Diagnostic Value of Neutrophil-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Diagnosis of Erythema Nodosum Leprosum: A Retrospective Study
Abstract Erythema nodosum leprosum (ENL) is an acute immune complex-mediated condition of the dermis, subcutaneous tissue, and other tissues seen in patients with multibacillary (MB) leprosy, causing severe impairment to patients’ quality of life. To date, there is no standard diagnostic criteria f...
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id-langga.1252892023-10-12T02:30:23Z https://repository.unair.ac.id/125289/ Diagnostic Value of Neutrophil-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Diagnosis of Erythema Nodosum Leprosum: A Retrospective Study Natalia Tanojo, Natalia Damayanti, Damayanti Budi Utomo, Budi Evy Ervianti, Evy Dwi Murtiastutik, Dwi Cita Rosita Sigit Prakoeswa, Cita Muhammad Yulianto Listiawan, Muhammad R5-920 Medicine (General) Abstract Erythema nodosum leprosum (ENL) is an acute immune complex-mediated condition of the dermis, subcutaneous tissue, and other tissues seen in patients with multibacillary (MB) leprosy, causing severe impairment to patients’ quality of life. To date, there is no standard diagnostic criteria for ENL. We aimed to study the diagnostic value and accuracy of Neutrophil-to-Lymphocyte ratio (NLR), Lymphocyte-to-Monocyte ratio (LMR), and Platelet-to-Lymphocyte ratio (PLR) in diagnosing ENL. This is an analytic retrospective study with a cross-sectional design that describes the distribution and clinical characteristics of all newly diagnosed MB patients of Dr. Soetomo General Hospital Surabaya in the years 2018–2020. NLR, LMR, and PLR were calculated for all patients, and a receiver operating characteristic curve (ROC) was generated to identify the cut-off points. Among a total of 182 patients with MB leprosy, 22 cases (12.09%) were reported with ENL. WBC, neutrophils, monocytes, and thrombocytes showed a positive correlation with the incidence of ENL, but not lymphocytes. The NLR cut-off point for the diagnosis of ENL was 4.99 (sensitivity 86.4%, specificity 82.5%, accuracy 82.97), while that of PLR was 237.46 (sensitivity 63.6%, specificity 73.1%, accuracy 71.98%). LMR had poor sensitivity and specificity levels of 50% and 28.7%, with cut-off point of 2.28 and accuracy of 31.32%. These results suggest that NLR and PLR could be potential biomarkers for the diagnosis of ENL. Keywords: neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, erythema nodosum leprosum, leprosy, tropical disease, infectious disease, neglected disease Multidisciplinary Digital Publishing Institute (MDPI) Article PeerReviewed text en https://repository.unair.ac.id/125289/1/06.%20Artikel.pdf text id https://repository.unair.ac.id/125289/2/C-6%20Karil.pdf text en https://repository.unair.ac.id/125289/3/06.%20Tunitin.pdf text id https://repository.unair.ac.id/125289/7/06%20etik.pdf Natalia Tanojo, Natalia and Damayanti, Damayanti and Budi Utomo, Budi and Evy Ervianti, Evy and Dwi Murtiastutik, Dwi and Cita Rosita Sigit Prakoeswa, Cita and Muhammad Yulianto Listiawan, Muhammad Diagnostic Value of Neutrophil-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Diagnosis of Erythema Nodosum Leprosum: A Retrospective Study. Tropical Medicine and Infectious Disease, 7 (3). ISSN 2414-6366 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8951533/ 10.3390/tropicalmed7030039 |
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R5-920 Medicine (General) Natalia Tanojo, Natalia Damayanti, Damayanti Budi Utomo, Budi Evy Ervianti, Evy Dwi Murtiastutik, Dwi Cita Rosita Sigit Prakoeswa, Cita Muhammad Yulianto Listiawan, Muhammad Diagnostic Value of Neutrophil-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Diagnosis of Erythema Nodosum Leprosum: A Retrospective Study |
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Abstract
Erythema nodosum leprosum (ENL) is an acute immune complex-mediated condition of the dermis, subcutaneous tissue, and other tissues seen in patients with multibacillary (MB) leprosy, causing severe impairment to patients’ quality of life. To date, there is no standard diagnostic criteria for ENL. We aimed to study the diagnostic value and accuracy of Neutrophil-to-Lymphocyte ratio (NLR), Lymphocyte-to-Monocyte ratio (LMR), and Platelet-to-Lymphocyte ratio (PLR) in diagnosing ENL. This is an analytic retrospective study with a cross-sectional design that describes the distribution and clinical characteristics of all newly diagnosed MB patients of Dr. Soetomo General Hospital Surabaya in the years 2018–2020. NLR, LMR, and PLR were calculated for all patients, and a receiver operating characteristic curve (ROC) was generated to identify the cut-off points. Among a total of 182 patients with MB leprosy, 22 cases (12.09%) were reported with ENL. WBC, neutrophils, monocytes, and thrombocytes showed a positive correlation with the incidence of ENL, but not lymphocytes. The NLR cut-off point for the diagnosis of ENL was 4.99 (sensitivity 86.4%, specificity 82.5%, accuracy 82.97), while that of PLR was 237.46 (sensitivity 63.6%, specificity 73.1%, accuracy 71.98%). LMR had poor sensitivity and specificity levels of 50% and 28.7%, with cut-off point of 2.28 and accuracy of 31.32%. These results suggest that NLR and PLR could be potential biomarkers for the diagnosis of ENL.
Keywords: neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, erythema nodosum leprosum, leprosy, tropical disease, infectious disease, neglected disease |
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Article PeerReviewed |
author |
Natalia Tanojo, Natalia Damayanti, Damayanti Budi Utomo, Budi Evy Ervianti, Evy Dwi Murtiastutik, Dwi Cita Rosita Sigit Prakoeswa, Cita Muhammad Yulianto Listiawan, Muhammad |
author_facet |
Natalia Tanojo, Natalia Damayanti, Damayanti Budi Utomo, Budi Evy Ervianti, Evy Dwi Murtiastutik, Dwi Cita Rosita Sigit Prakoeswa, Cita Muhammad Yulianto Listiawan, Muhammad |
author_sort |
Natalia Tanojo, Natalia |
title |
Diagnostic Value of Neutrophil-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Diagnosis of Erythema Nodosum Leprosum: A Retrospective Study |
title_short |
Diagnostic Value of Neutrophil-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Diagnosis of Erythema Nodosum Leprosum: A Retrospective Study |
title_full |
Diagnostic Value of Neutrophil-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Diagnosis of Erythema Nodosum Leprosum: A Retrospective Study |
title_fullStr |
Diagnostic Value of Neutrophil-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Diagnosis of Erythema Nodosum Leprosum: A Retrospective Study |
title_full_unstemmed |
Diagnostic Value of Neutrophil-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Diagnosis of Erythema Nodosum Leprosum: A Retrospective Study |
title_sort |
diagnostic value of neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio in the diagnosis of erythema nodosum leprosum: a retrospective study |
publisher |
Multidisciplinary Digital Publishing Institute (MDPI) |
url |
https://repository.unair.ac.id/125289/1/06.%20Artikel.pdf https://repository.unair.ac.id/125289/2/C-6%20Karil.pdf https://repository.unair.ac.id/125289/3/06.%20Tunitin.pdf https://repository.unair.ac.id/125289/7/06%20etik.pdf https://repository.unair.ac.id/125289/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8951533/ |
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