Tsegaye, Aster(MSc, PhD)Hagos, Afework(MD, Internist, Hematologist)Abate, Senait2020-01-302023-11-062020-01-302023-11-062019-11http://etd.aau.edu.et/handle/123456789/20534This is to certify that the thesis prepared by Senait Abate, entitled: Assessment of Platelet to Lymphocyte ratio and Neutrophil to Lymphocyte ratio as potential biomarkers in patients with rheumatoid arthritis at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia submitted in partial fulfillment of the requirements for Master of Science degree in Clinical Laboratory Sciences (Hematology and Immunohematology) complies with the regulations of the University and meets the accepted standards with respect to originality and quality.Background: Rheumatoid Arthritis (RA) is a chronic, systemic autoimmune disease involving inflammation of synovial joints. The interest in the study of platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio( NLR) has grown recently because they have been found to be predictive of the prognosis of patients with diverse inflammatory and ischemic conditions and these ratios are easily calculated from hematology analyzer printout. However, in Ethiopia no published study is available in this regard. Objective: This study aimed to assess platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) as potential biomarkers in patients with rheumatoid arthritis at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia from April-July, 2019. Method: This comparative cross-sectional study enrolled 61 newly diagnosed adult rheumatoid arthritis patients and 61 sex and age matched healthy controls. Blood sample was collected from all study participants using convenient sampling technique. CBC was measured using Mindray BC5300 hematology analyzer and BD sedintainer was used for ESR measurement, while RF and CRP were done based on latex agglutination method. Data analysis was done using SPSS version 20. Level of significance between groups was analyzed using independent student t-test and Mann-Whitney U test. Receiver operating characteristic (ROC) curves was used to evaluate the performance of PLR and NLR. P values less than 0.05 was taken as statistically significant. Result: The median PLR and NLR were significantly increased in RA patients compared with healthy controls 195(IQR, 150-242) vs 125(105-150), P<0.05; 2.4(1.85-3.5) vs. 1.6(1.3-1.9), P<0.05 respectively). ROC curves analysis showed that PLR had area under the curve(AUC) of 0.859 with 85.2% sensitivity and 66% specificity as a marker of rheumatoid arthritis and NLR had AUC of 0.80 with sensitivity and specificity of 78.3% and 68% respectively. Conclusion: There was a statistically significant increment in the level of Platelet to lymphocyte ratio and Neutrophil to lymphocyte ratio among new RA patients compared with healthy controls. In addition ROC curves analysis revealed a good diagnostic performance. Therefore, PLR and NLR can be added to routine diagnostic parameters as indicators in the assessment of rheumatoid arthritis patients. So, further studies with larger numbers of RA cases is needed to better understand the role of PLR and NLR in patients with RA.en-USRheumatoid arthritis, Platelet to lymphocyte ratio, Neutrophil to lymphocyte ratio.Thesis