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Available online 3 November 2025
Association of hematological indices, disease activity, and organ damage in systemic lupus erythematosus: A multicenter analysis of 319 cases
Asociación de índices hematológicos, actividad y daño orgánico en el lupus eritematoso sistémico: análisis multicéntrico de 319 casos
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Beatriz Tejera Segura
, Adrián Quevedo Rodriguez, María García Hernández, Judith Hernández Sánchez, Marta Hernández Díaz, Íñigo Rua-Figueroa de Larrinoa
Sección de Reumatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, Spain
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Received 09 July 2025. Accepted 12 August 2025
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Tables (3)
Table 1. Demographic and clinical characteristics of the cohort.
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Table 2. Relationship between haematological indices and activity and damage.
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Table 2.1. Association of NLR and PLR with activity measured by SLEDAI-2K.
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Abstract
Introduction

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a variable course. There is a need for simple and accessible biomarkers to assess disease activity and prognosis.

Objectives

To analyze the relationship between hematological indices NLR (neutrophil-to-lymphocyte ratio) and PLR (platelet-to-lymphocyte ratio) with disease activity and organ damage in patients with SLE.

Materials and methods

A multicenter retrospective study including 319 patients with SLE. Associations between NLR and PLR with disease activity (SLEDAI-2K), organ damage (SLICC/SDI), hypocomplementemia, mortality, and clinical manifestations were evaluated.

Results

Both indices showed a significant association with disease activity, even after adjusting for confounding factors. No associations were found with organ damage or specific clinical manifestations. NLR was associated with hypocomplementemia, and both indices were linked to mortality.

Conclusions

NLR and PLR may serve as useful, low-cost, and complementary tools for monitoring disease activity in SLE. Prospective studies are needed to confirm their value as independent biomarkers.

Keywords:
Systemic lupus erythematosus
Neutrophil-to-lymphocyte ratio
Platelet-to-lymphocyte ratio
Resumen
Introducción

El lupus eritematoso sistémico (LES) es una enfermedad autoinmune sistémica con un curso variable. Es necesario contar con biomarcadores simples y accesibles para evaluar su actividad y pronóstico.

Objetivos

Analizar la relación entre los índices hematológicos RNL (ratio neutrófilo-linfocito) y RPL (ratio plaqueta-linfocito) con la actividad y el daño en pacientes con LES.

Material y métodos

Estudio retrospectivo multicéntrico de 319 pacientes con LES. Se evaluó la asociación de RNL y RPL con la actividad (SLEDAI-2K), el daño orgánico (SLICC/SDI), la hipocomplementemia, la mortalidad y manifestaciones clínicas.

Resultados

Ambos índices se asociaron significativamente con la actividad de la enfermedad, incluso tras ajustar por factores de confusión. No se observaron asociaciones con el daño orgánico ni con manifestaciones clínicas específicas. RNL se relacionó con hipocomplementemia, y ambos índices con la mortalidad.

Conclusiones

RNL y RPL podrían ser herramientas útiles, económicas y complementarias para el seguimiento de la actividad en el LES. Se requieren estudios prospectivos para confirmar su valor como biomarcadores.

Palabras clave:
Lupus eritematoso sistémico
Ratio neutrófilo-linfocito
Ratio plaqueta-linfocito

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