JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

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Original Article
Immature granulocytes are a potential biomarker in the early diagnosis of lower extremity subacute arterial thrombosis
Abstract
Aims: Acute arterial embolism in peripheral arteries is generally diagnosed quickly. In contrast, subacute arterial thrombosis (SAT), which arises as an acute exacerbation of chronic peripheral artery disease (PAD), is often more challenging to diagnose rapidly, primarily due to the development of collateral circulation. This study aims to investigate the role of immature granulocytes (IG) in the early diagnosis of SAT in patients with chronic PAD.
Methods: This retrospective study was conducted at a single center between 2019 and 2021. A total of 99 patients with chronic lower extremity PAD were included in the study. Of these, 27 patients (27.2%) who developed exacerbations in the form of SAT were assigned to the SAT group. The remaining 72 patients (72.8%) with chronic PAD were included in the control group. Blood samples from patients in both groups were collected at their first admission before receiving any treatment. Complete blood count parameters were analyzed using an automatic hematological analyzer and compared between the two groups.
Results: Comparison between the control and SAT groups revealed significant differences in hemogram parameters. These parameters included white blood cell count (WBC, p<0.001), neutrophil count (NEUT#, p<0.001), lymphocyte count (LYMPH#, p=0.004), eosinophil count (EO#, p=0.035), neutrophil percentage (NEUT%, p<0.001), lymphocyte percentage (LYMPH%, p<0.001), monocyte percentage (MONO%, p=0.013), eosinophil percentage (EO%, p=0.008), immature granulocyte count (IG#, p<0.001), immature granulocyte percentage (IG%, p=0.002), neutrophil-to-lymphocyte ratio (NLR, p<0.001). These parameters were statistically significantly different in patients with SAT compared to patients with chronic atherosclerotic lower extremity peripheral artery.
Conclusion: Our study demonstrates that immature granulocytes show 81% sensitivity and %59 specificity for the early diagnosis of SAT. These findings suggest that immature granulocytes may serve as a reliable biomarker for the early detection of SAT.

Keywords : Peripheral arterial disease, diagnosis, immature granulocytes

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1. Obara H, Matsubara K, Kitagawa Y. Acute limb ischemia. Ann Vasc Dis. 2018;11(4):443-448. doi:10.3400/avd.ra.18-00074
2. Katzen BT. Clinical diagnosis and prognosis of acute limb ischemia. Rev Cardiovasc Med. 2002;3(Suppl 2):S2-S6.
3. Schwartz SM, Heimark RL, Majesky MW. Developmental mechanisms underlying pathology of arteries. Physiol Rev. 1990;70(4):1177-1209. doi: 10.1152/physrev.1990.70.4.1177
4. Smith DA, Lilie CJ. Acute Arterial Occlusion. [Updated 2023 Jan 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441851/
5. Dosluoglu HH, Harris LM. Endovascular management of subacute lower extremity ischemia. Semin Vasc Surg. 2008;21(4):167-179. doi:10.1053/j.semvascsurg.2008.11.002. PMID: 19073306
6. Olinic DM, Stanek A, Tataru DA, Homorodean C, Olinic M. Acute limb ischemia: an update on diagnosis and management. J Clin Med. 2019; 8(8):1215. doi:10.3390/jcm8081215
7. Ayres LS, Sgnaolin V, Munhoz TP. Immature Granulocytes Index as an early marker of sepsis. Int J Lab Hematol. 2019;41(3):392-396. doi:10. 1111/ijlh.12990
8. Karakulak S, Narcı H, Ayrık C, Erdoğan S, &Uuml;&ccedil;bilek E. The prognostic value of immature granulocyte in patients with acute pancreatitis. Am J Emerg Med. 2021;44:203-207. doi:10.1016/j.ajem.2020.03.028
9. Lipinski M, Rydzewska G. Immature granulocytes predict severe acute pancreatitis independently of systemic inflammatory response syndrome. Prz Gastroenterol. 2017;12(2):140-144. doi:10.5114/pg.2017. 68116
10. Park JH, Byeon HJ, Lee KH, et al. Delta Neutrophil Index (DNI) as a novel diagnostic and prognostic marker of infection: a systematic review and meta-analysis. Inflamm Res. 2017;66(10):863-870. doi:10.1007/s00011-017-1066-y
11. &Uuml;nal Y. A new and early marker in the diagnosis of acute complicated appendicitis: immature granulocytes. Ulus Travma Acil Cerrahi Derg. 2018;24:434-439. doi:10.5505/tjtes.2018.91661
12. Georgakopoulou VE, Makrodimitri S, Triantafyllou M, et al. Immature granulocytes: innovative biomarker for SARS-CoV-2 infection. Mol Med Rep. 2022;26(1):217. doi:10.3892/mmr.2022.12733
13. Lipinski M, Rydzewska G. Immature granulocytes predict severe acute pancreatitis independently of systemic inflammatory response syndrome. Prz Gastroenterol. 2017;12(2):140-144. doi:10.5114/pg.2017. 68116
14. Malengier-Devlies B, Metzemaekers M, Wouters C, Proost P, Matthys P. Neutrophil homeostasis and emergency granulopoiesis: the example of systemic juvenile idiopathic arthritis. Front Immunol. 2021;12:766620. doi:10.3389/fimmu.2021.766620
15. Wang L, Luqmani R, Udalova IA. The role of neutrophils in rheumatic disease-associated vascular inflammation. Nat Rev Rheumatol. 2022; 18(3):158-170. doi:10.1038/s41584-021-00738-4
16. Suszczyk D, Skiba W, Jakubowicz-Gil J, Kotarski J, Wertel I. The role of myeloid-derived suppressor cells (MDSCs) in the development and/or progression of endometriosis-state of the art. Cells. 2021;10(3):677. doi: 10.3390/cells10030677
17. Korkut M, Bedel C, Sivil R, et al. Usefulness of immature granulocytes as a prognostic factor in ST-elevation myocardial infarction. Braz J Cardiovasc Surg. 2022;37(6):893-899. doi:10.21470/1678-9741-2021-0088
18. Combadi&egrave;re B, Adam L, Guillou N, et al. LOX-1-expressing immature neutrophils identify critically-ill COVID-19 patients at risk of thrombotic complications. Front Immunol. 2021;12:752612. doi:10.3389/fimmu.2021.752612
19. Karahan F, &Uuml;nal S, Top&ccedil;u DB, &Ouml;ztaş Y, Bozlu G. The role of immature granulocyte percentage in predicting acute chest syndrome and the severity of the vaso-occlusive crisis in sickle cell disease. Turk J Pediatr. 2022;64(1):92-97. doi:10.24953/turkjped.2021.1385
20. Baril DT, Ghosh K, Rosen AB. Trends in the incidence, treatment, and outcomes of acute lower extremity ischemia in the United States Medicare population. J Vasc Surg. 2014;60(3):669-677. doi:10.1016/j.jvs. 2014.03.244 </ol> </div> <p>
Article available in :
Volume 8, Issue 3, 2025
Page : 498-501
https://doi.org/10.32322/jhsm.1631350
Article Information
Received : 01 Şub 2025
Accepted : 17 May 2025
Published : 30 May 2025
Corresponding Author :

Güler Gülsen Ersoy: Department of Cardiovascular Surgery, Faculty of Medicine, Kastamonu University, Kastamonu, Turkiye

[email protected]
Citation : Ersoy GG, Gülten S, Tamtekin B. Immature granulocytes are a potential biomarker in the early diagnosis of lower extremity subacute arterial thrombosis. J Health Sci Med. 2025;8(3):498-501.

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