Immature Granulocyte Count May Have a Role in Indicating The Severity of Diabetic Ketoacidosis

Öz

Immature granulocytes (IGs) have been widely used as biomarker in systemic inflammation. Diabetic ketoacidosis (DKA) is a condition characterized by systemic inflammation. We aimed to evaluate the relationship between IG count (IGC) and IG percentage (%IG) and severity of DKA in children. We evaluated the data of the patients with DKA. IGC was calculated using the white cell differential channel of the Sysmex XN 9000. IGC was expressed as the absolute number of IGs per microliter (IGCx10⁶/uL), and IG% was determined as percentage of total leukocyte count. The data of 68 patients with DKA were analyzed. IGC and IG% were significantly higher in patients with severe DKA compared with those with mild and moderate DKA (p<0.001 for each). In severe DKA, IGC and IG% had a predictive value (p<0.001, p=0.001, respectively). The area under curve values of IG% and IGC were 0.869±0.048 and 0.875±0.044, respectively. Sixteen patients had a concomitant infection at the admission. No significant differences were observed between patients with and without infection in terms of IGC and IG%. In patients with severe DKA, granulocytosis is accompanied by increased IGC and IG% in the peripheral bloodstream, regardless of the presence of an infection.

Anahtar Kelimeler

• : Children
• diabetic ketoacidosis
• immature granulocytes

İmmatür Granülosit Sayısının Diyabetik Ketoasidozun Şiddetini Belirlemedeki Rolü

Öz

İmmatür granülositler (IG’ler), sistemik inflamasyonda bir biyobelirteç olarak yaygın kullanılmaktadır. Diyabetik ketoasidoz (DKA), sistemik inflamasyon ile karakterize bir klinik durumdur. Bu çalışmada, çocuklarda immatür granülosit sayısı (IGC) ve immatür granülosit yüzdesi (%IG) ile DKA şiddeti arasındaki ilişkinin değerlendirilmesi amaçlandı. DKA tanısı alan hastaların verileri değerlendirildi. IGC, Sysmex XN 9000 cihazının lökosit diferansiyel kanalı kullanılarak hesaplandı. IGC, mikrolitre başına mutlak immatür granülosit sayısı (IGC ×10⁶/µL) olarak ifade edildi ve IG% toplam lökosit sayısının yüzdesi olarak belirlendi. DKA tanılı 68 hastanın verileri analiz edildi. IGC ve IG% değerleri, hafif ve orta DKA’ya kıyasla şiddetli DKA hastalarında anlamlı olarak daha yüksekti (her biri için p<0,001). Şiddetli DKA’da IGC ve IG%’nin prediktif değere sahip olduğu saptandı (sırasıyla p<0,001 ve p=0,001). IG% ve IGC için eğri altındaki alan değerleri sırasıyla 0,869±0,048 ve 0,875±0,044 olarak bulundu. On altı hastada başvuru sırasında eşlik eden enfeksiyon mevcuttu. Enfeksiyonu olan ve olmayan hastalar arasında IGC ve IG% açısından anlamlı fark saptanmadı. Şiddetli DKA hastalarında, enfeksiyon varlığından bağımsız olarak, granülositoza periferik kanda artmış IGC ve IG% eşlik etmektedir.

Anahtar Kelimeler

• çocuk
• diyabetik ketoasidoz
• immatür granülosit

Kaynakça

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