Bell Paralizisi Tanılı Çocukların Başvuru Anında Hemogram Parametreleri ve İzlemdeki Bulguları

Abstract

Amaç: İdiopatik fasiyal paralizinin (Bell paralizisi) kesin sebebi belli değildir. Çalışmamızda fasiyal paralizi tanılı çocuk hastalarda, bazı hemogram parametreleri ile klinik prognoz arasında ilişki olup olmadığının araştırılması amaçlandı. Gereç ve Yöntemler: Hastanemize başvuran 18 yaş altındaki Bell paralizi tanılı hasta dosyaları retrospektif değerlendirildi. Lökosit, nötrofil, lenfosit, trombosit sayısı, kırmızı hücre dağılım genişliği, nötrofil lenfosit oranı, trombosit lenfosit oranı ve monosit lenfosit oranı, Bell paralizili hastalar ile kontrol grubu arasında karşılaştırıldı. Son sağlık durumlarıyla ilgili bilgiler kaydedildi. Bulgular: Toplam on yedi Bell paralizi tanılı çocuk ve 17 kontrol grubu çalışmaya dahil edildi. Her bir grupta 7 erkek (%41.20), 10 kız (%58.70) vardı, yaş ortalaması 11.80±4.40 (minimum 3.00-maximum 17.90) yıldı. Bell paralizili hastalarda nötrofil lenfosit oranı medyanı 1.25 (0.41-7.63) iken kontrol grubunda nötrofil lenfosit oranı 1.40 (0.42-2.52), medyan ortalama trombosit hacim düzeyi Bell paralizili hastalarda 9.30 fL (8.20-12.30), kontrol grubunda 9.95 fL (9.30-11.70); medyan kırmızı hücre dağılım genişliği, Bell paralizili hastalarda 12.75 % (11.50-26.30) ve kontrol grubunda 12.70 % (12.10-26.30)’du. İstatistiksel olarak hiçbiri anlamlı değildi. Ortalama trombosit hacim düşüklüğü olan altı Bell paralizili hasta vardı, kontrol grubunda ortalama trombosit hacmi düşüklüğü olan kişi yoktu (p=0.007). Bell paralizili hastaların iyileşme süresi ile nötrofil lenfosit oranı, trombosit lenfosit oranı, monosit lenfosit oranı arasında pozitif korelasyon vardı. Sonuç: Bell paralizisi kızlarda daha iyi prognoz gösterebilir. Nötrofil lenfosit oranı, trombosit lenfosit oranı ve monosit lenfosit oranı yüksekliği Bell paralizisinde iyileşmede gecikme, inflamasyon ve mikrovasküler iskeminin bir göstergesi olabilir.

Keywords

• Bell Paralizisi
• Çocuk
• Tam Kan Sayımı
• İnflamasyon

Hemogram Parameters of Children with Bell’s Palsy at the Time of Admission and Their Findings in the Follow-up

Abstract

Objective: The exact cause of idiopathic facial paralysis (Bell’s palsy) is not clear. The objective of our study was to investigate the relationship between certain hemogram parameters and the clinical prognosis in pediatric patients with facial paralysis. Material and Methods: The files of patients with Bell’s palsy under the age of 18 who applied to our hospital were evaluated retrospectively. Leukocyte, neutrophil, lymphocyte, platelet count, red cell distribution width, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and monocyte to lymphocyte ratio were compared between patients with Bell’s palsy and the control group. Information about their last health status recorded. Results: A total of seventeen children with Bell’s palsy and 17 control groups were included in the study. There were 7 boys (41.20%) and 10 girls (58.70%) in each group, the mean age was 11.80±4.40 (minimum 3.0-maximum 17.9) years. While the median neutrophil-lymphocyte ratio was 1.25 (0.41-7.63) in patients with Bell’s palsy and 1.40 (0.42-2.52) in the control group, the median mean platelet volume level was 9.30 fL (8.20-12.30) in patients with Bell’s palsy and 9.95 fL (9.30-11.70) in the control group, and the median red cell distribution width level was 12.75 % (11.50-26.30) in patients with Bell’s palsy and 12.70% (12.10-26.30) in the control group. None of them were statistically significant. There were six patients with Bell’s palsy with low mean platelet volume levels and no patients with low mean platelet volume levels in the control group (p=0.007). There was a positive correlation between the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and monocyte-lymphocyte ratio and the recovery time of patients with Bell’s palsy. Conclusion: Bell’s palsy may show a better prognosis in girls. High neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and monocyte-lymphocyte ratio may be indicators of delayed recovery, inflammation, and microvascular ischemia in Bell’s palsy.

Keywords

• Bell’s palsy
• Child
• Blood Cell Count
• Inflammation

References

1. Özkale Y, Erol İ. Facial nerve disorders. Turkish J Pediatr Dis 2017; 60: 108-18.
2. Öztoprak Ü. Assessment of Hematological Parameters and The Relationship with Paralysis Degree in Children with Idiopathic Peripheral Facial Paralysis. Van Med J 2021;283: 393-9.
3. Yamamoto K, Kurioka T, Ohki M, Ohashi K, Harada Y, Asako Y, et al. Immune-Nutritional Status as a Novel Prognostic Predictor of Bell’s Palsy. Audiol Neurootol 2022;27:418-26.
4. Zhang W, Xu L, Luo T, Wu F, Zhao B, Li X. The etiology of Bell’s palsy: a review. J Neurol 2020;267:1896-905.
5. Heckmann JG, Urban PP, Pitz S, Guntinas-Lichius O, Gágyor I. The Diagnosis and Treatment of Idiopathic Facial Paresis (Bell’s Palsy). Dtsch Arztebl Int 2019;116:692-702.
6. Karalok ZS, Taskin BD, Ozturk Z, Gurkas E, Koc TB, Guven A. Childhood peripheral facial palsy. Childs Nerv Syst 2018;34:911-7.
7. Babl FE, Mackay MT, Borland ML, Herd DW, Kochar A, Hort J, et al. Bell’s Palsy in Children (BellPIC): protocol for a multicentre, placebo-controlled randomized trial. BMC Pediatr 2017;17:53.
8. Karadeniz FÖ, Karadeniz Y, Altuntaş E. Systemic immune-inflammation index, and neutrophilto-lymphocyte and platelet-to-lymphocyte ratios can predict clinical outcomes in patients with acute coronary syndrome. Cardiovasc J Afr Published online 2023;34:1-7.

9. Akbas EM, Demirtas L, Ozcicek A, Timuroglu A, Bakirci EM, Hamur H, et al. Association of epicardial adipose tissue, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with diabetic nephropathy. Int J Clin Exp Med 2014;7:1794-801.
10. Bucak A, Ulu S, Oruc S, Yucedag F, Tekin MS, Karakaya F, et al. Neutrophil-to-lymphocyte ratio as a novel-potential marker for predicting prognosis of Bell palsy. Laryngoscope 2014;124:1678-81.
11. Wasano K, Kawasaki T, Yamamoto S, Tomisato S, Shinden S, Ishikawa T, et al. Pretreatment Hematologic Findings as Novel Predictive Markers for Facial Palsy Prognosis. Otolaryngol Head Neck Surg 2016;155:581-7.
12. Danese E, Lippi G, Montagnana M. Red blood cell distribution width and cardiovascular diseases. J Thorac Dis 2015;7:402-11.
13. Dalrymple SN, Row JH, Gazewood J. Bell Palsy: Rapid Evidence Review. Am Fam Physician 2023;107:415-20.
14. Sahin C, Varım C. Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, Mean Platelet Volume and Red Cell Distribution Width Measures in Bells Palsy. Open Access Maced J Med Sci 2017;5:14-8.
15. Eryilmaz A, Basal Y, Tosun A, Kurt Omurlu I, Basak S. The neutrophil to lymphocyte ratios of our pediatric patients with Bell’s palsy. Int J Pediatr Otorhinolaryngol 2015;79:2374-7.
16. Özler GS, Günak G. Neutrophil-lymphocyte ratio: a new predictive and prognostic factor in patients with Bell palsy. J Craniofac Surg 2014;25:944-5.
17. Kum RO, Yurtsever Kum N, Ozcan M, Yilmaz YF, Gungor V, Unal A, et al. Elevated neutrophil-to-lymphocyte ratio in Bell’s palsy and its correlation with facial nerve enhancement on MRI. Otolaryngol Head Neck Surg 2015;152:130-5.
18. Atan D, İkincioğulları A, Köseoğlu S, Özcan KM, Çetin MA, Ensari S, et al. New Predictive Parameters of Bell’s Palsy: Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio. Balkan Med J 2015;32:167-70.
19. 19. Scherlinger M, Richez C, Tsokos GC, Boilard E, Blanco P. The role of platelets in immune-mediated inflammatory diseases. Nat Rev Immunol 2023;23: 495-510.
20. Kim DH, Oh JH, Kim J, Cho CH, Lee JH. Predictive Values of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Other Prognostic Factors in Pediatric Patients With Bell’s Palsy. Ear Nose Throat J 2021;100:720-5.
21. Cayir S, Kilicaslan C. Hematologic parameters as predictive markers in pediatric Bell’s palsy. Eur Arch Otorhinolaryngol 2021;278:1265-9.
22. Chen Y, Xiao Y, Lin Z, Xiao X, He C, Bihl JC, et al. The Role of Circulating Platelets Microparticles and Platelet Parameters in Acute Ischemic Stroke Patients. J Stroke Cerebrovasc Dis 2015;24:2313-20.
23. Farah R, Samra N. Mean platelets volume and neutrophil to lymphocyte ratio as predictors of stroke. J Clin Lab Anal 2018;32:e22189.
24. Uemura Y, Shibata R, Takemoto K, Uchikawa T, Koyasu M, Watanabe H, et al. Elevation of red blood cell distribution width during hospitalization predicts mortality in patients with acute decompensated heart failure. J Cardiol 2016;67:268-73.
25. Nonoyama H, Tanigawa T, Shibata R, Nakao Y, Horibe Y, Katahira N, et al. Red blood cell distribution width predicts prognosis in idiopathic sudden sensorineural hearing loss. Acta Otolaryngol 2016;136:1137-40.
26. Horibe Y, Tanigawa T, Shibata R, Nonoyama H, Kano F, Yamaguchi S, et al. Efficacy of the red blood cell distribution width for predicting the prognosis of Bell palsy: a pilot study. Eur Arch Otorhinolaryngol 2017;274:2303-06.