Serum Immunoglobulin M levels and neutrophil/lymphocyte index as predictors of treatment response in patients with primary biliary cholangitis

Introduction and Objectives

Primary biliary cholangitis (PBC) involves chronic inflammation of the bile ducts, with a high risk of progression to cirrhosis in non-responders to treatment. Identifying the relationship between immunoglobulin M (IgM) levels and neutrophil/lymphocyte index as predictors of response to treatment could optimize clinical outcomes.

Materials and Methods

A retrospective, longitudinal, analytical, and observational study was conducted that included the review of 71 records of patients diagnosed with PBC. Baseline serum IgM levels were recorded, and the neutrophil/lymphocyte index (NLI) was calculated. Response to treatment with ursodeoxycholic acid (UDCA) at doses of 13-15mg/kg was assessed after one year of follow-up, according to the Barcelona criteria. Subsequently, Pearson's correlation coefficient was determined to identify the relationship between the variables.

Results

A total of 67 patients diagnosed with PBC were included. The mean age reported was 55.5 years and the highest frequency was recorded in females, representing 91% of cases. The main comorbidities reported were hypothyroidism (20.8%), systemic sclerosis (11.9%) and Sjögren's syndrome (7.4%). Clinical portal hypertension was identified at diagnosis in 22 patients (32.8%). An adequate response to treatment was observed in 35 patients (52.2%), while 32 (47.8%) did not show a satisfactory response. The mean neutrophil/lymphocyte index value in the response group was 2.3 (range: 0.7-8.6), while in the non-response group, it was 2.5 (range: 0.8-18.5). Additionally, 42 patients (62%) were identified with IgM levels >240mg/dl. Subsequently, a Pearson correlation analysis was performed between IgM and NLI levels with treatment response, yielding a value of 0.04 (p>0.05) and -0.18 (p>0.5), respectively.

Conclusions

A considerable percentage of patients presented failure to treatment with UDCA and according to the results, there was no significant association between IGM levels and NLI and therapeutic response.

Ethical statement: The study was conducted in accordance with the ethical principles set forth in the Declaration of Helsinki and informed consent was obtained from all participants.

Declaration of Interests: None.

Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.