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Inflammatory markers of hemogram parameters as predictive factors for disease severity in anti-N-methyl-D-aspartate receptor encephalitis

  • Author Footnotes
    1 These authors contributed equally to this work.
    Yin-Xi Zhang
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Jia-Li Pu
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, China
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.
    Meng-Ting Cai
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, China
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  • Qing-Qing Tao
    Affiliations
    Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, China
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  • Jun Tian
    Affiliations
    Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, China
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  • Chun-Hong Shen
    Affiliations
    Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, China
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  • Yong-Feng Xu
    Correspondence
    Corresponding authors.
    Affiliations
    Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, China
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  • Bao-Rong Zhang
    Correspondence
    Corresponding authors.
    Affiliations
    Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, China
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.
Published:August 03, 2022DOI:https://doi.org/10.1016/j.msard.2022.104078

      Highlights

      • Anti-NMDAR encephalitis is the most common autoimmune encephalitis.
      • We aimed to investigate the utility of inflammatory markers of hemogram parameters as objective indicators of disease severity.
      • The moderate-to-severe group had higher NLR and MLR when compared with the mild group at admission.
      • NLR with a cut-off value of > 4.232 was an independent risk factor for moderate-to-severe status at admission.
      • NLR and MLR were associated with disease severity at different stages of follow-up but showed no independent predictive value.

      Abstract

      Objective

      This study aimed to investigate the utility of inflammatory markers of hemogram parameters as objective indicators of disease severity in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.

      Methods

      A total of 98 patients were retrospectively reviewed. Inflammatory markers of hemogram parameters, including neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio, were acquired within 24 h of admission. We then analyzed their utility as predictive factors for disease severity at different time points assessing with the modified Rankin Scale (mRS).

      Results

      There were 49 patients in the mild group (mRS ≤ 2) and 49 patients in the moderate-to-severe (mRS > 2) group at admission. The moderate-to-severe group presented more frequently with psychiatric symptoms and central hypoventilation, as well as a lower lymphocyte count, a higher neutrophil count, a higher NLR and a higher MLR (all p < 0.05) when compared with the mild group. NLR and MLR showed similar positive correlations with mRS scores (r = 0.40, r = 0.40, both p < 0.001). Further multivariate logistic regression analyses indicated that NLR > 4.232 was an independent risk factor for moderate-to-severe status at admission. Meanwhile, NLR and MLR were associated with disease severity at different stages of follow-up but showed no independent predictive value.

      Conclusion

      Our findings suggested that NLR was an independent risk factor for moderate-to-severe status in the initial stage of anti-NMDAR encephalitis with a cut-off value of > 4.232.

      Keywords

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