Hematological markers and ultrasound 7-joint inflammation score as add-on tools in the assessment of inflammation in rheumatoid arthritis patients

Abstract Background Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial inflammation and joint destruction that eventually induces severe disability. Inflammation is the key determinant and primary underlying mechanism leading to disability and increased mortality in patient...

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Main Authors: Abd Elatif Ahmed Gaballah, Noha Abdelhalim Elsawy, Wessam Mohamed El Gendy, Ahmed Hafez Afifi, Maha Saeid Mahmoud Hanafi
Format: Article
Language:English
Published: SpringerOpen 2022-05-01
Series:Egyptian Rheumatology and Rehabilitation
Subjects:
Online Access:https://doi.org/10.1186/s43166-022-00126-0
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author Abd Elatif Ahmed Gaballah
Noha Abdelhalim Elsawy
Wessam Mohamed El Gendy
Ahmed Hafez Afifi
Maha Saeid Mahmoud Hanafi
author_facet Abd Elatif Ahmed Gaballah
Noha Abdelhalim Elsawy
Wessam Mohamed El Gendy
Ahmed Hafez Afifi
Maha Saeid Mahmoud Hanafi
author_sort Abd Elatif Ahmed Gaballah
collection DOAJ
description Abstract Background Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial inflammation and joint destruction that eventually induces severe disability. Inflammation is the key determinant and primary underlying mechanism leading to disability and increased mortality in patients with RA. This study aimed to correlate the hematological markers and ultrasound 7-joint inflammation score to disease activity in rheumatoid arthritis patients. Results The current study involved 54 RA patients diagnosed according to the 2010 ACR/EULAR classification criteria for RA and thirty healthy control subjects. There were 48 females (88.9%) and 6 males (11.1%). The age of patients ranged from 32 to 60 years, with a mean of 46.04 ± 5.65 years. Using disease activity score 28-ESR, total white blood cell count and absolute lymphocytic count were significantly lower in RA patients with high disease activity. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume, ESR, and CRP were significantly higher in patients with high disease activity using disease activity score 28 CRP. Also, a statistically significant positive correlation was detected between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and both clinical disease activity scores. Red cell distribution width but not platelet distribution width was significantly higher in RA patients but both parameters had no association or correlation with clinical disease activity scores. Neutrophil-to-lymphocyte ratio was found to have a statistically significant positive correlation with the tenosynovitis score by powered Doppler ultrasound. There were statistically significant positive correlations between disease activity score 28 ESR and CRP and synovitis and tenosynovitis scores by greyscale and powered Doppler ultrasound using the ultrasound 7 score. Conclusion Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume could be potential inflammatory markers for follow-up of disease activity in RA patients. The ultrasound 7 score is a simple and practical scoring system for use in the detection of inflammation, even subclinically in RA patients, which may help the physician in his clinical decisions. The combined use of both hematological markers and the ultrasound 7 score may be of great value.
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spelling doaj.art-df5bb0f644da40138df84ba0c4b4e2f82022-12-22T00:44:56ZengSpringerOpenEgyptian Rheumatology and Rehabilitation1110-161X2090-32352022-05-0149111210.1186/s43166-022-00126-0Hematological markers and ultrasound 7-joint inflammation score as add-on tools in the assessment of inflammation in rheumatoid arthritis patientsAbd Elatif Ahmed Gaballah0Noha Abdelhalim Elsawy1Wessam Mohamed El Gendy2Ahmed Hafez Afifi3Maha Saeid Mahmoud Hanafi4Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Alexandria UniversityDepartment of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Alexandria UniversityDepartment of Clinical and Chemical pathology, Faculty of Medicine, Alexandria UniversityDepartment of Radiodiagnosis, Faculty of Medicine, Alexandria UniversityDepartment of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Alexandria UniversityAbstract Background Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial inflammation and joint destruction that eventually induces severe disability. Inflammation is the key determinant and primary underlying mechanism leading to disability and increased mortality in patients with RA. This study aimed to correlate the hematological markers and ultrasound 7-joint inflammation score to disease activity in rheumatoid arthritis patients. Results The current study involved 54 RA patients diagnosed according to the 2010 ACR/EULAR classification criteria for RA and thirty healthy control subjects. There were 48 females (88.9%) and 6 males (11.1%). The age of patients ranged from 32 to 60 years, with a mean of 46.04 ± 5.65 years. Using disease activity score 28-ESR, total white blood cell count and absolute lymphocytic count were significantly lower in RA patients with high disease activity. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume, ESR, and CRP were significantly higher in patients with high disease activity using disease activity score 28 CRP. Also, a statistically significant positive correlation was detected between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and both clinical disease activity scores. Red cell distribution width but not platelet distribution width was significantly higher in RA patients but both parameters had no association or correlation with clinical disease activity scores. Neutrophil-to-lymphocyte ratio was found to have a statistically significant positive correlation with the tenosynovitis score by powered Doppler ultrasound. There were statistically significant positive correlations between disease activity score 28 ESR and CRP and synovitis and tenosynovitis scores by greyscale and powered Doppler ultrasound using the ultrasound 7 score. Conclusion Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume could be potential inflammatory markers for follow-up of disease activity in RA patients. The ultrasound 7 score is a simple and practical scoring system for use in the detection of inflammation, even subclinically in RA patients, which may help the physician in his clinical decisions. The combined use of both hematological markers and the ultrasound 7 score may be of great value.https://doi.org/10.1186/s43166-022-00126-0Hematological markersUltrasound 7-joint inflammation scoreDAS28 CRPDAS28 ESR
spellingShingle Abd Elatif Ahmed Gaballah
Noha Abdelhalim Elsawy
Wessam Mohamed El Gendy
Ahmed Hafez Afifi
Maha Saeid Mahmoud Hanafi
Hematological markers and ultrasound 7-joint inflammation score as add-on tools in the assessment of inflammation in rheumatoid arthritis patients
Egyptian Rheumatology and Rehabilitation
Hematological markers
Ultrasound 7-joint inflammation score
DAS28 CRP
DAS28 ESR
title Hematological markers and ultrasound 7-joint inflammation score as add-on tools in the assessment of inflammation in rheumatoid arthritis patients
title_full Hematological markers and ultrasound 7-joint inflammation score as add-on tools in the assessment of inflammation in rheumatoid arthritis patients
title_fullStr Hematological markers and ultrasound 7-joint inflammation score as add-on tools in the assessment of inflammation in rheumatoid arthritis patients
title_full_unstemmed Hematological markers and ultrasound 7-joint inflammation score as add-on tools in the assessment of inflammation in rheumatoid arthritis patients
title_short Hematological markers and ultrasound 7-joint inflammation score as add-on tools in the assessment of inflammation in rheumatoid arthritis patients
title_sort hematological markers and ultrasound 7 joint inflammation score as add on tools in the assessment of inflammation in rheumatoid arthritis patients
topic Hematological markers
Ultrasound 7-joint inflammation score
DAS28 CRP
DAS28 ESR
url https://doi.org/10.1186/s43166-022-00126-0
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