Evaluation of Systemic Immune-Inflammation Index and Systemic Inflammation Response Index in Children with Celiac Disease

Background: Celiac disease is an enteropathy characterized by intestinal inflammation and systemic immune activation. In recent years, there has been a rising focus on systemic inflammation markers obtained from complete blood count parameters, including the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammation Response Index (SIRI), as readily available biomarkers reflecting inflammatory status. Nevertheless, their clinical significance in pediatric celiac disease remains incompletely understood. This study aimed to compare SII and SIRI levels between children with newly diagnosed celiac disease and healthy controls and to assess their relationships with laboratory parameters.Methods: A retrospective case–control design was used, including pediatric patients with celiac disease and age-matched healthy controls. SII and SIRI values were calculated using routine complete blood count parameters. Laboratory markers, C-reactive protein (CRP), hemoglobin, ferritin, albumin were compared between groups.Results: SII (507.55 ± 438.39 vs 738.15 ± 934.84; p=0.039) and SIRI (0.88 ± 1.14 vs 1.23 ± 1.30; p=0.022) levels were significantly lower in patients with CD than in controls. Compared with control groups, the celiac disease group showed significantly lower hemoglobin, ferritin, and albumin levels; however, there was no evidence of a significant difference in CRP levels between the groups. These findings suggest that systemic inflammatory indices in pediatric celiac disease may behave differently from those observed in other systemic inflammatory disorders.Conclusion: Significantly lower SII and SIRI levels were observed in the newly diagnosed celiac disease group than in the control group. Collectively, these findings indicate that systemic inflammatory indices may not fully reflect localized intestinal inflammation in pediatric celiac disease and may be influenced by malabsorption-related hematological changes. Moreover, the clinical significance of these findings should be further investigated in prospective studies.