Neutrophil- and Platelet-to-Lymphocyte Ratios (NLR & PLR) and Their Relation with Disease Activity in Rheumatoid Arthritis Patients

Abstract Background RA is the most common chronic inflammatory arthritis and is associated with progressive destruction of synovial joints and physical disability. It is a polygenic disease characterized by autoimmunity and systemic inflammation with progressive impairment of the joints, resulting in lifelong disability and increased mortality. Aim of the Work The aim of the study is to study the correlation between both of Neutrophil- and platelet-to-lymphocyte ratios (NLR&PLR) and disease activity in RA patients. Patients and Methods Our cross-sectional case-control study enrolled 50 patients with RA, in addition to 30 healthy volunteers as a control group.All included patients were subjected to full history taking with special emphasis on history of RA, thorough clinical examination was done with special emphasis on musculoskeletal examination. Results When we compared RA patients with the controls, we found a highly statistically significant difference between them regarding NLR and PLR being higher in the RA group. In our study we found that both NLR and PLR has fair diagnostic value to discriminate between RA patients and controls using the ROC curve at a cut-off value of 2.58 and 151.05 respectively. In RA patients, highly statistically significant correlation was found between both NLR and PLR. In addition, statistically significant correlation was found between NLR with both VAS score and DAS28_ESR and also between PLR with ESR, VAS score and RF.PLR also correlated significantly with US7 score, PDUS synovitis and gray GSUS tenosynovitis. Conclusion NLR and PLR that can be obtained via CBC (which is convenient, inexpensive and fast), can serve as an additional useful marker for the diagnosis of RA. NLR and PLR has important value in the assessment of RA related disease activity. In contrast to traditional markers, they are less expensive and effective measure of inflammation that is not impacted by the cytokines influencing the ESR and CRP. US7 score is a simple and effective measure to detect subclinical synovitis in RA patients and to assess and follow up disease activity.