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202 The role or neutrophil-lymphocyte ratio(NLR), and other biomarkers (C – reactive protein CRP, count of monocites and lymphocites) differentiating lupic activity (FLARE) from infection
  1. J Aponte1,
  2. J Carrizosa2,
  3. A Sanchez3,
  4. M Ospina4,
  5. A Cartagena1,
  6. C Zapata1 and
  7. R Cervera5
  1. 1Hospital Universitario de la Samaritana – Universidad de la Sabana, Medicina Interna, Bogota, Colombia
  2. 2Universidad del Rosario, Especialista en Cuidado Critico, Bogota, Colombia
  3. 3Hospital Universitario de la Samaritana, Cuidado intensivo – Medicina interna, Bogota, Colombia
  4. 4Hospital Universitario de la Samaritana, Cuidado intensivo, Bogota, Colombia
  5. 5Hospital Clínic de Barcelona, Médico Consultor Senior y Jefe del Servicio de Enfermedades Autoinmunes del Hospital Clínic de Barcelona, Barcelona, Spain

Abstract

Background and aims Systemic lupus erythematosus (SLE) is one of the most prevalent connective tissue diseases, it is commonly associated with an infection being so difficult to differentiate if the systemic inflammatory response is secondary to a bacterial infection, or to the underlying autoimmune activity (FLARE). The aim of this study was to determine the utility of C reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), count of monocites, and lymphocites in patients with positive cultures and flare.

Methods A retrospective study was conducted, 58 patients with SLE were admitted to the intensive care unit (ICU) at a University Hospital in Bogotá, Colombia, between 2008 and 2017. Bivariate analysis was performed to identify if there was a possible association with positive cultures in patients with (flare)

Results In patients with lupic activity (SLEDAI:8–12) NRL was consistently associated with flare, NRL >10 (OR: 17; 95% CI 2.13 to 136.8, p=0.007), count of lymphocites<500 cells/mm3 was associated with lupic activity (OR: 6.33; 95% CI 1.30 to 30.7, p=0.022), in severe lupic activiy de CRP did not show association; one variable consistently associated with positive cultures in the logistic regression model with adequiate prediction parameters: absolute count of monocite >400 cell/mm3 (OR: 3.51; 95% CI 1.13 to 10.88, p=0.029), the others variables NRL, CRP showed no association with positive cultures.

Conclusions The (NRL) >10 Could help to differentiate LES activity from infection, leading to early antibiotic therapy, or immunotherapy to improve survival rates. These results should be evaluated prospectively in future studies.

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