Laboratory Indices Association with Renal Involvement in Children with Henoch-Schonlein Purpura

Abstract

Background: Henoch-Schonlein purpura (HSP) is one of the most common vasculitides in children, often affecting multiple organs, particularly the kidneys. Objectives: This study aimed to compare the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) in HSP patients with and without renal involvement. Methods: This was a cross-sectional study conducted from June 2019 to December 2020, involving children aged 1 - 18 years who were admitted to Ali Ebn Abitalib Hospital affiliated with Zahedan University of Medical Sciences, Iran. A total of 236 inpatient children diagnosed with HSP were included after applying the exclusion criteria. The patients were divided into two groups: Those with renal involvement and those without. The NLR, PLR, and MPV values were compared between the groups. Data were analyzed using SPSS 23.0, with a significance level set at P < 0.05. Results: Among the 236 HSP patients, 35.6% had renal involvement. Of the 32 children diagnosed in spring, 34.4% had renal involvement, with no significant seasonal variation observed (χ² = 1.989, P = 0.594). The results showed that white blood cell (WBC) count, neutrophils, NLR, and platelet (PLT) count were significantly higher in HSP patients with renal involvement, while lymphocyte count and MPV were lower. Univariate logistic regression analysis revealed that age, WBC, neutrophil count, lymphocyte count, NLR, and PLR were significantly associated with renal involvement in children with HSP. Conclusions: Children with HSP and renal involvement demonstrated significant alterations in hematological markers, including elevated WBC count, neutrophil count, NLR, and PLT count, along with reduced MPV and lymphocyte levels. These findings highlight the value of early complete blood count (CBC) assessment at admission as a practical and accessible approach to support the early identification of renal complications in HSP.