Title:Serum Immunoglobulin G Level and Neutrophils to Lymphocytes Ratio Associated with the Prognosis of Neuromyelitis Optica Spectrum Disorder
Volume: 18
Issue: 2
Author(s): Ying Tong, Li Wang, Kai Liu, Weishi Liu, Shen Li, Bo Song, Zongping Xia, Yuming Xu and Rui Zhang*
Affiliation:
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou,China
Keywords:
Immunoglobulin G, neutrophils, lymphocytes, neuromyelitis optica spectrum disorder, prognosis, the expanded disability
status scale, aquaporin-4.
Abstract:
Objective: To investigate the factors related to the prognosis of Neuromyelitis Optica
Spectrum Disorder (NMOSD) in cerebrospinal fluid and peripheral blood examination.
Methods: In this study, we enrolled 111 patients who were admitted to the First Affiliated Hospital
of Zhengzhou University between January 2016 and January 2018 and diagnosed with NMOSD.
The patients were divided into the relapse group (n = 48) and remission group (n = 67). Before
treatment, all the patients underwent a routine Cerebrospinal Fluid (CSF) and peripheral blood test
on the second morning of admission. The association between laboratory data and disease prognosis
was evaluated.
Results: The immunoglobulin G (IgG) level in the serum showed a strong correlation with the relapse
of patients, especially in the aquaporin-4-Antibody (AQP4-Ab) positive group (p < 0.01). A
high level of serum IgG concentration was associated with the relapse of NMOSD, especially in
the anti-AQP4 positive group. The area under the Receiver Operating Characteristic (ROC) curve
of serum IgG level was 0.888 (p<0.001, 95%CI: 0.808-0.968). The ratio of Neutrophils to Lymphocytes
(NLR) was associated with the disability degree of NMOSD patients in 3 years. The NLR value
was a linear correlation with final Expanded Disability Status Scale (EDSS) scores; patients
with a high level of NLR value presented an increased degree of disability in the following three
years (R2 = 0.053, p= 0.015).
Conclusion: The serum IgG level and NLR of first-attack patients were correlated with the prognosis
of NMOSD.
