The role of inflammatory markers derived from complete blood count results in the diagnosis of intrahepatic cholestasis of pregnancy

Year 2022, , 640 - 645, 15.03.2022

Kader Irak , Mehmet Bayram , Tüba Fikriye Becerik

https://doi.org/10.32322/jhsm.1039050

Abstract

Objective: This study aimed to investigate complete blood count (CBC) markers, particularly those indicating systemic inflammation, in healthy subjects and those with mild and severe intrahepatic cholestasis of pregnancy (ICP).
Material and Method: Seventy-nine subjects with ICP and 100 healthy age-matched women who were matched based on their scheduled singleton deliveries (on the same day) were included. ICP was defined as the increase in serum bile acid levels ≥10 μmol/L coupled with pruritus which could not be explained by other conditions. Patients with ICP were further categorized to mild and severe ICP according to bile acid levels, as follows: Mild ICP (<40 μmol/L, n=55) and severe ICP (≥40 μmol/L, n=24). Venous blood samples were drawn upon admission to analyze bile acid concentration, liver enzymes and CBC.
Results: Mean platelet volume (MPV) was similar in subjects with mild and severe ICP whose values were higher than that of controls (p<0.001). The red cell distribution width (RDW) of subjects with severe ICP was lower compared to controls, although no significant difference existed between the mild and severe ICP groups. Platelet to lymphocyte ratio (PLR) was higher in subjects with mild and severe ICP compared to controls, but it was similar in mild and severe ICP. There were no significant differences in neutrophil to lymphocyte ratio (NLR) between the groups. Correlation analysis revealed that bile acid, bilirubin, AST and ALT levels were correlated positively with MPV and PLR, and negatively with RDW value. MPV was also positively correlated with the length of stay in ICU (intensive care unit). ROC (Receiver Operating Characteristic) curve analysis showed that MPV and PLR could discriminate subjects with ICP from controls with a high sensitivity but relatively low specificity. However, neither NLR nor PLR were sensitive for discriminating severe ICP from mild ICP.
Conclusions: Some CBC derived parameters associated with inflammatory state, such as MPV and PLR, appear to have value for ICP diagnosis. However, MPV, NLR, PLR, RDW, and leukocyte count cannot be used for the discrimination of mild and severe ICP.

Keywords

markers, pregnancy, cholestasis

Supporting Institution

Başakşehir Çam and Sakura City Hospital, Department of Gastroenterology

Thanks

Thank you for accepting my article in your journal.

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