Evaluation of New Inflammatory Parameters in Patients With Chronic Spontaneous Urticaria: A New Predictor of Refractoriness to Antihistamine Treatment

Abstract

Aim: Antihistamines is used as the first-line treatment in chronic spontaneous urticaria (CSU). We investigated whether complet blood count parameters might be used as a response factor in patients under antihistamine treatment for CSU. We also compared the NLR (neutrophil lymphocyte ratio), PLR (platelet lymphocyte ratio, MPV (mean platelet volume) and RDW (erythrocyte distribution width) levels of CSU patients with healthy controls.Materials and Methods: This study was conducted on a total of 150 cases, a hundred of which had CSU and fifty healthy control group.Results: NLR and RDW were significantly higher and MPV was significantly lower in the CSU group. NLR and PLR levels were found significantly lower in patients who responded to antihistamine treatment within 4 weeks. The ROC analysis showed that NLR predicted responders with a sensitivity of 92% and with a specificity of 84%, using a cut-off value of 1,98 (p<.001). The multivariate regression analysis showed that only NLR was found as the predictor of responders.Conclusion: NLR may be considered as a simple and cost-effective tool to determine which patients can respond to antihistamines. It may be a guide for non-responsive patients to switch to other treatment options in the early period.

Keywords

• urticaria
• neutrophil to lymphocyte ratio
• antihistamines