ArticleMedical journal of the Islamic Republic of Iran2026
The Role of Systemic Inflammatory Ratios in Refractory Chronic Spontaneous Urticaria Patients with Gastroesophageal Reflux Disease.
Article in Medical journal of the Islamic Republic of Iran, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Refractory chronic spontaneous urticaria (R-CSU) is characterized by systemic mast-cell-driven inflammation, which may present with extra-cutaneous conditions such as gastroesophageal reflux disease (GERD). The utility of simple blood-derived inflammatory ratios that characterize this systemic inflammation is currently limited. We investigated the neutrophil-to-lymphocyte ratio (NLR), eosinophil-to-lymphocyte ratio (ELR), and platelet-to-lymphocyte ratio (PLR) as potential inflammatory markers in patients with R-CSU, both with and without GERD. Methods: A retrospective case-control study was conducted involving 116 patients with recurrent chronic spontaneous urticaria (R-CSU) between 2023 and 2024 at Ali ibn Abi Talib Hospital in Zahedan. Among these patients, 58 were diagnosed with GERD, while the remaining 58 were not. Initially, GERD was clinically confirmed, after which complete blood count (CBC) parameters were utilized to calculate the neutrophil-to-lymphocyte ratio (NLR), eosinophil-to-lymphocyte ratio (ELR), and platelet-to-lymphocyte ratio (PLR). Group differences were analyzed using Mann-Whitney U tests and multivariate regression, adjusted for potential confounders. Receiver operating characteristic (ROC) analysis was employed to assess diagnostic accuracy. Results: NLR was significantly higher in R-CSU patients with GERD compared to those without GERD (NLR: 2.05 ± 1.7 vs 1.05 ± 0.91, Conclusion: Elevated NLR and ELR indicate systemic inflammation in patients with refractory CSU and GERD. These findings support the hypothesis that systemic inflammation contributes to extracutaneous symptoms in this population. Routine, readily available CBC-derived ratios may serve as cost-effective markers for identifying systemic inflammatory activity in R-CSU.
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