Evaluation of immature granulocyte percentage and count in pediatric nephrotic syndrome

ABSTRACT

Objective

The importance of immature granulocytes (IGs) in most infectious and inflammatory diseases has been highlighted. This study aimed to determine the clinical usability and importance of changes in the peripheral complete blood count profile, including IG percentage (IG%) and IG count (IG#), during the relapse and remission phases in pediatric nephrotic syndrome (NS) patients.

Methods

This retrospective observational study was performed at a tertiary care hospital between February 2020 and August 2022. Demographic characteristics and laboratory parameters were recorded. The IG count and IG% were measured using an automated hematological analyzer.

Results

IG% and IG# were both higher during the relapse phase of NS than during the remission phase (0.29% ± 0.14%, versus 0.23% ± 0.14%, p = 0.037 and 0.027 ± 0.015 × 10³/µL, versus 0.018 ± 0.014 × 10³/µL, p = 0.005, respectively). The neutrophil to lymphocyte ratio (NLR), platelet (PLT), white blood cell (WBC), and neutrophil counts had a strong positive correlation with IG# (r = 0.397, p < 0.001; r = 0.352, p < 0.001; r = 0.622, p < 0.001; r = 0.660, p < 0.001, respectively). The NLR, PLT, WBC, and neutrophil counts had a strong positive correlation with IG% (r = 0.348, p < 0.001; r = 0.187, p = 0.039; r = 0.303, p = 0.001; r = 0.426, p < 0.001, respectively). Receiver operating characteristic curve analysis showed that IG# had the best AUC value of 0.69 (95% CI: 0.58–0.77; p = 0.001) for the relapse phase of NS with a cutoff value of 0.025 × 10³/µL (sensitivity: 81.0%, specificity: 78.1%).

Conclusions

It is probable that a high level of immature granulocyte count has a positive correlation for NS relapse in pediatric patients. The IG % and IG# can be used together as biomarkers of inflammation in pediatric NS relapse.

KEYWORDS:

• Immature granulocyte count
• immature granulocyte percentage
• nephrotic syndrome
• relapse phase of nephrotic syndrome
• pediatric

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Conceptualization, data curation, software, supervision, validation, visualization, editing and approving the final manuscript and data, reviewing and updating all data, writing – original draft, and writing – review & editing: all authors. Formal analysis: Yazılıtaş, Çakıcı, Güngör and Özdemir. Investigation: Yazılıtaş and Özdemir. Methodology: Yazılıtaş, Bübül, Güngör, Çelikkaya. Project administration: Yazılıtaş. Resources: Yazılıtaş and Özdemir.

Ethics statement

This study was approved by local Ethics Committee (date:07/09/2022, number: E-22/09–401). The Ethics Committee waived the requirement for informed consent due to the retrospective observational nature of the study.

Additional information

Funding

This paper was not funded.