Clinical, demographical features, accompanying diseases and neutrophil to lymphocyte ratioplatelet to lymphocyte ratio in patients with bullous pemphigoid
Abstract
Objective: Bullous
pemphigoid (BP) is a rare autoimmune blistering disorder that affects the
elderly population. In this study, we retrospectively evaluated the clinical,
demographic characteristics and comorbid diseases in patients with BP. Mean
platelet volume (MPV), neutrophil to lymphocyte ratio (NLR) and platelet to
lymphocyte ratio (PLR) are known to be the indicators of inflammation. We also
investigated MPV, NLR, and PLR values in patients with BP and a control group.
To our knowledge, there is no previous study in the literature researching NLR,
PLR and MPV together in patients with BP.
Method: A total of
fourteen patients with BP and fourteen control subjects were included in the
study. Medical reports of the patients who received clinical and
histopathological diagnosis of BP between 2008 and 2018 were reviewed. MPV,
NLR, and PLR values were recorded in BP patients and the control group.
Results: Of the 14
patients, 9 were female and 5 male. The most frequent comorbid chronic disease
was hypertension, which was detected in 7 (50%) patients. Four of the 7
patients with hypertension had coronary artery disease (28,5%) at the same
time. The NLR of patients with BP was significantly higher than that of the
control group (p = 0.01). There was no difference in PLR and MPV between the groups.
Conclusions: The most common
comorbidity in patients with BP in our study was cardiovascular diseases. More
studies are needed to investigate the association between BP and cardiovascular
disorders. In addition, NLR may be an inexpensive and simple parameter of
inflammation in patients with BP and needs to be developed further.
References
- 1. Furue M, Kadono T. Bullous pemphigoid: What's ahead? J Dermatol. 2016 ;43:237-40.2. Kershenovich R, Hodak E, Mimouni D. Diagnosis and classification of pemphigus and bullous pemphigoid. Autoimmun Rev. 2014;13:477-81.3. Akay BN, Bodamyalı P, Şanlı H, Akyol A. 10-Year Observation of Bullous Pemphigoid Patients. Turkderm 2010; 44: 61-4. 4. Schmidt E, Zillikens D. Pemphigoid diseases. Lancet. 2013;381:320-32. 5. Marzano AV, Tedeschi A, Fanoni D, et al. Activation of blood coagulation in bullous pemphigoid: role of eosinophils, and local and systemic implications. Br J Dermatol. 2009;160:266-72. 6. Bancroft AJ, Abel EW, Mclaren M, Belch JJ. Mean platelet volume is a useful parameter: a reproducible routine method using a modified Coulter thrombocytometer. Platelets. 2000;11:379-87.7. Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 2002; 13: 301–306. 8. Polat M, Bugdayci G, Kaya H, Oğuzman H. Evaluation of neutrophil-to-lymphocyte ratio and platelet-to lymphocyte ratio in Turkish patients with chronic plaque psoriasis. Acta Dermatovenerol Alp Pannonica Adriat. 2017;26: 97-100. 9. Rifaioglu EN, Sen BB, Ekiz Ö, Dogramaci AC. Mean platelet volume and eosinophilia relationship in patients with bullous pemphigoid. Platelets.2014;25:264-7. 10. Ozer I, Balevi S, Ataseven A. Can Neutrophil/Lymphocyte Ratio Be Used As a Marker in the Diagnosis of Bullous Pemphigoid? Selcuk Med J 2018;34: 65-69. 11. Baum S, Sakka N, Artsi O, Trau H, Barzilai A. Diagnosis and classification of autoimmune blistering diseases. Autoimmun Rev 2014;13:482-9. 12. Ekiz Ö, Şen BB, Rifaioğlu EN, et al. Three-year observation of the patients with bullous pemphigoid: 29 cases. Turkderm 2013;47:205-8. 13. Yazıcı S, Başkan EB, Tunalı Ş, Aydoğan K, Sarıcaoğlu H. Kliniğimizde takip edilen kırk-altı büllöz pemfigoid olgusunun retrospektif analizi.Turkderm 2016;50:114-8.14. Tan SK, Tay YK. Bullous pemphigoid: Profile and outcome in a series of 100 cases in Singapore. J Dermatol Dermatol Surg 2018;22:12-5. 15. Kızılyel O, Elmas ÖF, Bilen H, et al. Bullous pemphigoid in Erzurum: A 10 year retrospective study. Turkderm 2015; 49: 66-9. 16. Ong E, Goldacre R, Hoang U, Sinclair R, Goldacre M. Associations between bullous pemphigoid and primary malignant cancers: an English national record linkage study, 1999-2011. Arch Dermatol Res 2014;306:75-80. 17. Marzano AV, Tedeschi A, Spinelli D, et al. Coagulation activation in autoimmune bullous diseases. Clin Exp Immunol. 2009;158:31-6. 18. Schmidt E, Della Torre R, Borradori L. Clinical features and practical diagnosis of bullous pemphigoid. Dermatol Clin 2011;29:427-38. 19. Ameglio F, D’Auria L, Bonifati C, et al. Cytokine pattern in blister fluid and serum of patients with bullous pemphigoid: Relationships with disease intensity. Br J Dermatol 1998;138:611-4. 20. Gökmen F, Akbal A, Reşorlu H, et al. Neutrophil-Lymphocyte Ratio Connected to Treatment Options and Inflammation Markers of Ankylosing Spondylitis. J Clin Lab Anal. 2015;29:294-8. 21. Sen BB, Rifaioglu EN, Ekiz O, et al. Neutrophil to lymphocyte ratio as a measure of systemic inflammation in psoriasis. Cutan Ocul Toxicol.2014;33:223-7.22. Ozturk C, Balta S, Balta I, et al. Neutrophil-lymphocyte ratio and carotid-intima media thickness in patients with Behçet disease without cardiovascular involvement. Angiology. 2015;66:291-6.23. Uçmak D, Akkurt M, Uçak H, et al. The relationship of neutrophil to lymphocyte ratio with pemphigus vulgaris. Konuralp Medical Journal 2015;2015:88-92. 24. Kridin K, Shihade W, Zelber-Sagi S. Mean Platelet Volume in Pemphigus Vulgaris. Angiology. 2018;69:303-307. 25. Canpolat F, Akpinar H, Eskioğlu F. Mean platelet volume in psoriasis and psoriatic arthritis. Clin Rheumatol. 2010;29:325-8.26. Balkarli A, Kucuk A, Babur H, Erbasan F. Neutrophil/lymphocyte ratio and mean platelet volume in Behçet's disease. Eur Rev Med Pharmacol Sci. 2016;20:3045-50. 27. Jiang Y, Ma W. Assessment of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Atopic Dermatitis Patients. Med Sci Monit. 2017;23:1340-1346. 28. Kim DS, Shin D, Lee MS, et al. Assessments of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis. J Dermatol. 2016;43:305-10. 29. Wu Y, Chen Y, Yang X, Chen L, Yang Y. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with disease activity in patients with systemic lupus erythematosus. Int Immunopharmacol. 2016;36:94-99. 30. Hayta SB, Güner R, Akyol M. Blood mean platelet volume may be predictive for disease course in the cases with pemphigus vulgaris. Biomedical Research 2017;28: 4223-4227.
Bolu yöresindeki büllöz pemfigoid hastalarının klinik, demografik özellikleri, eşlik eden hastalıkları ve nötrofil lenfosit oranı, platelet lenfosit oranının değerlendirilmesi
Abstract
Amaç: Büllöz pemfigoid (BP) genellikle yaşlı hastalarda görülen, nadir rastlanan bir otoimmün büllöz hastalıktır. Bu çalışmada BP'li hastalarda klinik, demografik özellikler ve eşlik eden hastalıklar retrospektif olarak değerlendirildi. Ortalama trombosit hacmi (OTH), nötrofil lenfosit oranı (NLO) ve trombosit lenfosit oranının (TLO) inflamasyon göstergeleri olduğu bilinmektedir. Bu çalışmada ayrıca BP ve kontrol grubundaki hastalarda OTH, NLO ve TLO değerleri incelendi. Bildiğimiz kadarıyla OTH, NLO, TLO değerlerinin tümünü büllöz pemfigoidli hastalarda inceleyen bir çalışma literatürde yer almamaktadır. Yöntem: Çalışmaya ondört BP hastası ve ondört kontrol grubu alındı. 2008-2018 yılları arasında klinik ve histopatolojik olarak BP tanısı alan hastaların kayıtları gözden geçirildi. BP hastalarında ve kontrol grubunda OTH, NLO ve TLO değerleri kaydedildi. Bulgular: Ondört hastanın dokuzu kadın beşi erkekti. En sık eşlik eden hastalık 7 (% 50) hastada tespit edilen hipertansiyondu. Hipertansiyonu olan 7 hastanın 4 (%28,5)’ünde aynı zamanda koroner arter hastalığı eşlik etmekteydi. BP'li hastaların NLO'su kontrol grubundan anlamlı derecede yüksekti (p=0.01). Gruplar arasında TLO ve OTH değerleri açısından anlamlı fark yoktu. Sonuç: Çalışmamızda BP'li hastalara en sık eşlik eden kardiyovasküler hastalıklardı. BP ve kardiyovasküler hastalıklar arasındaki ilişkiyi araştırmak için daha fazla sayıda çalışmaya ihtiyaç vardır. Ayrıca, NLO, BP hastalarındakullanılabilecek ucuz ve basit bir inflamasyon parametresi olabilir, bu yöndeki çalışmalar genişletilmelidir.
References
- 1. Furue M, Kadono T. Bullous pemphigoid: What's ahead? J Dermatol. 2016 ;43:237-40.2. Kershenovich R, Hodak E, Mimouni D. Diagnosis and classification of pemphigus and bullous pemphigoid. Autoimmun Rev. 2014;13:477-81.3. Akay BN, Bodamyalı P, Şanlı H, Akyol A. 10-Year Observation of Bullous Pemphigoid Patients. Turkderm 2010; 44: 61-4. 4. Schmidt E, Zillikens D. Pemphigoid diseases. Lancet. 2013;381:320-32. 5. Marzano AV, Tedeschi A, Fanoni D, et al. Activation of blood coagulation in bullous pemphigoid: role of eosinophils, and local and systemic implications. Br J Dermatol. 2009;160:266-72. 6. Bancroft AJ, Abel EW, Mclaren M, Belch JJ. Mean platelet volume is a useful parameter: a reproducible routine method using a modified Coulter thrombocytometer. Platelets. 2000;11:379-87.7. Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 2002; 13: 301–306. 8. Polat M, Bugdayci G, Kaya H, Oğuzman H. Evaluation of neutrophil-to-lymphocyte ratio and platelet-to lymphocyte ratio in Turkish patients with chronic plaque psoriasis. Acta Dermatovenerol Alp Pannonica Adriat. 2017;26: 97-100. 9. Rifaioglu EN, Sen BB, Ekiz Ö, Dogramaci AC. Mean platelet volume and eosinophilia relationship in patients with bullous pemphigoid. Platelets.2014;25:264-7. 10. Ozer I, Balevi S, Ataseven A. Can Neutrophil/Lymphocyte Ratio Be Used As a Marker in the Diagnosis of Bullous Pemphigoid? Selcuk Med J 2018;34: 65-69. 11. Baum S, Sakka N, Artsi O, Trau H, Barzilai A. Diagnosis and classification of autoimmune blistering diseases. Autoimmun Rev 2014;13:482-9. 12. Ekiz Ö, Şen BB, Rifaioğlu EN, et al. Three-year observation of the patients with bullous pemphigoid: 29 cases. Turkderm 2013;47:205-8. 13. Yazıcı S, Başkan EB, Tunalı Ş, Aydoğan K, Sarıcaoğlu H. Kliniğimizde takip edilen kırk-altı büllöz pemfigoid olgusunun retrospektif analizi.Turkderm 2016;50:114-8.14. Tan SK, Tay YK. Bullous pemphigoid: Profile and outcome in a series of 100 cases in Singapore. J Dermatol Dermatol Surg 2018;22:12-5. 15. Kızılyel O, Elmas ÖF, Bilen H, et al. Bullous pemphigoid in Erzurum: A 10 year retrospective study. Turkderm 2015; 49: 66-9. 16. Ong E, Goldacre R, Hoang U, Sinclair R, Goldacre M. Associations between bullous pemphigoid and primary malignant cancers: an English national record linkage study, 1999-2011. Arch Dermatol Res 2014;306:75-80. 17. Marzano AV, Tedeschi A, Spinelli D, et al. Coagulation activation in autoimmune bullous diseases. Clin Exp Immunol. 2009;158:31-6. 18. Schmidt E, Della Torre R, Borradori L. Clinical features and practical diagnosis of bullous pemphigoid. Dermatol Clin 2011;29:427-38. 19. Ameglio F, D’Auria L, Bonifati C, et al. Cytokine pattern in blister fluid and serum of patients with bullous pemphigoid: Relationships with disease intensity. Br J Dermatol 1998;138:611-4. 20. Gökmen F, Akbal A, Reşorlu H, et al. Neutrophil-Lymphocyte Ratio Connected to Treatment Options and Inflammation Markers of Ankylosing Spondylitis. J Clin Lab Anal. 2015;29:294-8. 21. Sen BB, Rifaioglu EN, Ekiz O, et al. Neutrophil to lymphocyte ratio as a measure of systemic inflammation in psoriasis. Cutan Ocul Toxicol.2014;33:223-7.22. Ozturk C, Balta S, Balta I, et al. Neutrophil-lymphocyte ratio and carotid-intima media thickness in patients with Behçet disease without cardiovascular involvement. Angiology. 2015;66:291-6.23. Uçmak D, Akkurt M, Uçak H, et al. The relationship of neutrophil to lymphocyte ratio with pemphigus vulgaris. Konuralp Medical Journal 2015;2015:88-92. 24. Kridin K, Shihade W, Zelber-Sagi S. Mean Platelet Volume in Pemphigus Vulgaris. Angiology. 2018;69:303-307. 25. Canpolat F, Akpinar H, Eskioğlu F. Mean platelet volume in psoriasis and psoriatic arthritis. Clin Rheumatol. 2010;29:325-8.26. Balkarli A, Kucuk A, Babur H, Erbasan F. Neutrophil/lymphocyte ratio and mean platelet volume in Behçet's disease. Eur Rev Med Pharmacol Sci. 2016;20:3045-50. 27. Jiang Y, Ma W. Assessment of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Atopic Dermatitis Patients. Med Sci Monit. 2017;23:1340-1346. 28. Kim DS, Shin D, Lee MS, et al. Assessments of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis. J Dermatol. 2016;43:305-10. 29. Wu Y, Chen Y, Yang X, Chen L, Yang Y. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with disease activity in patients with systemic lupus erythematosus. Int Immunopharmacol. 2016;36:94-99. 30. Hayta SB, Güner R, Akyol M. Blood mean platelet volume may be predictive for disease course in the cases with pemphigus vulgaris. Biomedical Research 2017;28: 4223-4227.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Medical Science Research Articles |
| Authors | |
| Publication Date | March 28, 2019 |
| Acceptance Date | March 27, 2019 |
| Published in Issue | Year 2019Volume: 41 Issue: 1 |