Predictive Value of Inflammation Markers in Brucellosis

Abstract

Background: It is important to identify new biomarkers for early detection of complications and treatment success in patients with brucellosis.

Methods: A total of 187 brucellosis patients in the Department of Infectious Diseases of Izmir Katip Celebi University Ataturk Training and Research Hospital were evaluated retrospectively from January 2010 to January 2016.Complications of brucellosis were hematologic, osteoarticular, genitourinary, neurologic, cardiovascular, gastrointestinal and ocular involvement. Specific organ involvement was defined as the presence of infection signs in any specific anatomic site except hematologic involvement. Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte-ratio (PLR) were evaluated statistically to predict complications and specific organ involvement of brucellosis.

Results: Complications occurred in 125 patients. We found that PLR and erythrocyte sedimentation rate (ESR) were higher in complicated patients (P = 0.007, P < 0.001). The area under curve (AUC) for PLR was 0.622 (95% confidence interval [CI], 0.538- 0.707) with a cutoff value of >119.6 in predicting complications in brucellosis. LMR and NLR were not significant in terms of predicting complications in brucellosis. We also evaluated only specific organ involvement as a complication due to frequent occurrence of hematologic abnormalities in brucellosis. ESR, mean platelet volume (MPV), NLR, PLR and LMR were significantly different in patients with specific organ involvement (P = 0.001, P = 0.011, P = 0.001, P = 0.013 and P = 0.040). The AUC values for NLR and LMR were 0.649 (95% CI 0.570-0.728) and 0.589 (95% Cl 0.507-0.671), respectively.

Conclusion: These biomarkers are cost-effective, simple and broadly available parameters for predicting complications and specific organ involvement of brucellosis.

Keywords: Brucellosis; Diagnosis; Inflammatory markers.