Role of neutrophils granularity intensity and reactive lymphocytes in assessing changes in lupus activity

Abstract Background Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by fluctuating activity. The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI‐2K) is commonly used to assess disease activity, but its complexity and limited diagnostic availability pose challenges. Alternative biomarkers, such as extended inflammatory parameters (EIP), can be measured using hematology analyzers. This study examined the correlation between changes in SLEDAI‐2K scores and EIP values in SLE patients. Methods A retrospective cohort study was conducted using secondary data from the Hasan Sadikin Lupus Registry. SLEDAI‐2K scores and EIP values were recorded at baseline and during follow‐up (1–6 months). EIP included neutrophils granularity intensity (Neut‐GI), neutrophils reactivity intensity, reactive lymphocytes (Re‐Lymp), and antibody synthesizing lymphocytes. Correlations were analyzed using Rank Spearman analysis. Results Among 53 patients (median age 32.2 [Q1–Q3: 27.9–43.8] years), Rank Spearman analysis revealed a moderate negative correlation between Neut‐GI changes and SLEDAI‐2K scores ( r = −0.4, p = 0.002). A weak negative correlation was found between Re‐Lymp changes and SLEDAI‐2K scores ( r = −0.3, p = 0.016), while neutrophils reactivity intensity and antibody synthesizing lymphocytes showed no significant correlation. Conclusions Changes in Neut‐GI and Re‐Lymp correlated with SLEDAI‐2K score fluctuations, suggesting that decreasing Neut‐GI and Re‐Lymp levels accompany increasing disease activity. These parameters may serve as simpler, cost‐effective alternatives for monitoring SLE activity.