Eosinophils to Basophils Rate, Mean Platelet Volume, and Neutrophils to Lymphocyte Rate for the Diagnosis of Systemic Amyloidosis

Methods: CBC, performed by an automated hematology analyzer, included hemoglobin

hematocrit, erythrocytes, MCV, MCH, MCHC, platelets, and white blood cell counts and

differentials (neutrophils, lymphocytes, monocytes, eosinophils, and basophils), as well as red

blood cell distribution width (RDW) and mean platelet volume (MPV). Other indicators were

indirectly calculated (by dividing the numerator by the denominator) based on the values of CBC

and included neutrophils to lymphocyte rate (NLR), monocytes to lymphocyte rate (MLR)

platelets to leukocyte rate (PLR), leukocytes to eosinophil rate (LER), and leukocytes to basophil

rate (LBR). Among them, NLR, MLR, and PLR have been linked to various inflammatory

conditions, but their role in SA diagnosis is unknown. CBC values obtained at diagnosis from a

set of 128 Vietnamese patients with SA (mean age 43, 67% female) treated at Hanoi Medical

University Hospital were compared with those derived from 596 age-matched healthy controls.

Results: Among the values directly obtained from CBC, only neutrophil counts and MPV were

statistically significant between the two groups, with higher neutrophil counts (4,200 vs. 3,700, p

= 0.02) and lower MPV (7.41 vs. 8.35, p = 0.0002) observed in SA patients compared with

controls. The analysis of other indicators showed significantly higher NLR (2.3 vs. 1.8, p = 0.04)

and EBR (4.42 vs. 5.64; p = 0.03) in SA patients compared with controls. No differences in MLR

and PLR were observed between SA patients and controls. In multivariate analysis, a higher

NLR (p = 0.05), lower MPV (p = 0.001), and higher EBR (p = 0.02) remained associated with

the diagnosis of SA.

Conclusions: This study substantiates the relevance of a decreased MPV as well as an increased

NLR and EBR in patients with SA. CBC is a rapid and low-cost test, and NLR and EBR are

easily calculated; thus, these indexes could help clinicians in the diagnosis of SA.