title: Diagnostic role of inflammatory markers in pediatric Brucella arthritis.
abstract: BACKGROUND
  As a multisystem infectious disease, there is an inflammation, which causes increase in acute phase reactants in brucellosis. The mean platelet volume (MPV), platelet distribution width (PDW), red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been identified as markers of inflammation. The present study aimed to evaluate diagnostic values of these biomarkers in brucella arthritis (BA).
  
  
  METHODS
  The study included 64 children with BA and 66 healthy control subjects. Demographic features, joint involvement, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and hematological variables were retrospectively recorded. In addition, results of synovial fluid and serum tube agglutination test for brucella together with treatment regimens were recorded.
  
  
  RESULTS
  The mean age of the patients (53.1 % male) was 92.3 ± 41.2 months. The most commonly affected joint was ankle (53.1 %). Synovial fluid puncture-brucella agglutination test was positive in 22 (34.3 %) patients. Puncture culture was positive in 9 patients. Most of the patients (57.8 %) were treated with a combination of rifampicin plus sulfamethoxazole/trimethoprim and gentamicin. Significantly higher mean PDW, RDW, MPV, NLR and PLR values were found in children with BA compared to control subjects (p < 0.05). A positive correlation was found between MPV and NLR values (R (2) = 0.192, p < 0.001).
  
  
  CONCLUSIONS
  Our findings indicated that NLR and PLR are indirect markers of inflammation that may be observed abnormally increased in children with brucella arthritis. Further longitudinal studies are needed to investigate this topic to establish the more clear associations.
authors.affiliation: Department of Pediatric Infectious Disease, Dicle University School of Medicine, 21280, Diyarbakir, Turkey. fesihaktar@yahoo.com.
authors.forename: Fesih
authors.initials: F
authors.lastname: Aktar
authors.affiliation: Department of Clinical Microbiology and Infectious Disease, Dicle University School of Medicine, Diyarbakir, Turkey. rectek21@hotmail.com.
authors.forename: Recep
authors.initials: R
authors.lastname: Tekin
authors.affiliation: Department of Pediatric, Van Research Hospital, Van, Turkey. selcukbektas008@gmail.com.
authors.forename: Mehmet Selçuk
authors.initials: MS
authors.lastname: Bektaş
authors.affiliation: Department of Pediatric Infectious Disease, Dicle University School of Medicine, 21280, Diyarbakir, Turkey. mdagunes@hotmail.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Güneş
authors.affiliation: Department of Pediatric Infectious Disease, Diyarbakir Children's Hospital, Diyarbakir, Turkey. muhammetkosker@gmail.com.
authors.forename: Muhammet
authors.initials: M
authors.lastname: Köşker
authors.affiliation: Department of Pediatric, Dicle University School of Medicine, Diyarbakir, Turkey. sertugrul68@yahoo.com.
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Ertuğrul
authors.affiliation: Department of Pediatric, Diyarbakir Children's Hospital, Diyarbakir, Turkey. kamilyilmaz@hotmail.com.
authors.forename: Kamil
authors.initials: K
authors.lastname: Yılmaz
authors.affiliation: Department of Pediatric, Yüzüncü Yil University School of Medicine, Van, Turkey. kamuran_karaman@hotmail.com.
authors.forename: Kamuran
authors.initials: K
authors.lastname: Karaman
authors.affiliation: Department of Pediatric, Dicle University School of Medicine, Diyarbakir, Turkey. drhasanbalik21@hotmail.com.
authors.forename: Hasan
authors.initials: H
authors.lastname: Balık
authors.affiliation: Department of Pediatric, Dicle University School of Medicine, Diyarbakir, Turkey. ilyasyolbas@hotmail.com.
authors.forename: İlyas
authors.initials: İ
authors.lastname: Yolbaş
mesh_terms: D000372:Agglutination Tests; D001170:Arthritis, Infectious / Q000382:microbiology*; D015415:Biomarkers / Q000097:blood*; D002006:Brucellosis / Q000175:diagnosis*; D016022:Case-Control Studies; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006403:Hematologic Tests; D006801:Humans; D008297:Male; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers