THE ROLE OF MEAN PLATELET VOLUME IN DIAGNOSIS AND PROGNOSIS OF MENINGITIS IN CHILDREN: A RETROSPECTIVE CASE-CONTROL STUDY

Öz

Objective: Mean platelet volume (MPV) is an emerging inflammatory biomarker; however, its clinical role in pediatric meningitis remains unclear. This study aimed to evaluate the diagnostic and prognostic value of MPV in children with meningitis. Material and Methods: This retrospective case–control study included children aged 0–18 years who were followed with a diagnosis of meningitis between 2012 and 2016. Age- and sex-matched healthy children served as controls. Demographic data, serial laboratory parameters, cerebrospinal fluid (CSF) findings, culture results, and clinical outcomes were recorded. Group comparisons were performed using appropriate parametric and nonparametric tests. A p-value <0.05 was considered statistically significant. Results: A total of 62 patients and 62 controls were included. No significant differences were observed between patients and controls in MPV, platelet count, or platelet distribution width, whereas WBC, neutrophil-to-lymphocyte ratio, and CRP levels were significantly higher in the meningitis group. Among patients who underwent lumbar puncture, bacterial growth was detected in 44.1% of CSF cultures. The first MPV measurement was significantly lower in the CSF culture–positive group compared with the culture-negative group (7.41 vs. 8.18, p=0.035). Serial MPV measurements did not show significant changes during follow-up. Four patients (6.5%) died; the initial MPV value was significantly higher in non-survivors than in survivors (9.43±1.24 vs. 7.81±0.92, p=0.002). CRP levels during follow-up were also significantly higher among non-survivors. Conclusions: Although MPV does not differentiate children with meningitis from healthy controls, it may have prognostic significance. Lower baseline MPV may be associated with CSF culture positivity, whereas higher admission MPV may predict poor clinical outcomes. Although serial MPV monitoring appears to have limited value during follow-up, admission MPV may serve as a simple, cost-effective adjunct prognostic marker when interpreted alongside clinical and laboratory findings.

Anahtar Kelimeler

• Meningitis
• child
• mean platelet volume
• prognosis

Ortalama Trombosit Hacminin Çocuklarda Menenjitin Tanısal ve Prognostik Değeri: Retrospektif Olgu-Kontrol Çalışması

Öz

Amaç: Ortalama trombosit hacmi (MPV), gitgide önem kazanan bir inflamatuvar biyobelirteçtir; ancak pediatrik menenjitteki klinik rolü henüz netleşmemiştir. Bu çalışmada, çocuklarda menenjitte MPV’nin tanısal ve prognostik değerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu retrospektif olgu-kontrol çalışmasına, 2012–2016 yılları arasında menenjit tanısı ile izlenen 0–18 yaş arası çocuklar dahil edildi. Yaş ve cinsiyet açısından eşleştirilmiş sağlıklı çocuklar kontrol grubunu oluşturdu. Demografik veriler, laboratuvar parametreleri, beyin omurilik sıvısı (BOS) bulguları, kültür sonuçları ve klinik sonuçlar analiz edildi. Uygun parametrik ve parametrik olmayan testler kullanıldı ve p<0,05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Çalışmaya 62 hasta ve 62 sağlıklı çocuk dahil edildi. MPV, trombosit sayısı ve trombosit dağılım genişliği açısından gruplar arasında anlamlı fark saptanmazken, beyaz küre sayısı, nötrofil/lenfosit oranı ve CRP düzeyleri menenjit grubunda anlamlı derecede daha yüksek bulundu. Lomber ponksiyon yapılan hastaların %44,1’inde BOS kültüründe üreme saptandı. Başlangıç MPV değeri, kültür pozitif grupta kültür negatif gruba göre anlamlı derecede daha düşüktü (7,41 vs. 8,18 p=0,035). İzlem süresince seri MPV ölçümlerinde anlamlı değişiklik gözlenmedi. Dört hasta (%6,5) kaybedildi; başlangıç MPV değeri, kaybedilen hastalarda yaşayanlara göre anlamlı derecede daha yüksekti (9,43±1,24 vs. 7,81±0,92 p=0,002). İzlem süresince CRP düzeyleri de kaybedilen hastalarda daha yüksekti. Sonuç: MPV tek başına menenjitli çocukları sağlıklı kontrollerden ayırt edememekle birlikte, düşük başlangıç MPV değeri beyin omurilik sıvısı kültür pozitifliği ile ilişkili olabilirken, yüksek başvuru MPV değeri kötü prognozu gösterebilir. Seri MPV ölçümlerinin izlemde sınırlı değeri olduğu görülmekle birlikte, başvuru MPV değeri klinik ve laboratuvar bulgularla birlikte değerlendirildiğinde basit ve maliyetsiz bir yardımcı prognostik belirteç olarak kullanılabilir.

Anahtar Kelimeler

• Menenjit
• çocuk
• ortalama trombosit hacmi
• prognoz

Kaynakça

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