{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:44:24Z","timestamp":1791949464328,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100017981","name":"Sysmex Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017981","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"\n Objective<\/jats:title>\n To evaluate the utility of novel parameters related to immune cell activation, known as white blood cell parameters of inflammation (WBC\u2010IP), as biomarkers of disease activity in childhood\u2010onset systemic lupus erythematosus (cSLE) and compare their performance with conventional markers, including erythrocyte sedimentation rate (ESR), C\u2010reactive protein (CRP), and procalcitonin (PCT).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a cross\u2010sectional analysis, including patients with cSLE with active disease (n\u00a0=\u00a043), remission (n\u00a0=\u00a031), and healthy controls (n\u00a0=\u00a0112). In a separate longitudinal cohort, patients with active cSLE at baseline were reassessed after four to six weeks and when achieving inactive disease. WBC\u2010IP was measured in dipotassium EDTA\u2013anticoagulated tubes using the Sysmex XN\u2010Series analyzer. Associations with SLEDAI\u20102K, clinical SLEDAI\u20102K, and physician global assessment (PGA) scores were assessed using Spearman's rank correlation. Diagnostic performance for distinguishing active disease from remission was evaluated by the area under the receiver operating characteristic curve (AUC).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Significant alterations in neutrophil\u2010 and lymphocyte\u2010related parameters were observed across disease states. The proportion of immature granulocytes (IG%) correlated most strongly with the SLEDAI\u20102K (r\n s<\/jats:sub>\n \u00a0=\u00a00.51), clinical SLEDAI\u20102K (r\n s<\/jats:sub>\n \u00a0=\u00a00.50), and PGA (r\n s<\/jats:sub>\n \u00a0=\u00a00.57; all\n P<\/jats:italic>\n \u2009<\u20090.0001) and showed comparable associations with ESR, CRP, and PCT. Longitudinal changes in IG%, neutrophil reactivity intensity, and lymphocyte complexity indices paralleled improvements in disease activity. IG% best discriminated active cSLE among WBC\u2010IP (AUC 0.90, 95% confidence interval [CI] 0.83\u20130.98; cutoff >0.35, sensitivity 81.4%, specificity 87.1%), whereas ESR demonstrated the highest AUC among conventional markers (AUC 0.92, 95% CI 0.85\u20130.99).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Among the WBC\u2010IP evaluated, IG% showed the strongest association with disease activity and demonstrated diagnostic performance comparable to that of ESR, suggesting it may represent a potential biomarker of disease activity. Further validation in independent cohorts is warranted.<\/jats:p>\n \n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/acr2.90152","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:44:56Z","timestamp":1791945896000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Usefulness of White Blood Cell Inflammatory Parameters in Children With Systemic Lupus Erythematosus"],"prefix":"10.1002","volume":"8","author":[{"given":"Butsabong","family":"Lerkvaleekul","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nongnuch","family":"Sirachainan","sequence":"additional","affiliation":[{"name":"Division of Hematology\u2010Oncology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duantida","family":"Songdej","sequence":"additional","affiliation":[{"name":"Division of Hematology\u2010Oncology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karan","family":"Paisooksantivatana","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawadee","family":"Chinudomwong","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2331-9711","authenticated-orcid":false,"given":"Soamarat","family":"Vilaiyuk","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"issue":"3","key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1136\/ard.2008.094813","article-title":"Juvenile\u2010onset systemic lupus erythematosus: different clinical and serological pattern than adult\u2010onset systemic lupus erythematosus","volume":"68","author":"Hoffman IE","year":"2009","journal-title":"Ann Rheum Dis"},{"issue":"1","key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.rdc.2009.12.012","article-title":"Pediatric lupus\u2013are there differences in presentation, genetics, response to therapy, and damage accrual compared with adult lupus?","volume":"36","author":"Mina R","year":"2010","journal-title":"Rheum Dis Clin North Am"},{"issue":"2","key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1111\/1756-185X.12419","article-title":"Childhood onset systemic lupus erythematosus: how is it different from adult SLE?","volume":"18","author":"Aggarwal A","year":"2015","journal-title":"Int J Rheum Dis"},{"issue":"12","key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"2355","DOI":"10.3899\/jrheum.080175","article-title":"Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): LXI. 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