“Platelet/lymphocyte” and “neutrophil/lymphocyte” ratios in children with rheumatic heart involvement

The aim of this study was to determine how platelet/lymphocyte (PLR) and neutrophil/lymphocyte (NLR) ratios change in children diagnosed with Acute Rheumatic Fever (ARF) who are followed up in our clinic. Additionally, we aimed to investigate whether these values are useful in predicting the long-term development of chronic rheumatic heart disease in these patients. A total of 27 patients diagnosed with ARF with who were referred to the Pediatric Cardiology outpatient clinic between January 2019 and August 2023 were included in this study. The retrospective records of the patients were reviewed. Twenty-seven ARF patients (14 females, 13 males; mean age 10.3 ± 2.3 years) and 27 controls (12 females, 15 males; mean age 8.9 ± 3.2 years) were evaluated. Carditis was present in 85.2% of ARF cases at diagnosis, with mitral regurgitation being the most common lesion (29.6%). Leukocyte count, PLR, and NLR were significantly elevated in the ARF group compared to controls (P = .04, .001, .014), while lymphocyte counts were reduced (P = .001). Severe valve involvement was associated with lower PLR (P = .022), but not with NLR (P = .12). Although ARF incidence is declining in developed countries, it remains a significant health issue in developing regions. Consistent with global data, carditis - especially mitral regurgitation - was the predominant finding in our cohort. NLR and PLR have emerged as stable markers for cardiovascular risk, unaffected by exercise or dehydration. Our results demonstrate increased leukocyte counts, NLR, and PLR alongside decreased lymphocytes in ARF patients. Importantly, lower PLR correlated with more severe valve disease, unlike NLR. These findings highlight PLR's potential as a prognostic biomarker, meriting further research in larger populations.