Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
The Predictive Value of Complete Blood Count Parameters in the Clinical Course of Acute Bronchiolitis: A Descriptive Study
Tam Kan Sayımı Parametrelerinin Akut Bronşiolitin Klinik Gidişatını Öngörmedeki Değeri: Tanımlayıcı Bir Araştırma
Mustafa Orhan DUYARa , Binnaz ÇELİKa
aKayseri City Hospital, Clinic of Pediatrics, Kayseri, Türkiye
Turkiye Klinikleri J Pediatr. 2025;34(2):39-46
doi: 10.5336/pediatr.2025-110504
Article Language: EN
Full Text
ABSTRACT
 Objective: Bronchiolitis is an inflammation of the bronchioles, commonly caused by viral pathogens, and is characterized by respiratory distress in children under the age of two. Early identification of disease severity is critical to initiate timely treatment and prevent clinical deterioration. This study aimed to investigate whether neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (TLR), mean platelet volume (MPV), and platelet mass index (PMI)-parameters derived from complete blood count-could serve as early biomarkers for diagnosis and clinical severity of the disease. Material and Methods: Patients were divided into three groups based on disease severity: outpatients (mild bronchiolitis), hospitalized patients (moderate bronchiolitis), and patients admitted to the pediatric intensive care unit (severe bronchiolitis). Age-matched healthy children with complete blood counts obtained during the same period were included as controls. Differences in CBC parameters (NLR, TLR, MPV, and PMI) at admission were compared among the groups. Results: NLR and TLR values were significantly higher in bronchiolitis patients compared to healthy controls (p<0.001). Furthermore, these values were significantly elevated in the severe bronchiolitis group compared to the mild and moderate groups (p<0.001). A statistically significant positive correlation was found between bronchiolitis severity and NLR (rho=0.460; p<0.001) and TLR (rho=0.349; p<0.001). MPV was significantly higher in healthy controls than in patients (p<0.001), while PMI showed no significant difference among the groups. Conclusion: This study demonstrates that complete blood count parameters, particularly NLR and TLR, may serve as early biomarkers to predict disease severity in patients with acute bronchiolitis.

Keywords: Bronchiolitis; complete blood count; lymphocyte count; neutrophil count; platelet count
ÖZET
 Amaç: Bronşiyolit, genellikle viral patojenlerin neden olduğu, 2 yaşın altındaki çocuklarda solunum sıkıntısı kliniği ile karakterize bir bronşiyol iltihabıdır. Hastaların klinik ciddiyetinin erken tespiti, tedaviye erken başlanarak ağır kliniğin önlenmesinde önemlidir. Bu çalışmanın amacı, tam kan sayımı ile değerlendirilebilen nötrofil/lenfosit oranı [neutrophil/ lymphocyte ratio (NLR)], trombosit/lenfosit [platelet/lymphocyte ratio (TLR)] oranı, ortalama trombosit hacmi [mean platelet volume (MPV)] ve trombosit kitle indeksi [platelet mass index (PMI)] parametrelerinin hastalığın tanısı ve klinik şiddeti için erken bir biyobelirteç olup olamayacağını göstermektir. Gereç ve Yöntemler: Hasta grubu, pediatri polikliniklerine başvuran ve ayaktan takip edilen hastalar (hafif bronşiyolit), pediatri servisine yatırılan hastalar (orta bronşiyolit) ve pediatrik yoğun bakım ünitesine yatırılan hastalar (ağır bronşiyolit) olmak üzere 3 gruba ayrıldı. Aynı zaman aralığında tam kan sayımı alınan sağlıklı çocuklar kontrol grubu olarak dâhil edildi. Başvuru sırasında elde edilen tam kan sayımı parametrelerindeki (NLR, TLR, MPV ve PMI) değişiklikler gruplar arasında değerlendirildi. Bulgular: Çalışmamızda bronşiyolitli bebeklerin NLR ve TLR değerleri sağlıklı kontrollere göre anlamlı olarak yüksektir (p<0,001). Aynı zamanda, NLR ve TLR değerleri ağır bronşiyolit hasta grubunda diğer bronşiyolit gruplarına göre anlamlı olarak daha yüksektir (p<0,001). Bronşiyolit şiddeti ile NLR ve TLR düzeyleri arasında istatistiksel olarak anlamlı pozitif korelasyon vardır (rho=0,460; p<0,001, rho=0,349; p<0,001). MPV değeri sağlıklı kontrol grubunda hasta grubuna göre anlamlı olarak yüksek bulunurken (p<0,001), PMI parametresi gruplar arasında anlamlı bir farklılık göstermedi. Sonuç: Bu çalışma, tam kan sayımı parametrelerinin, özellikle NLR ve TLR'nin, akut bronşiyolitli hastalarda hastalığın prognozunu tahmin etmek için erken biyobelirteç olarak kullanılabileceğini göstermiştir.

Anahtar Kelimeler: Bronşiyolit; tam kan sayımı; lenfosit sayımı; nötrofil sayımı; trombosit sayımı
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