James Broadley1,2, Robb Wesselingh1,2, Udaya Seneviratne1,3,4, Chris Kyndt5,6, Paul Beech7,8, Katherine Buzzard5,6, Cassie Nesbitt2,9, Wendyl D'Souza4,10, Amy Brodtmann5,6, Tomas Kalincik6,11, Helmut Butzkueven1,2, Terence J O'Brien1,2, Mastura Monif1,2,6,12. 1. Department of Neuroscience, Monash University, Melbourne, VIC, Australia. 2. Department of Neurology, Alfred Health, Melbourne, VIC, Australia. 3. Department of Neuroscience, Monash Health, Melbourne, VIC, Australia. 4. Department of Medicine, St Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia. 5. Department of Neurosciences, Eastern Health, Melbourne, VIC, Australia. 6. Department of Neurology, Melbourne Health, Melbourne, VIC, Australia. 7. Department of Radiology, Alfred Health, Melbourne, VIC, Australia. 8. Department of Radiology, Monash Health, Melbourne, VIC, Australia. 9. Department of Neuroscience, Barwon Health, Geelong, VIC, Australia. 10. Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia. 11. Clinical Outcomes Research, The University of Melbourne, Melbourne, VIC, Australia. 12. Department of Physiology, The University of Melbourne, Melbourne, VIC, Australia.
Abstract
Objective: To examine the utility of the peripheral blood neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) as biomarkers of prognosis in seropositive autoimmune encephalitis (AE). Methods: In this multicenter study, we retrospectively analyzed 57 cases of seropositive AE with hospital admissions between January 2008 and June 2019. The initial full blood examination was used to determine each patients' NLR and MLR. The modified Rankin Scale (mRS) was utilized to assess the patients' follow-up disability at 12 months and then at final follow-up. Primary outcomes were mortality and mRS, while secondary outcomes were failure of first line treatment, ICU admission, and clinical relapse. Univariate and multivariable regression analysis was performed. Results: During initial hospital admission 44.7% of patients had unsuccessful first line treatment. After a median follow-up of 700 days, 82.7% had good functional outcome (mRS ≤2) while five patients had died. On multivariable analysis, high NLR was associated with higher odds of first line treatment failure (OR 1.32, 95% CI 1.03-1.69, p = 0.029). Increased MLR was not associated with any short or long-term outcome. Conclusions: NLR on initial hospital admission blood tests may be provide important prognostic information for cases of seropositive AE. This study demonstrates the potential use of NLR as a prognostic marker in the clinical evaluation of patients with seropositive AE.
Objective: To examine the utility of the peripheral blood neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) as biomarkers of prognosis in seropositive autoimmune encephalitis (AE). Methods: In this multicenter study, we retrospectively analyzed 57 cases of seropositive AE with hospital admissions between January 2008 and June 2019. The initial full blood examination was used to determine each patients' NLR and MLR. The modified Rankin Scale (mRS) was utilized to assess the patients' follow-up disability at 12 months and then at final follow-up. Primary outcomes were mortality and mRS, while secondary outcomes were failure of first line treatment, ICU admission, and clinical relapse. Univariate and multivariable regression analysis was performed. Results: During initial hospital admission 44.7% of patients had unsuccessful first line treatment. After a median follow-up of 700 days, 82.7% had good functional outcome (mRS ≤2) while five patients had died. On multivariable analysis, high NLR was associated with higher odds of first line treatment failure (OR 1.32, 95% CI 1.03-1.69, p = 0.029). Increased MLR was not associated with any short or long-term outcome. Conclusions: NLR on initial hospital admission blood tests may be provide important prognostic information for cases of seropositive AE. This study demonstrates the potential use of NLR as a prognostic marker in the clinical evaluation of patients with seropositive AE.
Authors: Christian G Bien; Angela Vincent; Michael H Barnett; Albert J Becker; Ingmar Blümcke; Francesc Graus; Kurt A Jellinger; David E Reuss; Teresa Ribalta; Jürgen Schlegel; Ian Sutton; Hans Lassmann; Jan Bauer Journal: Brain Date: 2012-04-25 Impact factor: 13.501
Authors: Hai Ethan Hoang; Jessica Robinson-Papp; Lan Mu; Kiran T Thakur; Jacqueline Sarah Gofshteyn; Carla Kim; Vivian Ssonko; Rachelle Dugue; Eileen Harrigan; Brittany Glassberg; Michael Harmon; Allison Navis; Mu Ji Hwang; Kerry Gao; Helena Yan; Nathalie Jette; Anusha K Yeshokumar Journal: Ann Clin Transl Neurol Date: 2022-06-17 Impact factor: 5.430