Evaluation of Neutrophil Lymphocytic Ratio, Platelet Lymphocytic Ratio and Red Cell Distribution Width in Patients with Rheumatoid Arthritis..

Background: Rheumatoid arthritis (RA) is a chronic auto-immune disease. Along with extra-articular symptoms and sys-temic consequences. It causes progressive symmetrical inflam-mation of the joints resulting in cartilage damage, bone erosion and articular disability. Aim of Study: To study the Neutrophil lymphocytic ratio (NLR), platelet lymphocytic ratio (PLR) and red cell distribu-tion width (RDW) levels in patients with RA, and the correla-tion between them and disease activity using DAS-28ESR. Patients and Methods: Sixty-five RA patients were com-pared to 65 age and sex matched healthy volunteers as a control group. Disease activity was determined using DAS-28ESR. NLR and PLR were calculated and recorded with RDW level for all participants. They were analyzed and correlated to dis-ease activity. Results: NLR was statistically significantly higher in all RA patients and active RA patients compared to control group. PLR and RDW displayed statistically significantly higher values in all RA patients, active and inactive RA patients in comparison to control group. NLR had significant positive correlation with DAS-28ESR, VAS(0-100), TJC, and PtGA. PLR and RDW did not show any significant correlation with any of the clinical and laboratory parameters in RA patients, except for RDW which showed significant positive correlation with RF. NLR, PLR and RDW with AUC 0.677, 0.681 and 0.935 respectively could differentiate between RA patients and healthy controls. NLR, PLR and RDW with AUC 0.723, 0.702 and 0.933 respectively could differentiate between active RA patients and control indi-viduals. PLR and RDW with AUC 0.649 and 0.939 respectively could separate inactive RA patients from healthy individuals. Conclusions: NLR, PLR and RDW are present at higher levels in RA patients compared to normal population. NLR correlates with RA disease activity measured by DAS-28ESR. NLR correlates with RA disease activity.