Monocyte, Lymphocyte and Neutrophil Ratios - Easy-to-Use Biomarkers for the Diagnosis of Pediatric Tuberculosis.

Autor:	Kissling M; From the Department of Clinical Research, Mycobacterial and Migrant Health Research Group, University of Basel, Switzerland., Fritschi N; From the Department of Clinical Research, Mycobacterial and Migrant Health Research Group, University of Basel, Switzerland.; University Children's Hospital Basel, Switzerland., Baumann P; Department of Intensive Care Medicine and Neonatology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.; Infectious Disease and Vaccinology Unit, University Children's Hospital Basel, University of Basel, Basel, Switzerland., Buettcher M; Paediatric Infectious Diseases Unit, Children's Hospital, Lucerne Cantonal Hospital, Lucerne Switzerland.; Paediatric Pharmacology and Pharmacometrics Research Center, University Children's Hospital Basel, University of Basel, Basel, Switzerland., Bonhoeffer J; University Children's Hospital Basel, Switzerland., Naranbhai V; Massachusetts General Hospital Cancer Center, Massachusetts General Hospital, Boston.; Dana-Farber Cancer Institute, Boston, Massachusetts.; Center for the AIDS Programme of Research in South Africa, Durban, South Africa., Ritz N; From the Department of Clinical Research, Mycobacterial and Migrant Health Research Group, University of Basel, Switzerland.; University Children's Hospital Basel, Switzerland.; Paediatric Infectious Diseases Unit, Children's Hospital, Lucerne Cantonal Hospital, Lucerne Switzerland.; Department of Pediatrics, The Royal Children's Hospital Melbourne, The University of Melbourne, Australia.
Jazyk:	angličtina
Zdroj:	The Pediatric infectious disease journal [Pediatr Infect Dis J] 2023 Jun 01; Vol. 42 (6), pp. 520-527. Date of Electronic Publication: 2023 Mar 22.
DOI:	10.1097/INF.0000000000003901
Abstrakt:	Background: The neutrophil-to-lymphocyte-ratio (NLR), neutrophil-to-monocyte-plus-lymphocyte-ratio (NMLR) and monocyte-to-lymphocyte-ratio (MLR) may have diagnostic potential for tuberculosis (TB). Methods: Data of two prospective multicenter studies in Switzerland were used, which included children <18 years with TB exposure, infection or disease or with febrile non-TB lower-respiratory-tract infection (nTB-LRTI). Results: Of the 389 children included 25 (6.4%) had TB disease, 12 (3.1%) TB infection, 28 (7.2%) were healthy TB exposed and 324 (83.3%) nTB-LRTI. Median (IQR) NLR was highest with 2.0 (1.2, 2.2) in children with TB disease compared to TB exposed [0.8 (0.6, 1.3); P = 0.002] and nTB-LRTI [0.3 (0.1, 1.0); P < 0.001]. Median (IQR) NMLR was highest with 1.4 (1.2, 1.7) in children with TB disease compared to healthy exposed [0.7 (0.6, 1.1); P = 0.003] and children with nTB-LRTI [0.2 (0.1, 0.6); P < 0.001). Receiver operating characteristic curves to detect TB disease compared to nTB-LRTI for NLR and NMLR had an area under the curve of 0.82 and 0.86, the sensitivity of 88% and 88%, and specificity of 71% and 76%, respectively. Conclusion: NLR and NMLR are promising, easy-to-obtain diagnostic biomarkers to differentiate children with TB disease from other lower respiratory tract infections. These results require validation in a larger study and in settings with high and low TB endemicity. Competing Interests: The authors have no conflicts of interest to disclose. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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