La Trobe
1157690_Broadley,J_2021.pdf (403.19 kB)

Peripheral Immune Cell Ratios and Clinical Outcomes in Seropositive Autoimmune Encephalitis: A Study by the Australian Autoimmune Encephalitis Consortium

Download (403.19 kB)
journal contribution
posted on 08.04.2021, 07:11 by J Broadley, R Wesselingh, U Seneviratne, C Kyndt, P Beech, K Buzzard, C Nesbitt, W D’Souza, A Brodtmann, T Kalincik, H Butzkueven, TJ O’Brien, M Monif, S Griffiths, J Fielding, M Clough, T Tan, D Velakoulis, C Malpas, R Alpitsis, R Macdonell, D Tarlinton, S Reddel, T Hardy, B Taylor, B Long, Kulasekara Wijeratne, O White, M Ligtermoet, M Tan, J Kulkarni, R Bourke, E Butler
© Copyright © 2021 Broadley, Wesselingh, Seneviratne, Kyndt, Beech, Buzzard, Nesbitt, D’Souza, Brodtmann, Kalincik, Butzkueven, O’Brien, Monif and Australian Autoimmune Encephalitis Consortium. 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.

History

Publication Date

14/01/2021

Journal

Frontiers in Immunology

Volume

11

Article Number

597858

Pagination

pp. 1-10

Publisher

Frontiers Media

ISSN

1664-3224

Rights Statement

The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.