Pan-immune-inflammation value and systemic inflammation indices as predictors of disease severity in hidradenitis suppurativa

Abstract

Aims: This study aimed to evaluate complete blood count derived inflammatory indices, including the pan-immune-inflammation value (PIV), systemic immune inflammation index (SII), and systemic inflammation response index (SIRI), in patients with hidradenitis suppurativa (HS). Additional objectives were to examine their associations with disease severity using Hurley stage and IHS4 and to assess their diagnostic performance and their potential role in identifying severe disease. Methods: A retrospective analysis was conducted among adults diagnosed with HS controls selected from individuals without inflammatory skin disease. Demographic data, laboratory results, and clinical severity scores were reviewed. PIV, SII, and SIRI were calculated from neutrophil, lymphocyte, monocyte, and platelet counts. Group comparisons, correlation analyses, receiver operating characteristic (ROC) curves, and logistic regression models were used to assess the relationships between inflammatory indices and disease features. Results: A total of 101 HS patients and 82 controls were included. HS patients showed higher inflammatory activity, with increased neutrophils (5.88 vs 4.12×10³/mm³, p<0.001), platelets (308 vs 205×10³/mm³, p<0.001). CRP levels were higher in HS (8.64 vs. 1.0 mg/L, p<0.001), whereas ESR levels were comparable between groups (11 vs. 8 mm/h, p=0.45). All indices were significantly elevated in HS, including SII (650.2 vs 277.6, p<0.001), SIRI (1.45 vs 0.98, p<0.001), and PIV (479.5 vs 203.2, p<0.001). Each index showed a progressive rise across Hurley stages: PIV increased from 264.28 in stage I to 621.41 in stage III (p<0.01), SII from 445.20 to 819.73 (p<0.01), and SIRI from 1.10 to 1.65 (p<0.05). All indices correlated positively with IHS4, with the strongest correlations observed for SII (r=0.444, p<0.001) and PIV (r=0.433, p<0.001). ROC analysis showed high diagnostic performance for CRP (AUC 0.94), followed by SII (AUC 0.91) and PIV (AUC 0.84; specificity 92.7%). In multivariable logistic regression analyses adjusted for age, sex, BMI, and smoking status, higher SII and PIV values were independently associated with severe HS. Conclusion: SII showed a consistent association with severe disease, while PIV showed an increase with disease severity and demonstrated a modest independent association. Overall, these indices appear to support clinical evaluation rather than replace it. Larger prospective studies are needed to determine their value in long-term monitoring and treatment response.

Keywords

• Hidradenitis suppurativa
• pan-immune-inflammation value
• systemic inflammation response index
• systemic immune inflammation index
• disease severity

Hidradenitis suppurativa’da hastalık şiddetinin değerlendirilmesinde pan-immün-inflamasyon değeri ve sistemik inflamasyon indeksleri

Abstract

Amaç: Bu çalışmada, hidradenitis suppurativa (HS) hastalarında pan-immün-inflamasyon değeri (PIV), sistemik immün inflamasyon indeksi (SII) ve sistemik inflamasyon yanıt indeksi (SIRI) dahil olmak üzere tam kan sayımından türetilen inflamatuvar indeksleri değerlendirmek amaçlanmıştır. Ek amaçlar arasında bu indekslerin Hurley evresi ve IHS4 ile hastalık şiddeti arasındaki ilişkilerini incelemek, tanısal performanslarını değerlendirmek ve şiddetli hastalığın belirlenmesindeki potansiyel rollerini araştırmak yer almaktadır. Yöntemler: İnflamatuvar deri hastalığı bulunmayan, yaş ve cinsiyet açısından eşleştirilmiş kontroller ile HS tanısı alan yetişkin hastalar arasında retrospektif bir analiz gerçekleştirildi. Demografik veriler, laboratuvar sonuçları ve klinik şiddet skorları değerlendirildi. PIV, SII ve SIRI; nötrofil, lenfosit, monosit ve trombosit sayılarından hesaplandı. İnflamatuvar indeksler ile hastalık özellikleri arasındaki ilişkileri değerlendirmek için grup karşılaştırmaları, korelasyon analizleri, ROC eğrileri ve lojistik regresyon modelleri uygulandı. Bulgular: Çalışmaya 101 HS hastası ve 82 kontrol dahil edildi. HS hastalarında inflamatuvar aktivitenin daha yüksek olduğu görüldü; nötrofiller (5.88’e karşı 4.12 ×10³/mm³, p < 0.001), trombositler (308’e karşı 205 ×10³/mm³, p < 0.001), CRP (8.64’e karşı 1.0 mg/L) ve ESR (11’e karşı 8 mm/sa) belirgin şekilde yüksekti. Tüm indeksler HS grubunda anlamlı olarak artmıştı; SII (650.2’ye karşı 277.6, p < 0.001), SIRI (1.45’e karşı 0.98, p < 0.001) ve PIV (479.5’e karşı 203.2, p < 0.001). Her indeks Hurley evreleri boyunca kademeli bir yükseliş gösterdi: PIV evre I’de 264.28’den evre III’te 621.41’e (p < 0.01), SII 445.20’den 819.73’e (p < 0.01) ve SIRI 1.10’dan 1.65’e (p < 0.05) yükseldi. Tüm indeksler IHS4 ile pozitif korelasyon gösterdi; en güçlü ilişkiler SII (r = 0.444, p < 0.001) ve PIV (r = 0.433, p < 0.001) için saptandı. ROC analizi, SII için iyi tanısal performans (AUC 0.91) ve PIV için yüksek özgüllükle birlikte iyi performans (AUC 0.84; özgüllük yüzde 92.7) gösterdi. Lojistik regresyonda SII, Hurley evre III’ün tek bağımsız belirleyicisi olarak bulundu (OR 1.003, p = 0.012); PIV ve SIRI ise düzeltme sonrası anlamlılığını korumadı. Sonuç: SII şiddetli hastalık ile en güçlü ilişkiyi gösterirken, PIV de evreler boyunca belirgin bir artış sergileyerek yüksek özgüllük sağlamıştır. Genel olarak bu indeksler klinik değerlendirmeyi tamamlayıcı niteliktedir. Hastalık izlemi ve tedavi yanıtındaki yerlerini belirlemek için daha geniş kapsamlı prospektif çalışmalara ihtiyaç vardır.

Keywords

• hidradenitis suppurativa
• pan-immün-inflamasyon değeri
• sistemik inflamasyon yanıt indeksi
• sistemik immün inflamasyon indeksi
• hastalık şiddeti

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