Complete blood count parameters as predictors of disease phenotype in pediatric inflammatory bowel disease

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OBJECTIVES: Complete blood count (CBC) is a simple and cost-effective test performed during routine examination. We investigated whether CBC could assist in the assessment of disease phenotype and disease activity at diagnosis in pediatric inflammatory bowel disease (IBD). METHODS: We included 120 pediatric patients (73 ulcerative colitis [UC] and 47 Crohn's disease [CD]) and 120 age-matched healthy controls (6-18 years). CBC indices, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-monocyte ratio (NMR) measured at onset, were compared between the patient and control groups. Optimal cut-off values for absolute lymphocyte count (ALC) and LMR were determined using the ROC curve analysis and the Youden Index to predict disease behavior in patients with CD. Multivariate logistic regression analysis was used to evaluate the independent relationship between these parameters and to predict disease behavior in CD. RESULTS: UC and CD patients demonstrated significantly higher leukocyte, platelet, neutrophil, monocyte counts and NLR compared to controls (p < 0.05). CD patients had significantly lower ALC than UC and control groups (p = 0.008 and p = 0.039, respectively). Patients with moderate- severe UC and pancolitis exhibited significantly decreased Hgb levels, MCV and increased PLT counts (p < 0.05). After adjusting for age and sex at diagnosis, multivariate logistic regression analysis revealed that decreased ALC (< 1.65 ×109/L) and LMR (< 2.54) were significant predictors of CD with stricturing, penetrating disease and perianal involvement (p = 0.049 and p = 0.004, respectively). CONCLUSIONS: In pediatric IBD, the severity of UC and disease behavior of CD can be assessed using CBC indices at diagnosis. These results demonstrate the potential role of CBC indices in predicting disease phenotype.