Evaluation of Hematological Parameters as Activity Markers in Systemic Lupus Erythematosus

BACKGROUND: Systemic lupus erythematosus (SLE) is a complex multifaceted auto-immune disorder. Tracking SLE activity is essential in management. In recent years, hematological indices have gained attention as novel indicators of SLE activity. These markers are often attractive because of their accessibility, affordability, and ease of use. Assessing their predictive value and clinical application may provide valuable insights to guide clinical decision-making in management. OBJECTIVE: The objective of the study was to evaluate the potential role of hematological indicators as mean platelet volume (MPV), red cell distribution width (RDW), platelet to lymphocyte ratio (PLR), and neutrophil to lymphocyte ratio (NLR), as activity markers in SLE. PATIENTS AND METHODS: One hundred two SLE one patients were included in this cross-sectional study. Erythrocyte sedimentation rate, complete blood count (CBC) and urinalysis, C-reactive protein, anti-dsDNA antibodies, and C3 were done. Disease activity was assessed using Safety of Estrogens in Lupus Erythematosus National Assessment-SLE Disease Activity Index (SLEDAI) according to which patients were divided into 3 groups no flare, mild to moderate, and severe disease flare. RESULTS: CBC-derived RDW, NLR, and PLR had strong positive correlations with SLE activity, measured by SLEDAI. Patients with active SLE showed higher values than those in remission. In addition, those with severe flare showed much higher levels than low-to-moderate disease activity. No significant difference in MPV levels among the three groups, nor did MPV exhibit a significant connection with SLEDAI. CONCLUSION: Hematological indices as NLR, PLR, and RDW effectively correlate with the activity status of SLE patients expressed as SLEDAI score, being higher in those with severe flare than mild to moderate flare. However, these markers alone are not strong discriminators; they are more useful as part of a combined model and can be used as supportive adjuncts.