Pediatrik periferik fasiyal paralizide klinik özellikler ve hematolojik inflamatuvar belirteçler: Retrospektif bir çalışma

Abstract

Amaç: Çocukluk çağı idiyopatik Bell paralizisinde başvuru anındaki tam kan sayımı kaynaklı inflamatuvar indekslerin sistemik inflamasyonu gösterip göstermediğini belirlemek amaçlandı. Gereç ve Yöntemler: Mart 2022–Haziran 2025 tarihleri arasında üçüncü basamak pediatrik nöroloji kliniğinde izlenen Bell paralizili 23 çocuk ile yaş ve cinsiyete göre eşleştirilmiş 69 sağlıklı kontrol geriye dönük olarak analiz edildi. Periferik kan örnekleri başvuruda ve kortikosteroid tedavisi öncesinde alındı. İncelenen indeksler: nötrofil/lenfosit oranı, trombosit/lenfosit oranı, sistemik immün-inflamasyon indeksi, sistemik inflamasyon yanıt indeksi, lenfosit/monosit oranı, eozinofil/lenfosit oranı, türetilmiş nötrofil/lenfosit oranı, eritrosit dağılım genişliği/trombosit oranı, ortalama trombosit hacmi, trombosit dağılım genişliği ve plateletkrit; karşılaştırmalı analiz yapıldı. İstatistiksel anlamlılık için p<0,05 kabul edildi. Bulgular: Hastaların 12’si (%52,2) kız, 11’i (%47,8) erkek; ortalama yaş 12,1±3,8 yıl (2–17). House–Brackmann sınıflamasına göre 17’si (%73,9) derece 2, 5’i (%21,7) derece 3, 1’i (%4,4) derece 4’tü. Nötrofil/lenfosit oranı, trombosit/lenfosit oranı, sistemik immün-inflamasyon indeksi, sistemik inflamasyon yanıt indeksi, lenfosit/monosit oranı, eozinofil/lenfosit oranı, türetilmiş nötrofil/lenfosit oranı, plateletkrit ve eritrosit dağılım genişliği/trombosit oranı açısından hasta ve kontrol grupları arasında anlamlı fark saptanmadı (tüm değişkenler için p > 0,05). Ortalama trombosit hacmi ve trombosit dağılım genişliği hasta grubunda daha düşüktü (Cliff’s δ = −0.34; %95 güven aralığı −0.58 ile −0.10; her iki değişken için p = 0,015). House–Brackmann derecesi ile plateletkrit arasında pozitif korelasyon saptandı (Spearman’s ρ = 0,58; 95% güven aralığı 0.24–0.79; p = 0,004). Sonuç: Ortalama trombosit hacmi ve trombosit dağılım genişliğindeki ılımlı düşüşler ile plateletkrit ve House–Brackmann derecesi arasındaki pozitif korelasyon, trombosit ekseninin olası etkilenimini düşündürmektedir. Ancak sınırlı örneklem nedeniyle sonuçlar, daha geniş ve metodolojik olarak standart kohortlarda teyit edilmelidir.

Keywords

• Hematolojik belirteçler
• inflamatuvar belirteçler
• pediatrik bell paralizisi

Clinical characteristics and hematological inflammatory markers in pediatric peripheral facial paralysis: A retrospective study

Abstract

Aim: This study aimed to determine whether inflammatory indices derived from complete blood count indicate systemic inflammation at presentation in pediatric idiopathic Bell’s palsy. Material and Methods: We retrospectively analyzed 23 children with Bell’s palsy and 69 age- and sex-matched healthy controls (March 2022–June 2025). Peripheral blood was drawn at presentation and before corticosteroid therapy. Indices included neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, lymphocyte/monocyte ratio, eosinophil/lymphocyte ratio, derived neutrophil/lymphocyte ratio, and red cell distribution width/platelet ratio, mean platelet volume, platelet distribution width, plateletcrit were analyzed comparatively. Results: Of the patients, 12 (52.2%) were female and 11 (47.8%) were male, with a mean age of 12.1 ± 3.8 years (range: 2–17). Based on the House–Brackmann classification, 17 (73.9%) patients were grade 2, 5 (21.7%) were grade 3, and 1 (4.4%) was grade 4. No statistically significant differences were found between the patient and control groups in terms of neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, lymphocyte/monocyte ratio, eosinophil/lymphocyte ratio, derived neutrophil/lymphocyte ratio, plateletcrit, and red cell distribution width/platelet ratio values (for all variables p > 0.05). Mean platelet volume and platelet distribution width were lower in patients (Cliff’s δ = −0.34 for both; 95% CI −0.58 to −0.10, p = 0.015 for each). House–Brackmann grade correlated with plateletcrit (Spearman’s ρ = 0.58; 95% CI 0.24 to 0.79; p = 0.004). Conclusion: Modest reductions in mean platelet volume and platelet distribution width, along with a positive correlation between plateletcrit and clinical severity, may indicate platelet-axis involvement. Given the limited sample size and statistical power, these findings require confirmation in larger, standardized cohorts.

Keywords

• Hematologic markers
• inflammatory markers
• pediatric bell’s palsy

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