title: Low density neutrophils in patients with juvenile idiopathic arthritis.
abstract: OBJECTIVE
  (1) To study the correlation among conventional clinical and laboratory parameters and the relation between the number of lymphocytes and neutrophils (L/N) in cell suspensions from peripheral blood of patients with juvenile idiopathic arthritis (JIA). (2) To evaluate the L/N relation of JIA patients after an 8 year follow-up period.
  
  
  METHODS
  Fifty-one JIA patients (25 female, disease course: 19 systemic, 15 polyarticular, 17 pauciarticular) were enrolled in the study. To measure the L/N relation, we used Boyum's method: The leucocyte separation was done by centrifugation of peripheral blood on Ficoll-Hypaque (FH) gradient, and the number of lymphocytes, monocytes, and neutrophils in 500 cells was determined. The following clinical and laboratory parameters were evaluated: disease activity, number of active and limited joints, functional capacity, erythrocyte sedimentation rate (ESR), and C reactive protein (CRP). Twenty-four healthy children were used as controls. We also studied 13/51 patients from our Pediatric Rheumatology Unit who had been evaluated by the same method 8 years before.
  
  
  RESULTS
  We observed the lowest L/N relation in patients with active disease, especially those with polyarticular course. A statistical correlation was also observed with the acute-phase reactants (ESR and CRP, p < 0.05). The majority of patients who had presented a low L/N relation at the first evaluation (8 years before) had a worse outcome.
  
  
  CONCLUSIONS
  The measure of L/N relation from peripheral blood could be used as an auxiliary tool in the assessment of the activity and outcome of JIA patients, especially at disease onset.
authors.affiliation: Pediatric Rheumatology Unit, Department of Pediatrics, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil.
authors.forename: M V
authors.initials: MV
authors.lastname: Ronchezel
authors.forename: E T
authors.initials: ET
authors.lastname: Hacbarth
authors.forename: C A
authors.initials: CA
authors.lastname: Len
authors.forename: M T
authors.initials: MT
authors.lastname: Terreri
authors.forename: L E
authors.initials: LE
authors.lastname: Andrade
authors.forename: M O
authors.initials: MO
authors.lastname: Hilário
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000097:blood* / Q000175:diagnosis; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002469:Cell Separation; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D009000:Monocytes / Q000166:cytology; D009504:Neutrophils / Q000166:cytology*
chemical_list: D002097:C-Reactive Protein