). In this study, we aimed to investigate peripheral blood-derived inflammation biomarkers such as neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and eosinophil/monocyte ratio in patients with Down syndrome.
Material and Methods: Ninety-eight patients with karyotypically ascertained DS and 103 healthy controls were included. All subjects were divided into three age groups: 0-2 years (34 patients, 34 controls), 2-6 years (32 patients, 33 controls), and >6 years (32 patients, 36 controls). Demographic, clinical, and laboratory data between June 2010 and December 2021 were written from the file records from the pediatric allergy and immunology department.
Results: Lymphocyte, eosinophil, and EMR were found to be significantly lower in children with DS compared to controls in group 2 (2-6 years) and group 3 (>6 years). PLR was found to be higher in children with DS in group 2 and group 3. There was no statistically significant difference between DS and controls in group 1 (<2 years) in terms of all parameters.
In group 2 (2-6 years) and group 3 (>6 years), there was a statistically significant difference between DS and controls in terms of lymphocyte, eosinophil, PLR, and EMR variables (P>0.05).
Conclusion: We found significant differences among lymphocyte, eosinophil, PLR, and EMR in patients with DS. As a result, these parameters should be evaluated carefully for clinical outcomes.

References

  • Referans1. Cocchi G, Mastrocola M, Capelli M, Bastelli A, Vitali F, Corvaglia L. Immunological patterns in young children with Down syndrome: is there a temporal trend? Acta Paediatr 2007; 96: 1479-1482.
  • Referans2. Lockitch G, Singh VK, Puterman ML, Godolphin WJ, Sheps S, Tringle A, et al. Age-related changes in humoral and cell-mediated immunity in Down syndrome children living at home. Pediatr Res 1987; 22: 536–40.
  • Referans3. Kuşkonmaz B, Çetin M. Down Sendromunda AML. Katkı Pediatri Dergisi 2004; 26:397.
  • Referans4. Huggard D, Kelly L, Ryan E, McGrane F, Lagan N, Roche E, et al. Increased systemic inflammation in children with Down syndrome. Cytokine. 2020; 127: 154938.
  • Referans5. Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol. 2013; 88(1): 218-30.
  • Referans6. Mertoglu C, Gunay M. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as useful predictive markers of prediabetes and diabetes mellitus. Diabetes Metab Syndr. 2017; Suppl 1: S127-S131.
  • Referans7. Balta S, Celik T, Mikhailidis DP, Ozturk C, Demirkol S, Aparci M, et al. The relation between atherosclerosis and the neutrophil-lymphocyte ratio. Clin Appl Thromb Hemost. 2016; 22(5): 405-11.
  • Referans8. Manuel V, Miana LO, Solla DJF, Fernandes N, Carrillo G, Jatene MC. Preoperative level of neutrophil‐lymphocyte ratio: Comparison between cyanotic and acyanotic congenital heart disease. J Card Surg. 2021; 36(4): 1376-1380.
  • Referans9. Kim HS, Jung J, Dong SH, Kim SH, Jung SY, Yeo SG. Association between high neutrophil to lymphocyte ratio and delayed recovery from Bell’s palsy. Clin Exp Otorhinolaryngol. 2019; 12(3): 261-266.
  • Referans10. Angkananard T, Anothaisintawee T, McEvoy M, Attia J, Thakkinstian A. Neutrophil lymphocyte ratio and cardiovascular disease risk: A systematic review and meta-analysis. Biomed Res Int. 2018; 2703518.
  • Referans11. Mochimaru T, Ueda S, Suzuki Y, Asano K, Fukunaga K. Neutrophil to lymphocyte ratio is a novel independent predictor of severe exacerbation in asthma patients. Ann Allergy Asthma Immunol. 2019; 122(3): 337-339.e1.
  • Referans12. Renaud S, Seitlinger J, St-Pierre D, Garfinkle R, Al Lawati Y, Guerrera F, et al. Prognostic value of neutrophil to lymphocyte ratio in lung metastasectomy for colorectal cancer. Eur J Cardiothorac Surg. 2019; 55(5): 948-955.
  • Referans13. Hasselbalch IC, Søndergaard HB, Koch-Henriksen N, Olsson A, Ullum H, Sellebjerg F, et al. The neutrophil-to-lymphocyte ratio is associated with multiple sclerosis. Mult Scler J Exp Transl Clin. 2018; 4(4): 2055217318813183.
  • Referans14. Cho Y, Kim JW, Yoon HI, Lee CG, Keum KC, Lee IJ. The prognostic significance of neutrophil-to-lymphocyte ratio in head and neck cancer patients treated with radiotherapy. J Clin Med. 2018; 7(12): 512.
  • Referans15. Kara A, Guven M, Yilmaz MS, Demir D, Elden H. Are neutrophil, platelet, and eosinophil-to-lymphocyte ratio and red blood cell distribution width can be used for nasal polyposis? Eur Arch Otorhinolaryngol. 2018; 275(2): 409-413.
  • Referans16. Elbistanli MS, Koçak HE, Acipayam H, Yiğider AP, Keskin M, Kayhan FT. The predictive value of neutrophil-lymphocyte and platelet-lymphocyte ratio for the effusion viscosity in otitis media with chronic effusion. J Craniofac Surg. 2017; 28(3) :e244-e247.
  • Referans17. Bloemers BLP, van Bleek GM, Kimpen JLL, Bont L. Distinct abnormalities in the innate immune system of children with Down syndrome. J Pediatr 2010; 156: 804-809.
  • Referans18. Kusters MAA, Verstegen RHJ, Gemen EFA, de Vries E. Intrinsic defect of the immune system in children with Down syndrome: a review. Clin Exp Immunol. 2009; 156: 189–193.
  • Referans19. Mitwalli M, Wahba Y, Shaltout A, Gouida M. Lymphocyte subgroups and recurrent infections in children with Down syndrome – a prospective case control study. Cent Eur J Immunol 2018; 43: 248-254.
  • Referans20. Yazar A, Yorulmaz A, Ture E, Akin F, Sert A. A relationship between subclinical hypothyroidism and hematologic parameters in patients with Down Syndrome. Fam Pract Palliat Care 2018; 3(2): 92-97.
  • Referans21. İkincioğullari A, Kendirli T, Doğu F, Eğin Y, Reisli İ, Cin S, et al. Peripheral blood lymphocyte subsets in healthy Turkish children. Turk J Pediatr 2004; 46(2): 125-130.
  • Referans22. Seckin AN, Ozdemir H, Ceylan A, Artac H. Age-related alternations of the CD19 complex and memory B cells in children with Down syndrome. Clin Exp Med 2018; 18: 125-131.
  • Referans23. Joshi AY, Abraham RS, Snyder MR, Boyce TG. Immune evaluation and vaccine responses in Down syndrome: Evidence of immunodeficiency? Vaccine 2011; 29: 5040-5046.
  • Referans24. Ram G, Chinen J. Infections and immunodeficiency in Down syndrome. Clin Exp Immunol 2011; 164(1): 9-16.
  • Referans25. Verstegen RH, Kusters MA, Gemen EF, deVries E. Down syndrome B-lymphocyte populations, intrinsic defect or decreased T lymphocyte help. Pediatr Res 2010; 67: 563–6.

Down sendromlu çocuklarda hematolojik parametrelerin değerlendirilmesi

Year 2022, Volume: 32 Issue: 5, 605 - 609, 29.10.2022
https://doi.org/10.54005/geneltip.1189081

Abstract

Amaç: Konjenital hematolojik bozukluklar Down sendromunda (DS) sıklıkla gözlenmektedir. Bu çalışmada Down sendromlu hastalarda nötrofil/lenfosit oranı, trombosit/lenfosit oranı ve eozinofil/monosit oranı gibi periferik kan kaynaklı inflamasyon biyobelirteçlerini araştırmayı amaçladık.
Gereç ve yöntem: Çalışmaya karyotipik olarak tanısı konulan DS’li 98 hasta ve 103 sağlıklı kontrol dahil edildi. Hasta ve kontroller üç yaş grubuna ayrıldı: 0-2 yaş (34 hasta, 34 kontrol), 2-6 yaş (32 hasta, 33 kontrol) ve 6-18 yaş (32 hasta, 36 kontrol). Haziran 2010 ile Aralık 2021tarihleri arasındaki demografik, klinik ve laboratuvar verileri, Çocuk Alerji ve İmmünoloji bölümündeki dosya kayıtlarından yazıldı.
Bulgular: Lenfosit, eozinofil ve EMR, DS'li çocuklarda grup 2 (2-6 yaş) ve grup 3'te (>6 yaş) kontrollere göre anlamlı derecede düşük bulundu. Grup 2 ve grup 3'te DS'li çocuklarda PLO daha yüksek bulundu. Grup 1'de (<2 yaş) DS ve kontroller arasında tüm parametreler açısından istatistiksel olarak anlamlı fark yoktu.
Sonuç: DS'li hastalarda lenfosit, eozinofil, PLR ve EMR arasında anlamlı farklılıklar bulduk. Sonuç olarak, bu parametreler klinik sonuçlar için dikkatli bir şekilde değerlendirilmelidir.

References

  • Referans1. Cocchi G, Mastrocola M, Capelli M, Bastelli A, Vitali F, Corvaglia L. Immunological patterns in young children with Down syndrome: is there a temporal trend? Acta Paediatr 2007; 96: 1479-1482.
  • Referans2. Lockitch G, Singh VK, Puterman ML, Godolphin WJ, Sheps S, Tringle A, et al. Age-related changes in humoral and cell-mediated immunity in Down syndrome children living at home. Pediatr Res 1987; 22: 536–40.
  • Referans3. Kuşkonmaz B, Çetin M. Down Sendromunda AML. Katkı Pediatri Dergisi 2004; 26:397.
  • Referans4. Huggard D, Kelly L, Ryan E, McGrane F, Lagan N, Roche E, et al. Increased systemic inflammation in children with Down syndrome. Cytokine. 2020; 127: 154938.
  • Referans5. Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol. 2013; 88(1): 218-30.
  • Referans6. Mertoglu C, Gunay M. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as useful predictive markers of prediabetes and diabetes mellitus. Diabetes Metab Syndr. 2017; Suppl 1: S127-S131.
  • Referans7. Balta S, Celik T, Mikhailidis DP, Ozturk C, Demirkol S, Aparci M, et al. The relation between atherosclerosis and the neutrophil-lymphocyte ratio. Clin Appl Thromb Hemost. 2016; 22(5): 405-11.
  • Referans8. Manuel V, Miana LO, Solla DJF, Fernandes N, Carrillo G, Jatene MC. Preoperative level of neutrophil‐lymphocyte ratio: Comparison between cyanotic and acyanotic congenital heart disease. J Card Surg. 2021; 36(4): 1376-1380.
  • Referans9. Kim HS, Jung J, Dong SH, Kim SH, Jung SY, Yeo SG. Association between high neutrophil to lymphocyte ratio and delayed recovery from Bell’s palsy. Clin Exp Otorhinolaryngol. 2019; 12(3): 261-266.
  • Referans10. Angkananard T, Anothaisintawee T, McEvoy M, Attia J, Thakkinstian A. Neutrophil lymphocyte ratio and cardiovascular disease risk: A systematic review and meta-analysis. Biomed Res Int. 2018; 2703518.
  • Referans11. Mochimaru T, Ueda S, Suzuki Y, Asano K, Fukunaga K. Neutrophil to lymphocyte ratio is a novel independent predictor of severe exacerbation in asthma patients. Ann Allergy Asthma Immunol. 2019; 122(3): 337-339.e1.
  • Referans12. Renaud S, Seitlinger J, St-Pierre D, Garfinkle R, Al Lawati Y, Guerrera F, et al. Prognostic value of neutrophil to lymphocyte ratio in lung metastasectomy for colorectal cancer. Eur J Cardiothorac Surg. 2019; 55(5): 948-955.
  • Referans13. Hasselbalch IC, Søndergaard HB, Koch-Henriksen N, Olsson A, Ullum H, Sellebjerg F, et al. The neutrophil-to-lymphocyte ratio is associated with multiple sclerosis. Mult Scler J Exp Transl Clin. 2018; 4(4): 2055217318813183.
  • Referans14. Cho Y, Kim JW, Yoon HI, Lee CG, Keum KC, Lee IJ. The prognostic significance of neutrophil-to-lymphocyte ratio in head and neck cancer patients treated with radiotherapy. J Clin Med. 2018; 7(12): 512.
  • Referans15. Kara A, Guven M, Yilmaz MS, Demir D, Elden H. Are neutrophil, platelet, and eosinophil-to-lymphocyte ratio and red blood cell distribution width can be used for nasal polyposis? Eur Arch Otorhinolaryngol. 2018; 275(2): 409-413.
  • Referans16. Elbistanli MS, Koçak HE, Acipayam H, Yiğider AP, Keskin M, Kayhan FT. The predictive value of neutrophil-lymphocyte and platelet-lymphocyte ratio for the effusion viscosity in otitis media with chronic effusion. J Craniofac Surg. 2017; 28(3) :e244-e247.
  • Referans17. Bloemers BLP, van Bleek GM, Kimpen JLL, Bont L. Distinct abnormalities in the innate immune system of children with Down syndrome. J Pediatr 2010; 156: 804-809.
  • Referans18. Kusters MAA, Verstegen RHJ, Gemen EFA, de Vries E. Intrinsic defect of the immune system in children with Down syndrome: a review. Clin Exp Immunol. 2009; 156: 189–193.
  • Referans19. Mitwalli M, Wahba Y, Shaltout A, Gouida M. Lymphocyte subgroups and recurrent infections in children with Down syndrome – a prospective case control study. Cent Eur J Immunol 2018; 43: 248-254.
  • Referans20. Yazar A, Yorulmaz A, Ture E, Akin F, Sert A. A relationship between subclinical hypothyroidism and hematologic parameters in patients with Down Syndrome. Fam Pract Palliat Care 2018; 3(2): 92-97.
  • Referans21. İkincioğullari A, Kendirli T, Doğu F, Eğin Y, Reisli İ, Cin S, et al. Peripheral blood lymphocyte subsets in healthy Turkish children. Turk J Pediatr 2004; 46(2): 125-130.
  • Referans22. Seckin AN, Ozdemir H, Ceylan A, Artac H. Age-related alternations of the CD19 complex and memory B cells in children with Down syndrome. Clin Exp Med 2018; 18: 125-131.
  • Referans23. Joshi AY, Abraham RS, Snyder MR, Boyce TG. Immune evaluation and vaccine responses in Down syndrome: Evidence of immunodeficiency? Vaccine 2011; 29: 5040-5046.
  • Referans24. Ram G, Chinen J. Infections and immunodeficiency in Down syndrome. Clin Exp Immunol 2011; 164(1): 9-16.
  • Referans25. Verstegen RH, Kusters MA, Gemen EF, deVries E. Down syndrome B-lymphocyte populations, intrinsic defect or decreased T lymphocyte help. Pediatr Res 2010; 67: 563–6.
There are 25 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Article
Authors

Hülya Özdemir 0000-0002-0287-5260

Hasibe Artaç 0000-0002-9807-2605

Early Pub Date October 24, 2022
Publication Date October 29, 2022
Submission Date October 14, 2022
Published in Issue Year 2022 Volume: 32 Issue: 5

Cite

Vancouver Özdemir H, Artaç H. Evaluation of hematologic parameters in children with Down syndrome. Genel Tıp Derg. 2022;32(5):605-9.