{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:17:59Z","timestamp":1792801079686,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T00:00:00Z","timestamp":1637625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Neutrophil\u2010to\u2010lymphocyte ratio (NLR), platelet\u2010to\u2010lymphocyte ratio (PLR), and lymphocyte\u2010to\u2010monocyte ratio (LMR) are emerging biomarkers for systemic inflammation and have been shown to predict morbidity and mortality for several diseases. However, lack of pediatric reference intervals (RIs) prevents their comprehensive use in patient care and medical research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>\n                      We calculated reference intervals and corresponding confidence intervals for NLR, PLR, and LMR from birth to 18\u00a0years using a data\u2010mining approach: We analyzed 232\u00a0746 blood counts from 60\u00a0685 patients performed during patient care and excluded patients with elevated C\u2010reactive protein and procalcitonin. Test results were separated according to age and sex, and the distribution of physiological ratios was estimated using an indirect approach (\n                      <jats:italic>refineR<\/jats:italic>\n                      ). Additionally, we investigated the ratios\u2019 diagnostic benefit for different inflammatory diseases (acute appendicitis, asthma, Bell's palsy, Henoch\u2010Schonlein purpura, and cystic fibrosis) using the newly obtained reference intervals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We estimated age\u2010 and sex\u2010specific reference intervals from birth to adulthood for NLR, PLR, and LMR. Analyses in pediatric inflammatory diseases showed that PLR and LMR were poor markers to detect the examined inflammatory diseases, while NLR was significantly increased in patients with appendicitis and asthma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We provide pediatric reference intervals for NLR, PLR, and LMR to improve the interpretation of these biomarkers in children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijlh.13768","type":"journal-article","created":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:20:22Z","timestamp":1637713222000},"page":"296-301","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":78,"title":["Age\u2010 and sex\u2010specific pediatric reference intervals for neutrophil\u2010to\u2010lymphocyte ratio, lymphocyte\u2010to\u2010monocyte ratio, and platelet\u2010to\u2010lymphocyte ratio"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8843-7084","authenticated-orcid":false,"given":"Julia","family":"Moosmann","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology University Hospital Erlangen Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Krusemark","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine University Hospital Erlangen Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Dittrich","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology University Hospital Erlangen Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana","family":"Ammer","sequence":"additional","affiliation":[{"name":"Chair of Medical Informatics Friedrich\u2010Alexander\u2010University Erlangen\u2010Nuremberg Erlangen Germany"},{"name":"Roche Diagnostics GmbH Penzberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfred","family":"Rauh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine University Hospital Erlangen Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Woelfle","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine University Hospital Erlangen Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Metzler","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine University Hospital Erlangen Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Zierk","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine University 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