Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-25T13:36:32.632Z Has data issue: false hasContentIssue false

Relationship between mean platelet volume-to-lymphocyte ratio and coronary artery abnormalities in Kawasaki disease

Published online by Cambridge University Press:  16 April 2018

Gulcin Bozlu*
Affiliation:
Department of Pediatrics, University of Mersin Faculty of Medicine, Mersin, Turkey
Derya Karpuz
Affiliation:
Department of Pediatrics, University of Mersin Faculty of Medicine, Mersin, Turkey Division of Pediatric Cardiology, University of Mersin Faculty of Medicine, Mersin, Turkey
Olgu Hallioglu
Affiliation:
Department of Pediatrics, University of Mersin Faculty of Medicine, Mersin, Turkey Division of Pediatric Cardiology, University of Mersin Faculty of Medicine, Mersin, Turkey
Selma Unal
Affiliation:
Department of Pediatrics, University of Mersin Faculty of Medicine, Mersin, Turkey Division of Pediatric Hematology, University of Mersin Faculty of Medicine, Mersin, Turkey
Necdet Kuyucu
Affiliation:
Department of Pediatrics, University of Mersin Faculty of Medicine, Mersin, Turkey Division of Pediatric Infectious Diseases, University of Mersin Faculty of Medicine, Mersin, Turkey
*
Author for correspondence: G. Bozlu, MD, Department of Pediatrics, University of Mersin Faculty of Medicine, 34. Cadde, Ciftlikkoy Kampusu, 33343 Mersin, Turkey. Tel: +90 324 241 00 00; Fax: +90 324 241 00 00; E-mail: gulnebi@hotmail.com

Abstract

Objectives

Recently, mean platelet volume-to-lymphocyte ratio has emerged as a novel parameter of inflammation. No study has investigated the role of mean platelet volume-to-lymphocyte ratio in children with Kawasaki disease. We aimed to evaluate the relationship between mean platelet volume-to-lymphocyte ratio and coronary artery abnormalities in Kawasaki disease.

Methods

Between January 2008 and January 2017, a total of 58 children with Kawasaki disease and 42 healthy subjects matched for sex and age were enrolled. Before the treatment, transthoracic echocardiography for all children was performed. Clinical and laboratory results including mean platelet volume, platelet distribution width, red blood cell distribution width, and counts of platelets, neutrophils, lymphocytes, and white blood cells, erythrocyte sedimentation rate, and C-reactive protein levels were measured. Mean platelet volume-to-lymphocyte ratio was calculated as mean platelet volume divided by lymphocyte count.

Results

Compared with healthy controls, mean platelet volume-to-lymphocyte ratio was significantly lower in the children with Kawasaki disease (p<0.01). A total of 14 patients (24.1%) had incomplete Kawasaki disease and 15 (25.8%) children with Kawasaki disease had coronary involvement. Mean platelet volume-to-lymphocyte ratio was significantly lower in patients with coronary artery abnormalities (p<0.01). According to receiver operating characteristic curve analysis performed for the prediction of coronary artery abnormalities, the best cut-off point for mean platelet volume-to-lymphocyte ratio was 2.5 (area under curve=0.593, sensitivity 53.3%, specificity 51.1%).

Conclusion

It was first shown that the children with Kawasaki disease have lower mean platelet volume-to-lymphocyte ratio compared with control subjects. Mean platelet volume-to-lymphocyte ratio may be helpful in predicting coronary artery lesions in patients with Kawasaki disease.

Type
Original Articles
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. McCrindle, BW, Rowley, AH, Newburger, JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation 2017; 135: e927e999.CrossRefGoogle ScholarPubMed
2. Makino, N, Nakamura, Y, Yashiro, M, et al. Descriptive epidemiology of Kawasaki disease in Japan, 2011-2012: from the results of the 22nd nationwide survey. J Epidemiol 2015; 25: 239245.Google Scholar
3. Garg, J, Krishnamoorthy, P, Palaniswamy, C, et al. Prevalence and predictors of coronary artery disease in adults with Kawasaki disease. Cardiol Young 2015; 25: 11241129.Google Scholar
4. Kobayashi, T, Inoue, Y, Takeuchi, K, et al. Prediction of intravenous immunoglobulin unresponsiveness in patients with Kawasaki disease. Circulation 2006; 113: 26062612.Google Scholar
5. Egami, K, Muta, H, Ishii, M, et al. Prediction of resistance to intravenous immunoglobulin treatment in patients with Kawasaki disease. J Pediatr 2006; 149: 237240.Google Scholar
6. Sano, T, Kurotobi, S, Matsuzaki, K, et al. Prediction of non-responsiveness to standard high-dose gamma-globulin therapy in patients with acute Kawasaki disease before starting initial treatment. Eur J Pediatr 2007; 166: 131137.CrossRefGoogle ScholarPubMed
7. Takeuchi, M, Inuzuka, R, Hayashi, T, et al. Novel risk assessment tool for immunoglobulin resistance in Kawasaki disease: application using a random forest classifier. Pediatr Infect Dis J 2017; 36: 821826.Google Scholar
8. Sleeper, LA, Minich, LL, McCrindle, BM, et al. Evaluation of Kawasaki disease risk-scoring systems for intravenous immunoglobulin resistance. J Pediatr 2011; 158: 831835.e3.Google Scholar
9. Hudzik, B, Szkodziński, J, Lekston, A, Gierlotka, M, Poloński, L, Gąsior, M. Mean platelet volume-to-lymphocyte ratio: a novel marker of poor short- and long-term prognosis in patients with diabetes mellitus and acute myocardial infarction. J Diabetes Complications 2016; 30: 10971102.Google Scholar
10. Kurtul, A, Acikgoz, SK. Usefulness of mean platelet volume-to-lymphocyte ratio for predicting angiographic no-reflow and short-term prognosis after primary percutaneous coronary ıntervention in patients with ST-segment elevation myocardial infarction. Am J Cardiol 2017; 120: 534541.CrossRefGoogle ScholarPubMed
11. Ornek, E, Kurtul, A. Relationship of mean platelet volume to lymphocyte ratio and coronary collateral circulation in patients with stable angina pectoris. Coron Artery Dis 2017; 28: 492497.Google Scholar
12. Al-Ammouri, I, Al-Wahsh, S, Khuri-Bulos, N. Kawasaki disease in Jordan: demographics, presentation, and outcome. Cardiol Young 2012; 22: 390395.Google Scholar
13. Tremoulet, AH, Dutkowski, J, Sato, Y, Kanegaye, JT, Ling, XB, Burns, JC. Novel data-mining approach identifies biomarkers for diagnosis of Kawasaki disease. Pediatr Res 2015; 78: 547553.Google Scholar
14. Ha, KS, Lee, J, Jang, GY, et al. Value of neutrophil-lymphocyte ratio in predicting outcomes in Kawasaki disease. Am J Cardiol 2015; 116: 301306.Google Scholar
15. Kawamura, Y, Takeshita, S, Kanai, T, Yoshida, Y, Nonoyama, S. The combined usefulness of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in predicting intravenous immunoglobulin resistance with Kawasaki disease. J Pediatr 2016; 178: 281284.e1.CrossRefGoogle ScholarPubMed
16. Gasparyan, AY, Ayvazyan, L, Mikhailidis, DP, Kitas, GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des 2011; 17: 4758.Google Scholar
17. Liu, R, Gao, F, Huo, J, Yi, Q. Study on the relationship between mean platelet volume and platelet distribution width with coronary artery lesion in children with Kawasaki disease. Platelets 2012; 23: 1116.Google Scholar
18. Makay, B, Turkyilmaz, Z, Unsal, E. Mean platelet volume in children with familial Mediterranean fever. Clin Rheumatol 2009; 28: 975978.Google Scholar
19. Igarashi, H, Hatake, K, Tomizuka, H, Yamada, M, Gunji, Y, Momoi, MY. High serum levels of M-CSF and G-CSF in Kawasaki disease. Br J Haematol 1999; 105: 613615.CrossRefGoogle ScholarPubMed