Evaluation of neutrophil-to-lymphocyte ratio, platelet-tolymphocyte ratio, and mean platelet volume in patients with pemphigus vulgaris

Pemphigus vulgaris (PV) is a rare autoimmune disease characterized by the development of flaccid blisters on the skin and mucous membranes. Detection of anti-desmoglein (Dsg) 1 and anti- Dsg3 antibodies are frequently used for diagnosing the disease and evaluating disease activity. Recently, the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) were introduced as new biomarkers indicating inflammation in autoimmune and autoinflammatory diseases. We aimed to evaluate the possible associations of NLP, PLR, and MPV with pemphigus disease severity and anti-Dsg1/3 levels. Thirty-three newly diagnosed cases of PV and 33 age and sex-matched controls were included in this study. A complete blood count (CBC) was obtained from the participants to evaluate NLP, PLR, and MPV. Serological anti-Dsg1/3 and Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) were assessed in patients based on ELISA assay and clinical examination, respectively. The median (interquartile range) NLR and PLR values in patients were 2.50 (1.94–6.59) and 90.30 (71.60–196.80), respectively, compared with 1.69 (1.45–2.30) and 56.00 (50.00–85.00) in controls. The NLR and PLR were significantly higher in patients than in controls (P < 0.001 for both). However, no significant difference regarding MPV levels was detected. Neither the ABSIS nor the anti- Dsg1/3 levels correlated with the studied inflammatory markers. Our study revealed that NLR and PLR are elevated in patients with PV but do not correlate with disease activity (evaluated by the ABSIS) or anti-Dsg1/3 levels. These laboratory parameters can be considered inflammatory markers of PV but cannot predict the disease activity.