Lupus & antiphospholipid syndrome
Complete blood count-derived biomarkers as indicators of systemic lupus erythematosus activity: a cross-sectional comparative study
Authors' conclusion
These biomarkers may serve as simple, accessible and cost-effective tools for detecting lupus flares, particularly in resource-limited settings.
Study context
- Population
- SLE patients, internal medicine department of Sahloul Hospital, over 10 years; median age 32 years, sex ratio 0.1683 SLE patients
- Participants
- 40 / 43 / 85
- Exposure
- SLE flare vs remission, and SLE flare vs healthy controls
- Flaren = 40
- Remissionn = 43reference
- Controlsn = 85reference
- Outcome
- Discriminative value of CBC-derived biomarkers (NLR, PLR, MLR, ELR, BLR, mean platelet volume, RDW) in identifying lupus flares (AUC, sensitivity (Se), specificity (Sp) at optimal cut-off)
Methodological detailscomparative, single-centre, matched healthy controls, ROC analysis
- Comparative
- Single-centre
- Matched healthy controls
- ROC analysis
Main finding
As reported in the abstract
Discrimination of flare vs remission (ROC)
| Group | AUC | Cutoff | Sensitivity | Specificity |
|---|---|---|---|---|
| RDW | 0.708 | ≥14.65 | 75.9% | 60.6% |
| Neutrophil-to-lymphocyte ratio (NLR) | 0.636 | ≥2.63 | 72.4% | 51.5% |
| Eosinophil-to-lymphocyte ratio (ELR) | 0.647 | ≤0.0076 | 74.4% | 65% |
AUC
RDW0.708
Neutrophil-to-lymphocyte ratio (NLR)0.636
Eosinophil-to-lymphocyte ratio (ELR)0.647
Cutoff
RDW≥14.65
Neutrophil-to-lymphocyte ratio (NLR)≥2.63
Eosinophil-to-lymphocyte ratio (ELR)≤0.0076
Sensitivity
RDW75.9%
Neutrophil-to-lymphocyte ratio (NLR)72.4%
Eosinophil-to-lymphocyte ratio (ELR)74.4%
Specificity
RDW60.6%
Neutrophil-to-lymphocyte ratio (NLR)51.5%
Eosinophil-to-lymphocyte ratio (ELR)65%
Observational data: associations, not effects.
Further findings
Discrimination of flare vs controls (ROC)
AUC RDW 0.864 · NLR 0.822 · ELR 0.775
Cutoff RDW ≥13.85 · NLR ≥2.28 · ELR ≤0.029
Sensitivity
Specificity
Discrimination of flare vs controls (ROC)
- Compared with controls, flares showed higher NLR, platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), RDW and lower ELR and basophil-to-lymphocyte ratio (BLR)
Correlation of SLEDAI-2K with biomarkers
- NLR (r)
- 0.228
- PLR (r)
- 0.238
- RDW (r)
- 0.303
- ELR (r)
- −0.317
Original publication
Complete blood count-derived biomarkers as indicators of systemic lupus erythematosus activity: a cross-sectional comparative study. Lupus Sci Med. Published 28 November 2025. doi:10.
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