Evaluation of new inflammatory parameters in patients with chronic spontaneous urticaria: A new predictor of refractoriness to antihistamine treatment

Abstract

Objective: Antihistamines is used as the first-line treatment in chronic spontaneous urticaria (CSU). We investigated whether complet blood count parameters might be used as a response factor in patients under antihistamine treatment for CSU. We also compared the NLR (neutrophil lymphocyte ratio), PLR (platelet lymphocyte ratio, MPV (mean platelet volume) and RDW (erythrocyte distribution width) levels of CSU patients with healthy controls. Material and Method: This study was conducted on a total of 150 cases, a hundred of which had CSU and fifty healthy control group. Results: NLR and RDW were significantly higher and MPV was significantly lower in the CSU group. NLR and PLR levels were found significantly lower in patients who responded to antihistamine treatment within 4 weeks. The ROC analysis showed that NLR predicted responders with a sensitivity of 92% and with a specificity of 84%, using a cut-off value of 1,98 (p<.001). The multivariate regression analysis showed that only NLR was found as the predictor of responders. Conclusion: NLR may be considered as a simple and cost-effective tool to determine which patients can respond to antihistamines. It may be a guide for non-responsive patients to switch to other treatment options in the early period.

Keywords

• Urticaria,Neutrophil to lymphocyte ratio,Antihistamines

Kronik spontan ürtikerli hastalarda yeni inflamatuar parametrelerin değerlendirilmesi: Antihistaminik tedaviye refrakterliğin yeni bir öngördürücüsü

Öz

Amaç: Antihistaminikler kronik spontan ürtikerde (KSU) ilk basamak tedavi olarak kullanılır. Çalışmada KSU için antihistaminik tedavi gören hastalarda tam kan sayımı parametrelerinin yanıt faktörü olarak kullanılıp kullanılamayacağını araştırdık. Ayrıca KSU hastalarının NLR (nötrofil lenfosit oranı), PLR (trombosit lenfosit oranı), MPV (ortalama trombosit hacmi) ve RDW (eritrosit dağılım genişliği) düzeylerini sağlıklı kontroller ile karşılaştırdık. Materyal ve Metod: Bu çalışma, yüz KSU ve elli sağlıklı kontrol grubuna sahip toplam 150 vaka üzerinde gerçekleştirilmiştir. Bulgular: KSU grubunda NLR ve RDW anlamlı olarak yüksek ve MPV anlamlı olarak düşüktü. Antihistaminik tedaviye 4 hafta içinde yanıt veren hastalarda NLR ve PLR düzeyleri anlamlı olarak düşük bulundu. ROC analizi NLR'nin, 1,98 kesme değeri kullanılarak, yanıt verenleri % 92 hassasiyet ve % 84 özgüllük ile tahmin ettiğini göstermiştir (p <.001). Çok değişkenli regresyon analizi, sadece NLR'nin yanıt öngördürücüsü olduğunu göstermiştir. Sonuç: NLR hangi hastaların antihistaminiklere yanıt verebileceğini belirlemek için basit ve uygun maliyetli bir araç olarak düşünülebilir. NLR, yanıt vermeyecek hastaların erken dönemde diğer tedavi seçeneklerine geçmeleri için rehberlik edebilir.

Anahtar Kelimeler

• Ürtiker,Nötrofil / lenfosit oranı,Antihistaminikler

Kaynakça

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