Pan-Immune-Inflammation Index as a Biomarker for Rheumatoid Arthritis Progression and Diagnosis

• Published in: Curēus (Palo Alto, CA) CA), 2023-10, Vol.15 (10), p.e46609-e46609
• Main Authors: Tutan, Duygu, Doğan, Ayşe G
• Format: Article
• Language: English
• Subjects: Biomarkers; Blood platelets; Blood tests; Breast cancer; Cancer therapies; Comparative analysis; Diabetes; Disease; Granulocytes; Hemoglobin; Inflammation; Internal Medicine; Lymphocytes; Medical diagnosis; Medical prognosis; Neutrophils; Patients; Remission (Medicine); Rheumatoid arthritis; Rheumatology; Steroids; Tumor necrosis factor-TNF; Variables
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.46609

IntroductionRheumatoid arthritis (RA) is a chronic autoimmune condition that causes systemic inflammation and affects multiple joints. It is characterized by joint warmth, swelling, pain, and the formation of invasive synovial tissue known as pannus, which contributes to cartilage and bone degradation. Pan-immune-inflammation value (PIV), a marker derived from complete blood count parameters, has shown promise in predicting prognosis in various cancer types and pediatric conditions associated with immune abnormalities. This study aims to explore the relationship between RA, characterized by chronic inflammation and immune system involvement, and PIV, potentially shedding light on novel insights into RA's clinical implications.MethodsOne hundred four participants, including 64 RA patients (both newly diagnosed and established cases) and 40 healthy controls, were included in the study. Exclusion criteria for RA patients included acute infection, cancer, diabetes, or chronic illness, while control participants were excluded for inflammatory disorders, active infection, diabetes, or malignancy. We assessed disease severity using Disease Activity Score 28 (DAS 28) and obtained complete blood count values, including neutrophil, lymphocyte, platelet, monocyte, and red cell distribution width. C-reactive peptide (CRP) and erythrocyte sedimentation rate were also added. Statistical analyses included correlation assessments, t-tests, Mann-Whitney U tests, and multivariate linear regression. A multiclass receiver operating characteristic analysis determined optimal PIV cut-off values for distinguishing control, remission, and active RA groups, with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and odds ratios calculated.ResultsThis study comprised a cohort of 104 participants, with a median age of 43.5±17.5. The Remission group was significantly younger than the Control group (p=0.006) but not compared to the Active RA group (p=0.393). CRP levels were significantly higher in the Active RA group (p