Skip to main content
Erschienen in: Clinical Rheumatology 4/2021

16.09.2020 | Original Article

Variation of red blood cell parameters in Behcet’s disease: association with disease severity and vascular involvement

verfasst von: Linlin Cheng, Liubing Li, Chenxi Liu, Songxin Yan, Haizhen Chen, Haolong Li, Fengchun Zhang, Hua Chen, Yongzhe Li

Erschienen in: Clinical Rheumatology | Ausgabe 4/2021

Einloggen, um Zugang zu erhalten

Abstract

Introduction/objectives

Behcet’s disease (BD) is a systemic and chronic inflammatory vasculitis with unknown etiology. Diagnosis is determined by evaluating several clinical criteria, but the lack of specific laboratory diagnostic markers makes the diagnosis of BD more difficult. Therefore, the aim of this study was to determine the changes in hematological parameters in BD patients to investigate their relationship with BD clinical features.

Method

A total of 48 BD patients and 96 healthy controls were included in this study. The severity of each BD patient was associated to a severity score according to the entire spectrum of disease manifestations. Several laboratory tests were assessed, and the difference in their results between BD patients and healthy controls was evaluated. Correlation analysis was performed to reveal the interaction of these parameters.

Results

C-reactive protein (CRP), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), neutrophil count, platelet count, and plateletcrit significantly increased in BD patients compared with healthy controls (P < 0.05). CRP was higher in patients with skin lesions, MCH and MCHC were lower in patients with vascular involvement, and the neutrophil count was higher in patients with skin lesions and genital ulcers. In addition, higher CRP and lower MCH and MCHC were associated with a severe condition. Besides, MCH and MCHC were negatively correlated with the platelet count, plateletcrit, and neutrophil count.

Conclusions

This study revealed that MCH and MCHC are valuable parameters for BD. Their levels help assess the disease severity and indicate the vascular involvement in BD.
Key Points
This is the first study reporting MCH and MCHC as important biomarkers in BD.
BD patients with vascular involvement and thrombosis potential have lower levels of MCH and MCHC.
MCH and MCHC are negatively correlated with platelet count, plateletcrit, and neutrophil count.
Lower MCH and MCHC are associated with a severe condition.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Yazici H, Seyahi E, Hatemi G, Yazici Y (2018) Behçet syndrome: a contemporary view. Nat Rev Rheumatol 14(2):107–119CrossRef Yazici H, Seyahi E, Hatemi G, Yazici Y (2018) Behçet syndrome: a contemporary view. Nat Rev Rheumatol 14(2):107–119CrossRef
2.
Zurück zum Zitat (1990) Criteria for diagnosis of Behcet’s disease. International study group for Behcet’s disease. Lancet 335(8697):1078–1080 (1990) Criteria for diagnosis of Behcet’s disease. International study group for Behcet’s disease. Lancet 335(8697):1078–1080
3.
Zurück zum Zitat Davatchi F, Assaad-Khalil S, Calamia KT et al (2014) The international criteria for Behçet’s disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol 28(3):338–347CrossRef Davatchi F, Assaad-Khalil S, Calamia KT et al (2014) The international criteria for Behçet’s disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol 28(3):338–347CrossRef
4.
Zurück zum Zitat Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD (2019) The platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases. Ann Lab Med 39(4):345–357CrossRef Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD (2019) The platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases. Ann Lab Med 39(4):345–357CrossRef
5.
Zurück zum Zitat Yolbas S, Yildirim A, Gozel N, Uz B, Koca SS (2016) Hematological indices may be useful in the diagnosis of systemic lupus erythematosus and in determining disease activity in Behcet’s disease. Med Princ Pract 25(6):510–516CrossRef Yolbas S, Yildirim A, Gozel N, Uz B, Koca SS (2016) Hematological indices may be useful in the diagnosis of systemic lupus erythematosus and in determining disease activity in Behcet’s disease. Med Princ Pract 25(6):510–516CrossRef
6.
Zurück zum Zitat Soydinc S, Turkbeyler IH, Pehlivan Y, Soylu G, Goktepe MF, Bilici M, Zengin O, Kisacik B, Onat AM (2014) Mean platelet volume seems to be a valuable marker in patients with systemic sclerosis. Inflammation. 37(1):100–106CrossRef Soydinc S, Turkbeyler IH, Pehlivan Y, Soylu G, Goktepe MF, Bilici M, Zengin O, Kisacik B, Onat AM (2014) Mean platelet volume seems to be a valuable marker in patients with systemic sclerosis. Inflammation. 37(1):100–106CrossRef
7.
Zurück zum Zitat Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H, Hu Z, Liang Y, Yang Z, Zhong R (2016) Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol 26(3):372–376CrossRef Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H, Hu Z, Liang Y, Yang Z, Zhong R (2016) Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol 26(3):372–376CrossRef
8.
Zurück zum Zitat Gheita TA, Sakr BR, Rabea RE, Abd ElHamid SM (2019) Value of hematological indices versus VEGF as biomarkers of activity in Behcet’s disease. Clin Rheumatol 38(8):2201–2210CrossRef Gheita TA, Sakr BR, Rabea RE, Abd ElHamid SM (2019) Value of hematological indices versus VEGF as biomarkers of activity in Behcet’s disease. Clin Rheumatol 38(8):2201–2210CrossRef
9.
Zurück zum Zitat Dong Z, Shi J, Dorhoi A, Zhang J, Soodeen-Lalloo AK, Tan WL, Yin H, Sha W, Li W, Zheng R, Liu Z, Yang H, Qin L, Wang J, Huang X, Wu C, Kaufmann SHE, Feng Y (2018) Hemostasis and lipoprotein indices signify exacerbated lung injury in TB with diabetes comorbidity. Chest. 153(5):1187–1200CrossRef Dong Z, Shi J, Dorhoi A, Zhang J, Soodeen-Lalloo AK, Tan WL, Yin H, Sha W, Li W, Zheng R, Liu Z, Yang H, Qin L, Wang J, Huang X, Wu C, Kaufmann SHE, Feng Y (2018) Hemostasis and lipoprotein indices signify exacerbated lung injury in TB with diabetes comorbidity. Chest. 153(5):1187–1200CrossRef
10.
Zurück zum Zitat Atas H, Canpolat F, Eskioglu F (2018) Evaluation of mean platelet volume in patients with Behcet’s disease as an indicator of vascular thrombosis. Arch Iran Med 21(6):234–239PubMed Atas H, Canpolat F, Eskioglu F (2018) Evaluation of mean platelet volume in patients with Behcet’s disease as an indicator of vascular thrombosis. Arch Iran Med 21(6):234–239PubMed
11.
Zurück zum Zitat Ataş H, Canpolat F, Eskioglu F (2018) Evaluation of mean platelet volume in patients with Behcet’s disease as an indicator of vascular thrombosis. Arch Iran Med 21(6):234–239PubMed Ataş H, Canpolat F, Eskioglu F (2018) Evaluation of mean platelet volume in patients with Behcet’s disease as an indicator of vascular thrombosis. Arch Iran Med 21(6):234–239PubMed
12.
Zurück zum Zitat Jiang Y, Zang M, Li S (2017) Serum PLR and LMR in Behcet’s disease: can they show the disease activity? Medicine (Baltimore) 96(21):e6981CrossRef Jiang Y, Zang M, Li S (2017) Serum PLR and LMR in Behcet’s disease: can they show the disease activity? Medicine (Baltimore) 96(21):e6981CrossRef
13.
Zurück zum Zitat Olumuyiwa-Akeredolu OO, Pretorius E (2015) Platelet and red blood cell interactions and their role in rheumatoid arthritis. Rheumatol Int 35(12):1955–1964CrossRef Olumuyiwa-Akeredolu OO, Pretorius E (2015) Platelet and red blood cell interactions and their role in rheumatoid arthritis. Rheumatol Int 35(12):1955–1964CrossRef
14.
Zurück zum Zitat Krause I, Mader R, Sulkes J, Paul M, Uziel Y, Adawi M, Weinberger A (2001) Behcet’s disease in Israel: the influence of ethnic origin on disease expression and severity. J Rheumatol 28(5):1033–1036PubMed Krause I, Mader R, Sulkes J, Paul M, Uziel Y, Adawi M, Weinberger A (2001) Behcet’s disease in Israel: the influence of ethnic origin on disease expression and severity. J Rheumatol 28(5):1033–1036PubMed
15.
Zurück zum Zitat Mumcu G, Ergun T, Inanc N, Fresko I, Atalay T, Hayran O, Direskeneli H (2004) Oral health is impaired in Behcet’s disease and is associated with disease severity. Rheumatology (Oxford) 43(8):1028–1033CrossRef Mumcu G, Ergun T, Inanc N, Fresko I, Atalay T, Hayran O, Direskeneli H (2004) Oral health is impaired in Behcet’s disease and is associated with disease severity. Rheumatology (Oxford) 43(8):1028–1033CrossRef
16.
Zurück zum Zitat Latger-Cannard V, Hoarau M, Salignac S, Baumgart D, Nurden P, Lecompte T (2012) Mean platelet volume: comparison of three analysers towards standardization of platelet morphological phenotype. Int J Lab Hematol 34(3):300–310CrossRef Latger-Cannard V, Hoarau M, Salignac S, Baumgart D, Nurden P, Lecompte T (2012) Mean platelet volume: comparison of three analysers towards standardization of platelet morphological phenotype. Int J Lab Hematol 34(3):300–310CrossRef
17.
Zurück zum Zitat Trowbridge EA, Reardon DM, Hutchinson D, Pickering C (1985) The routine measurement of platelet volume: a comparison of light-scattering and aperture-impedance technologies. Clin Phys Physiol Meas 6(3):221–238CrossRef Trowbridge EA, Reardon DM, Hutchinson D, Pickering C (1985) The routine measurement of platelet volume: a comparison of light-scattering and aperture-impedance technologies. Clin Phys Physiol Meas 6(3):221–238CrossRef
18.
Zurück zum Zitat Maugeri N, Manfredi AA (2015) Tissue factor expressed by neutrophils: another piece in the vascular inflammation puzzle. Semin Thromb Hemost 41(7):728–736CrossRef Maugeri N, Manfredi AA (2015) Tissue factor expressed by neutrophils: another piece in the vascular inflammation puzzle. Semin Thromb Hemost 41(7):728–736CrossRef
19.
Zurück zum Zitat Seyahi E (2016) Behçet’s disease: how to diagnose and treat vascular involvement. Best Pract Res Clin Rheumatol 30(2):279–295CrossRef Seyahi E (2016) Behçet’s disease: how to diagnose and treat vascular involvement. Best Pract Res Clin Rheumatol 30(2):279–295CrossRef
20.
Zurück zum Zitat Rezende SM, Lijfering WM, Rosendaal FR, Cannegieter SC (2014) Hematologic variables and venous thrombosis: red cell distribution width and blood monocyte count are associated with an increased risk. Haematologica. 99(1):194–200CrossRef Rezende SM, Lijfering WM, Rosendaal FR, Cannegieter SC (2014) Hematologic variables and venous thrombosis: red cell distribution width and blood monocyte count are associated with an increased risk. Haematologica. 99(1):194–200CrossRef
21.
Zurück zum Zitat Khorana AA, Kuderer NM, Culakova E, Lyman GH, Francis CW (2008) Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood. 111(10):4902–4907CrossRef Khorana AA, Kuderer NM, Culakova E, Lyman GH, Francis CW (2008) Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood. 111(10):4902–4907CrossRef
22.
Zurück zum Zitat Aksoy ŞN, Savaş E, Sucu M, Kisacik B, Kul S, Zengin O (2015) Association between red blood cell distribution width and disease activity in patients with Behçet’s disease. J Int Med Res 43(6):765–773CrossRef Aksoy ŞN, Savaş E, Sucu M, Kisacik B, Kul S, Zengin O (2015) Association between red blood cell distribution width and disease activity in patients with Behçet’s disease. J Int Med Res 43(6):765–773CrossRef
23.
Zurück zum Zitat Vayá A, Rivera L, Todolí J, Hernandez JL, Laiz B, Ricart JM (2014) Haematological, biochemical and inflammatory parameters in inactive Behçet’s disease. Its association with red blood cell distribution width. Clin Hemorheol Microcirc 56(4):319–324CrossRef Vayá A, Rivera L, Todolí J, Hernandez JL, Laiz B, Ricart JM (2014) Haematological, biochemical and inflammatory parameters in inactive Behçet’s disease. Its association with red blood cell distribution width. Clin Hemorheol Microcirc 56(4):319–324CrossRef
24.
Zurück zum Zitat Mohandas N, Clark MR, Jacobs MS, Shohet SB (1980) Analysis of factors regulating erythrocyte deformability. J Clin Invest 66(3):563–573CrossRef Mohandas N, Clark MR, Jacobs MS, Shohet SB (1980) Analysis of factors regulating erythrocyte deformability. J Clin Invest 66(3):563–573CrossRef
25.
Zurück zum Zitat Shiga T, Maeda N, Kon K (1990) Erythrocyte rheology. Crit Rev Oncol Hematol 10(1):9–48CrossRef Shiga T, Maeda N, Kon K (1990) Erythrocyte rheology. Crit Rev Oncol Hematol 10(1):9–48CrossRef
26.
Zurück zum Zitat Aarts PA, Heethaar RM, Sixma JJ (1984) Red blood cell deformability influences platelets--vessel wall interaction in flowing blood. Blood. 64(6):1228–1233CrossRef Aarts PA, Heethaar RM, Sixma JJ (1984) Red blood cell deformability influences platelets--vessel wall interaction in flowing blood. Blood. 64(6):1228–1233CrossRef
27.
Zurück zum Zitat Yedgar S, Koshkaryev A, Barshtein G (2002) The red blood cell in vascular occlusion. Pathophysiol Haemost Thromb 32(5-6):263–268CrossRef Yedgar S, Koshkaryev A, Barshtein G (2002) The red blood cell in vascular occlusion. Pathophysiol Haemost Thromb 32(5-6):263–268CrossRef
28.
Zurück zum Zitat Saadoun D, Wechsler B, Desseaux K, Huong DLT, Amoura Z, Resche-Rigon M, Cacoub P (2010) Mortality in Behçet’s disease. Arthritis Rheum 62(9):2806–2812CrossRef Saadoun D, Wechsler B, Desseaux K, Huong DLT, Amoura Z, Resche-Rigon M, Cacoub P (2010) Mortality in Behçet’s disease. Arthritis Rheum 62(9):2806–2812CrossRef
29.
Zurück zum Zitat Ye J-F, Chen Y, Cai J-F, Shen Y, Zou J, Guan J-L (2019) Incidence and risk factors for anemia among newly-diagnosed intestinal Behcet's disease patients. J Natl Med Assoc 111(4):407–412CrossRef Ye J-F, Chen Y, Cai J-F, Shen Y, Zou J, Guan J-L (2019) Incidence and risk factors for anemia among newly-diagnosed intestinal Behcet's disease patients. J Natl Med Assoc 111(4):407–412CrossRef
30.
Zurück zum Zitat «iÁek D, Kandi Ba, lhan N, Bakar Dertlio·lu S, Demir Bl (2007) Frequency of anemia of chronic disease in patients with Behcetís disease. TURKDERM - Turkish Archives of Dermatology and Venereology 41(4):121–124 «iÁek D, Kandi Ba, lhan N, Bakar Dertlio·lu S, Demir Bl (2007) Frequency of anemia of chronic disease in patients with Behcetís disease. TURKDERM - Turkish Archives of Dermatology and Venereology 41(4):121–124
31.
Zurück zum Zitat Daglı M, Yilmaz S, Sivrikaya A, Celik G (2012) The role of prohepcidin and hepcidin in anemia associated with Behçet’s disease. UHOD-Uluslar Hematol-Onkol De 22(2):94–98 Daglı M, Yilmaz S, Sivrikaya A, Celik G (2012) The role of prohepcidin and hepcidin in anemia associated with Behçet’s disease. UHOD-Uluslar Hematol-Onkol De 22(2):94–98
32.
Zurück zum Zitat Emmi G, Becatti M, Bettiol A, Hatemi G, Prisco D, Fiorillo C (2019) Behçet’s syndrome as a model of thrombo-inflammation: the role of neutrophils. Front Immunol 10:1085 Emmi G, Becatti M, Bettiol A, Hatemi G, Prisco D, Fiorillo C (2019) Behçet’s syndrome as a model of thrombo-inflammation: the role of neutrophils. Front Immunol 10:1085
33.
Zurück zum Zitat Hammad M, Shehata OZ, Abdel-Latif SM, El-Din AMM (2018) Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in Behcet’s disease: which and when to use? Clin Rheumatol 37(10):2811–2817CrossRef Hammad M, Shehata OZ, Abdel-Latif SM, El-Din AMM (2018) Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in Behcet’s disease: which and when to use? Clin Rheumatol 37(10):2811–2817CrossRef
34.
Zurück zum Zitat Maugeri N, Campana L, Gavina M, Covino C, de Metrio M, Panciroli C, Maiuri L, Maseri A, D'Angelo A, Bianchi ME, Rovere-Querini P, Manfredi AA (2014) Activated platelets present high mobility group box 1 to neutrophils, inducing autophagy and promoting the extrusion of neutrophil extracellular traps. J Thromb Haemost 12(12):2074–2088CrossRef Maugeri N, Campana L, Gavina M, Covino C, de Metrio M, Panciroli C, Maiuri L, Maseri A, D'Angelo A, Bianchi ME, Rovere-Querini P, Manfredi AA (2014) Activated platelets present high mobility group box 1 to neutrophils, inducing autophagy and promoting the extrusion of neutrophil extracellular traps. J Thromb Haemost 12(12):2074–2088CrossRef
35.
Zurück zum Zitat Acikgoz N, Karincaoglu Y, Ermis N, Yagmur J, Atas H, Kurtoglu E, Cansel M, Barutcu I, Pekdemir H, &Ouml;zdemir R (2010) Increased mean platelet volume in Behcet’s disease with thrombotic tendency. Tohoku J Exp Med 221(2):119–123CrossRef Acikgoz N, Karincaoglu Y, Ermis N, Yagmur J, Atas H, Kurtoglu E, Cansel M, Barutcu I, Pekdemir H, &Ouml;zdemir R (2010) Increased mean platelet volume in Behcet’s disease with thrombotic tendency. Tohoku J Exp Med 221(2):119–123CrossRef
36.
Zurück zum Zitat Jagroop IA, Tsiara S, Mikhailidis DP (2003) Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets. 14(5):335–336CrossRef Jagroop IA, Tsiara S, Mikhailidis DP (2003) Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets. 14(5):335–336CrossRef
37.
Zurück zum Zitat Tang J, Gao X, Zhi M, Zhou HM, Zhang M, Chen HW, Yang QF, Liang ZZ (2015) Plateletcrit: a sensitive biomarker for evaluating disease activity in Crohn’s disease with low hs-CRP. J Dig Dis 16(3):118–124CrossRef Tang J, Gao X, Zhi M, Zhou HM, Zhang M, Chen HW, Yang QF, Liang ZZ (2015) Plateletcrit: a sensitive biomarker for evaluating disease activity in Crohn’s disease with low hs-CRP. J Dig Dis 16(3):118–124CrossRef
38.
Zurück zum Zitat Demir Pektas S, Alatas E, Yilmaz N (2016) Plateletcrit is potential biomarker for presence and severity of psoriasis vulgaris. Acta Medica Mediterr 32:1785 Demir Pektas S, Alatas E, Yilmaz N (2016) Plateletcrit is potential biomarker for presence and severity of psoriasis vulgaris. Acta Medica Mediterr 32:1785
Metadaten
Titel
Variation of red blood cell parameters in Behcet’s disease: association with disease severity and vascular involvement
verfasst von
Linlin Cheng
Liubing Li
Chenxi Liu
Songxin Yan
Haizhen Chen
Haolong Li
Fengchun Zhang
Hua Chen
Yongzhe Li
Publikationsdatum
16.09.2020
Verlag
Springer International Publishing
Erschienen in
Clinical Rheumatology / Ausgabe 4/2021
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-020-05397-6

Weitere Artikel der Ausgabe 4/2021

Clinical Rheumatology 4/2021 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.