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Cited by 607Inflammatory Biomarkers in Disease PrognosisSystemic Lupus Erythematosus ResearchRheumatoid Arthritis Research and Therapies

The Platelet-to-Lymphocyte Ratio as an Inflammatory Marker in Rheumatic Diseases

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Gasparyan, Armen Yuri, Ayvazyan, Lilit, Mukanova, Ulzhan, Yessirkepov, Marlen, Kitas, George D.·2019·Annals of Laboratory Medicine
DOI 10.3343/alm.2019.39.4.345PMC PMC6400713
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Abstract

The platelet-to-lymphocyte ratio (PLR) has emerged as an informative marker revealing shifts in platelet and lymphocyte counts due to acute inflammatory and prothrombotic states. PLR has been extensively examined in neoplastic diseases accompanied by immune suppression and thrombosis, which can be predicted by combined blood cell counts and their ratios. Several large observational studies have demonstrated the value of shifts in PLR in evaluating the severity of systemic inflammation and predicting infections and other comorbidities, in inflammatory rheumatic diseases. The value of PLR as an inflammatory marker increases when its fluctuations are interpreted along with other complementary hematologic indices, particularly the neutrophil-to-lymphocyte ratio (NLR), which provides additional information about the disease activity, presence of neutrophilic inflammation, infectious complications, and severe organ damage in systemic lupus erythematosus. PLR and NLR have high predictive value in rheumatic diseases with predominantly neutrophilic inflammation (e.g., Behçet disease and familial Mediterranean fever). High PLR, along with elevated platelet count, is potentially useful in diagnosing some systemic vasculitides, particularly giant-cell arteritis. A few longitudinal studies on rheumatic diseases have demonstrated a decrease in PLR in response to anti-inflammatory therapies. The main limitations of PLR studies are preanalytical faults, inadequate standardization of laboratory measurements, and inappropriate subject selection. Nonetheless, accumulating evidence suggests that PLR can provide valuable information to clinicians who encounter multisystem manifestations of rheumatic diseases, which are reflected in shifts in platelet, lymphocyte, neutrophil, or monocyte counts. Interpretation of PLR combined with complementary hematologic indices is advisable to more accurately diagnose inflammatory rheumatic diseases and predict related comorbidities.

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  • ICRs have been repeatedly proposed as solid prognostic markers for various additional conditions including low-grade inflammation, rheumatic diseases, sepsis, myocarditis, thrombosis, ischemic and cardiovascular events, autoimmune and systemic diseases, cancer incidence, progression, response and outcome, COVID-19 severity and prognosis, critical illness, and overall mortality.

    “Since then, IRCs have been repeatedly proposed as solid prognostic markers for various additional conditions including low-grade inflammation, rheumatic diseases, sepsis, myocarditis, thrombosis, ischemic and cardiovascular events, autoimmune and systemic diseases, cancer incidence, progression, response and outcome, COVID-19 severity and prognosis, critical illness, and overall mortality [26,27,2”

    From Immune Cell Ratios Are Higher in Bipolar Affective than Unipolar Depressive Disorder and Modulated by Mood Episode: A Retrospective, Cross-Sectional Study (2023) · cites this paper as [34]

    The Concluding Remarks describe platelet-to-lymphocyte ratio (PLR) as a potentially useful marker in rheumatic, inflammatory, prothrombotic, and neoplastic diseases. The section on neoplastic, prothrombotic, and metabolic diseases also reports associations with cancer survival and cardiovascular mortality. But the paper calls PLR an emerging marker and notes important uncertainties; it does not support calling inflammatory cell ratios solid prognostic markers across the entire list, including COVID-19 and myocarditis. Page numbers are unavailable in our copy. (LLM, conf=0.88)

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Authors
Gasparyan, A. Y., Ayvazyan, L., Mukanova, U., Yessirkepov, M., & Kitas, G. D.
Affiliations
  • Russells Hall Hospital (GB)
  • Yerevan State Medical University (AM)
  • South Kazakhstan Medical Academy (KZ)
Corresponding author
Gasparyan, Armen Yuri
ORCID
Venue
Annals of Laboratory Medicine
Publisher
Annals of Laboratory Medicine
Published
2019-07-01
Volume
39
Issue
4
Pages
345-357
ISSN
  • 2234-3806 (ISSN-L)
  • 2234-3814
DOI
10.3343/alm.2019.39.4.345
PMC
PMC6400713
OpenAlex
W2917958408
Cited by
607
References
106
Citations by year
2026: 69 · 2025: 101 · 2024: 105 · 2023: 95 · 2022: 95 · 2021: 79 · 2020: 47 · 2019: 13 · 2017: 1
FWCI
5.58
Type
journal article
Language
en
Open access
Licence
Locations
  • Annals of Laboratory Medicine (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
  • Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
  • Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
Keywords
platelet-to-lymphocyte ratio, inflammatory markers, rheumatic diseases, systemic lupus erythematosus, neutrophil-to-lymphocyte ratio, Behçet's disease, familial Mediterranean fever, giant cell arteritis, vasculitis, neutrophilic inflammation, systemic inflammation, infection prediction
MeSH terms
Anti-Inflammatory Agents, Blood Platelets, Humans, Lymphocytes, Neoplasms, Rheumatic Diseases, Giant Cell Arteritis, Biomarkers

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