Research Article
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The diagnostic weight of hemogram parameters in diagnosis, severity, and disease duration of childhood atopic dermatitis: a thorough evidence-focused study

Year 2023, Volume: 6 Issue: 6, 1313 - 1321, 29.10.2023
https://doi.org/10.32322/jhsm.1364897

Abstract

Aims: We aimed to assess the association of hemogram parameters with atopic dermatitis (AD), severity of AD, and disease duration.
Methods: We included the hemogram parameters of patients under follow-up in our pediatric allergy outpatient clinic and healthy group. The blood samples were drawn when they had no complaints or after at least 30 days of infection or a drug-free period. We built H1 and H0 (null) hypotheses, subjected data to Bayesian statistics, and assessed which hemogram parameters have potential and which shall not be used, with presenting evidence levels. We split the transactions into two groups (<49 and ≥49 months old) as there is a lymphocyte predominancy before four years of age and built another model with all individuals.
Results: We included 197 AD-diagnosed patients and 150 controls in the study. Eosinophil was the significant confounder for AD, and White Blood Cell Count, Absolute Neutrophil Count, Platelet Count, and Red Cell Distribution Width (RDW)/Platelet Ratio were independent of AD. Eosinophil/Lymphocyte Ratio (ELR) was correlated with SCORAD index (anecdotal evidence) under four years old, ELR and total IgE in older four years old, and ELR and Eosinophil/Neutrophil Ratio in all age groups. None of the hemogram parameters were correlated with disease duration in our under-4-year-old patient group. However, there was anecdotal evidence for RDW correlation with disease duration in the older four years group. Age, Neutrophil/ Lymphocyte Ratio, and Platelet/Lymphocyte Ratio had a strong association with disease duration.
Conclusion: We presented which hemogram parameter could be used and should not be used in children for AD diagnosis and AD follow-up. Multicenter studies are needed for the final conclusion.

References

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  • Pelc J, Czarnecka-Operacz M, Adamski Z. Structure and function of the epidermal barrier in patients with atopic dermatitis - treatment options. Part one. Postepy Dermatol Alergol. 2018;35(1):1-5.
  • Wang SS, Hon KL, Kong AP, Pong HN, Wong GW, Leung TF. Vitamin D deficiency is associated with diagnosis and severity of childhood atopic dermatitis. Pediatr Allergy Immunol. 2014;25(1):30-35.
  • Ertam İ, Su Ö, Alper S, et al. The Turkish guideline for the diagnosis and management of atopic dermatitis-2018. Turkderm Turkish Arch Dermatology Venereol. 2018;52.
  • Peng W, Novak N. Pathogenesis of atopic dermatitis. Clin Exp Allergy. 2015;45(3):566-574.
  • Batmaz SB. Simple markers for systemic inflammation in pediatric atopic dermatitis patients. Indian J Dermatol. 2018;63(4):305-310.
  • Kubo A, Nagao K, Amagai M. Epidermal barrier dysfunction and cutaneous sensitization in atopic diseases. J Clin Invest. 2012;122(2):440-447.
  • Di Bari F. Atopic dermatitis and alpha-chemokines. Clin Ter. 2015;166(3):e182-e187.
  • Esaki H, Takeuchi S, Furusyo N, et al. Levels of immunoglobulin E specific to the major food allergen and chemokine (C-C motif) ligand (CCL)17/thymus and activation regulated chemokine and CCL22/macrophage-derived chemokine in infantile atopic dermatitis on Ishigaki Island. J Dermatol. 2016;43(11):1278-1282.
  • Leonardi S, Cuppari C, Manti S, et al. Serum interleukin 17, interleukin 23, and interleukin 10 values in children with atopic eczema/dermatitis syndrome (AEDS): association with clinical severity and phenotype. Allergy Asthma Proc. 2015;36(1):74-81.
  • Kalelioglu T, Karamustafalioglu N, Emul M, et al. Detecting biomarkers associated with antipsychotic-induced extrapyramidal syndromes by using machine learning techniques. J Psychiatr Res. 2023;158:300-304.
  • Ünal Ç, Tunçer G, Çopur B, et al. Clinical and inflammation marker features of cancer patients with COVID-19: data of İstanbul, Turkey multicenter cancer patients (2020-2022). Curr Med Res Opin. 2023;39(7):987-996.
  • Bhat T, Teli S, Rijal J, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev Cardiovasc Ther. 2013;11(1):55-59.
  • Inokuchi-Sakata S, Ishiuji Y, Katsuta M, et al. Role of eosinophil relative count and neutrophil-to-lymphocyte ratio in the assessment of severity of atopic dermatitis. Acta Derm Venereol. 2021;101(7):adv00491.
  • Hon KL, Wang SS, Pong NH, Leung TF. Circulating immunoglobulins, leucocytes and complements in childhood-onset atopic eczema. Indian J Pediatr. 2013;80(2):128-131.
  • Altaş U, Ünlü DA, Güllüce H, et al. Evaluation of the relationship between laboratory parameters and allergy tests in children with atopic dermatitis: laboratory parameters and allergy tests in children with atopic dermatitis. Chron Precis Med Res. 2023;4(2):168-171.
  • Oranje AP, Glazenburg EJ, Wolkerstorfer A, de Waard-van der Spek FB. Practical issues on interpretation of scoring atopic dermatitis: the SCORAD index, objective SCORAD and the three-item severity score. Br J Dermatol. 2007;157(4):645-648.
  • Topal E, Celiksoy MH, Catal F, Karakoç HT, Karadağ A, Sancak R. The platelet parameters as inflammatory markers in preschool children with atopic eczema. Clin Lab. 2015;61(5-6):493-496.
  • Gayret ÖB, Erol M, Şener A, Nacaroğlu HT. Neutrophil-lymphocyte ratio and the platelet parameters as biomarkers of atopic dermatitis severity in children. Iranian Red Crescent Med J. 2019;21(7):e91594.
  • Sanli Gunes H, Ozkars MY, Ipek S. The evaluation of mean platelet volume in infants with atopic dermatitis. Ann Med Res. 2019;26(5):899-903
  • Oztas Kara R, Solak B. Assessment of venous blood leukocyte profiles and immunoglobulin e levels in atopic dermatitis patients. Dermatitis. 2022;33(6S):S69-S72.
  • Dogru M, Citli R. The neutrophil-lymphocyte ratio in children with atopic dermatitis: a case-control study. Clin Ter. 2017;168(4):e262-e265.
  • Jiang Y, Ma W. Assessment of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in atopic dermatitis patients. Med Sci Monit. 2017;23:1340-1346.
  • Akcal O, Taskırdı İ. Do platelet count and mean platelet volume have a predictive role as a marker in children with atopic dermatitis?. Indian J Dermatol. 2022;67(6):688-692.
  • Hu Y, Liu S, Liu P, Mu Z, Zhang J. Clinical relevance of eosinophils, basophils, serum total IgE level, allergen-specific IgE, and clinical features in atopic dermatitis. J Clin Lab Anal. 2020;34(6):e23214.
  • Zühre KA. Tam kan sayım çıktılarının yorumlanması. Dicle Med J. 2013;40(3):521-528.
  • Cansever M, Oruç Ç. What plays a role in the severity of atopic dermatitis in children?. Turk J Med Sci. 2021;51(5):2494-2501.
  • Kuo HC, Chu CH, Su YJ, Lee CH. Atopic dermatitis in Taiwanese children: The laboratory values that correlate best to the SCORAD index are total IgE and positive Cheddar cheese IgE. Medicine (Baltimore). 2020;99(30):e21255.
Year 2023, Volume: 6 Issue: 6, 1313 - 1321, 29.10.2023
https://doi.org/10.32322/jhsm.1364897

Abstract

References

  • Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66 Suppl 1:8-16.
  • Pelc J, Czarnecka-Operacz M, Adamski Z. Structure and function of the epidermal barrier in patients with atopic dermatitis - treatment options. Part one. Postepy Dermatol Alergol. 2018;35(1):1-5.
  • Wang SS, Hon KL, Kong AP, Pong HN, Wong GW, Leung TF. Vitamin D deficiency is associated with diagnosis and severity of childhood atopic dermatitis. Pediatr Allergy Immunol. 2014;25(1):30-35.
  • Ertam İ, Su Ö, Alper S, et al. The Turkish guideline for the diagnosis and management of atopic dermatitis-2018. Turkderm Turkish Arch Dermatology Venereol. 2018;52.
  • Peng W, Novak N. Pathogenesis of atopic dermatitis. Clin Exp Allergy. 2015;45(3):566-574.
  • Batmaz SB. Simple markers for systemic inflammation in pediatric atopic dermatitis patients. Indian J Dermatol. 2018;63(4):305-310.
  • Kubo A, Nagao K, Amagai M. Epidermal barrier dysfunction and cutaneous sensitization in atopic diseases. J Clin Invest. 2012;122(2):440-447.
  • Di Bari F. Atopic dermatitis and alpha-chemokines. Clin Ter. 2015;166(3):e182-e187.
  • Esaki H, Takeuchi S, Furusyo N, et al. Levels of immunoglobulin E specific to the major food allergen and chemokine (C-C motif) ligand (CCL)17/thymus and activation regulated chemokine and CCL22/macrophage-derived chemokine in infantile atopic dermatitis on Ishigaki Island. J Dermatol. 2016;43(11):1278-1282.
  • Leonardi S, Cuppari C, Manti S, et al. Serum interleukin 17, interleukin 23, and interleukin 10 values in children with atopic eczema/dermatitis syndrome (AEDS): association with clinical severity and phenotype. Allergy Asthma Proc. 2015;36(1):74-81.
  • Kalelioglu T, Karamustafalioglu N, Emul M, et al. Detecting biomarkers associated with antipsychotic-induced extrapyramidal syndromes by using machine learning techniques. J Psychiatr Res. 2023;158:300-304.
  • Ünal Ç, Tunçer G, Çopur B, et al. Clinical and inflammation marker features of cancer patients with COVID-19: data of İstanbul, Turkey multicenter cancer patients (2020-2022). Curr Med Res Opin. 2023;39(7):987-996.
  • Bhat T, Teli S, Rijal J, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev Cardiovasc Ther. 2013;11(1):55-59.
  • Inokuchi-Sakata S, Ishiuji Y, Katsuta M, et al. Role of eosinophil relative count and neutrophil-to-lymphocyte ratio in the assessment of severity of atopic dermatitis. Acta Derm Venereol. 2021;101(7):adv00491.
  • Hon KL, Wang SS, Pong NH, Leung TF. Circulating immunoglobulins, leucocytes and complements in childhood-onset atopic eczema. Indian J Pediatr. 2013;80(2):128-131.
  • Altaş U, Ünlü DA, Güllüce H, et al. Evaluation of the relationship between laboratory parameters and allergy tests in children with atopic dermatitis: laboratory parameters and allergy tests in children with atopic dermatitis. Chron Precis Med Res. 2023;4(2):168-171.
  • Oranje AP, Glazenburg EJ, Wolkerstorfer A, de Waard-van der Spek FB. Practical issues on interpretation of scoring atopic dermatitis: the SCORAD index, objective SCORAD and the three-item severity score. Br J Dermatol. 2007;157(4):645-648.
  • Topal E, Celiksoy MH, Catal F, Karakoç HT, Karadağ A, Sancak R. The platelet parameters as inflammatory markers in preschool children with atopic eczema. Clin Lab. 2015;61(5-6):493-496.
  • Gayret ÖB, Erol M, Şener A, Nacaroğlu HT. Neutrophil-lymphocyte ratio and the platelet parameters as biomarkers of atopic dermatitis severity in children. Iranian Red Crescent Med J. 2019;21(7):e91594.
  • Sanli Gunes H, Ozkars MY, Ipek S. The evaluation of mean platelet volume in infants with atopic dermatitis. Ann Med Res. 2019;26(5):899-903
  • Oztas Kara R, Solak B. Assessment of venous blood leukocyte profiles and immunoglobulin e levels in atopic dermatitis patients. Dermatitis. 2022;33(6S):S69-S72.
  • Dogru M, Citli R. The neutrophil-lymphocyte ratio in children with atopic dermatitis: a case-control study. Clin Ter. 2017;168(4):e262-e265.
  • Jiang Y, Ma W. Assessment of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in atopic dermatitis patients. Med Sci Monit. 2017;23:1340-1346.
  • Akcal O, Taskırdı İ. Do platelet count and mean platelet volume have a predictive role as a marker in children with atopic dermatitis?. Indian J Dermatol. 2022;67(6):688-692.
  • Hu Y, Liu S, Liu P, Mu Z, Zhang J. Clinical relevance of eosinophils, basophils, serum total IgE level, allergen-specific IgE, and clinical features in atopic dermatitis. J Clin Lab Anal. 2020;34(6):e23214.
  • Zühre KA. Tam kan sayım çıktılarının yorumlanması. Dicle Med J. 2013;40(3):521-528.
  • Cansever M, Oruç Ç. What plays a role in the severity of atopic dermatitis in children?. Turk J Med Sci. 2021;51(5):2494-2501.
  • Kuo HC, Chu CH, Su YJ, Lee CH. Atopic dermatitis in Taiwanese children: The laboratory values that correlate best to the SCORAD index are total IgE and positive Cheddar cheese IgE. Medicine (Baltimore). 2020;99(30):e21255.
There are 28 citations in total.

Details

Primary Language English
Subjects Pediatric Immunology and Allergic Diseases
Journal Section Original Article
Authors

Fatih Çiçek 0000-0001-7348-7081

İbrahim Kandemir 0000-0002-1720-9711

Mehmet Tolga Köle 0000-0002-6055-7746

Early Pub Date October 28, 2023
Publication Date October 29, 2023
Published in Issue Year 2023 Volume: 6 Issue: 6

Cite

AMA Çiçek F, Kandemir İ, Köle MT. The diagnostic weight of hemogram parameters in diagnosis, severity, and disease duration of childhood atopic dermatitis: a thorough evidence-focused study. J Health Sci Med / JHSM. October 2023;6(6):1313-1321. doi:10.32322/jhsm.1364897

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