Ratio of monocytes to lymphocytes in peripheral blood in children diagnosed with active tuberculosis

INTRODUCTION: The ratio of monocytes to lymphocytes (ML) could reflect an immunity to Mycobacterium tuberculosis. The objective of this study was to evaluate the relationship between ratio of monocytes to lymphocytes, clinical status of patients with active tuberculosis (TB).
METHODS: This was a retrospective review of data collected from the clinical database of the Behcet Uz Children Research Hospital.138 patients were diagnosed with pulmonary and extrapulmonary TB from January 2006 to January 2015. White blood cell count, absolute monocyte and absolute lymphocyte counts, ML ratio, erhytrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were compared between extra-pulmonary and pulmonary TB. Pre-treatment and after treatment values of the paramters were also compared in both of the groups.
RESULTS: A total of 138 patients were diagnosed as pulmonary and extrapulmonary tuberculosis during the study period. No significant difference between pulmonary and extra pulmonary TB was present regarding white blood cell count, absolute monocyte and lymphocyte, ESR and CRP (p>0.05). In patients with pulmonary TB and extra-pulmonary TB, significant decrease in white blood cell count, absolute monocyte count, ESR and CRP values after treatment comparing to pretreatment (p<0.05). The ML ratio was not significantly different in extrapulmonary tuberculosis (p>0.05) while significantly difference was present between pre and post-treatment group in pulmonary tuberculosis (p=0,000).
DISCUSSION AND CONCLUSION: The hematological markers including ML rate were found to be more useful for monitoring the response of tuberculosis therapy, rather than differential diagnosis of pulmonary tuberculosis from extra-pulmonary tuberculosis.