TY - JOUR
T1 - Peripheral Immune Cell Ratios and Clinical Outcomes in Seropositive Autoimmune Encephalitis
T2 - A Study by the Australian Autoimmune Encephalitis Consortium
AU - Broadley, James
AU - Wesselingh, Robb
AU - Seneviratne, Udaya
AU - Kyndt, Chris
AU - Beech, Paul
AU - Buzzard, Katherine
AU - Nesbitt, Cassie
AU - D’Souza, Wendyl
AU - Brodtmann, Amy
AU - Kalincik, Tomas
AU - Butzkueven, Helmut
AU - O’Brien, Terence J.
AU - Monif, Mastura
AU - Griffiths, Sarah
AU - Fielding, Jo
AU - Clough, Meaghan
AU - Tan, Tracie
AU - Velakoulis, Dennis
AU - Malpas, Charles
AU - Alpitsis, Rubina
AU - Macdonell, Richard
AU - Tarlinton, David
AU - Reddel, Steve
AU - Hardy, Todd
AU - Taylor, Bruce
AU - Long, Brian
AU - Wijeratne, Tissa
AU - White, Owen
AU - Ligtermoet, Matt
AU - Tan, Meng
AU - Kulkarni, Jayashri
AU - Bourke, Robert
AU - Butler, Ernie
AU - Australian Autoimmune Encephalitis Consortium
PY - 2021/1/14
Y1 - 2021/1/14
N2 - 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.
AB - 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.
KW - autoimmune encephalitis
KW - biomarker
KW - monocyte-to-lymphocyte ratio
KW - neutrophil-to-lymphocyte ratio
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=85100116782&partnerID=8YFLogxK
U2 - 10.3389/fimmu.2020.597858
DO - 10.3389/fimmu.2020.597858
M3 - Article
C2 - 33519810
AN - SCOPUS:85100116782
SN - 1664-3224
VL - 11
JO - Frontiers in Immunology
JF - Frontiers in Immunology
M1 - 597858
ER -