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Predictive value of the neutrophil-to-lymphocyte ratio for treatment response in patients diagnosed with definite or probable autoimmune encephalitis/encephalopathy

INTRODUCTION: Autoimmune encephalitis/encephalopathy (AE) is a complex and heterogeneous disease, making it difficult to predict the prognosis. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a potential prognostic tool, but its usefulness remains a matter of debate. This study aimed to expl...

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Autores principales: Ogami, Shuhei, Koh, Jinsoo, Miyamoto, Katsuichi, Mori, Megumi, Takahashi, Maiko, Nakayama, Yoshiaki, Sakata, Mayumi, Hiwatani, Yasuhiro, Kajimoto, Yoshinori, Ishiguchi, Hiroshi, Ito, Hidefumi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626493/
https://www.ncbi.nlm.nih.gov/pubmed/37936916
http://dx.doi.org/10.3389/fneur.2023.1284717
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author Ogami, Shuhei
Koh, Jinsoo
Miyamoto, Katsuichi
Mori, Megumi
Takahashi, Maiko
Nakayama, Yoshiaki
Sakata, Mayumi
Hiwatani, Yasuhiro
Kajimoto, Yoshinori
Ishiguchi, Hiroshi
Ito, Hidefumi
author_facet Ogami, Shuhei
Koh, Jinsoo
Miyamoto, Katsuichi
Mori, Megumi
Takahashi, Maiko
Nakayama, Yoshiaki
Sakata, Mayumi
Hiwatani, Yasuhiro
Kajimoto, Yoshinori
Ishiguchi, Hiroshi
Ito, Hidefumi
author_sort Ogami, Shuhei
collection PubMed
description INTRODUCTION: Autoimmune encephalitis/encephalopathy (AE) is a complex and heterogeneous disease, making it difficult to predict the prognosis. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a potential prognostic tool, but its usefulness remains a matter of debate. This study aimed to explore prognostic factors in cases of clinically definite or probable AE, including those with autoantibody-negative, or unknown status. METHODS: Data on patients diagnosed with definite or probable AE, including those with autoantibody-negative, or unknown status, were retrospectively collected from the admission records of our department between January 2013 and December 2022. These patients were then categorized into either a good- or poor-response group, based on their short-term treatment response. Clinical characteristics, auxiliary examinations, and treatments were compared between the two groups. A multivariable logistic regression model was constructed to identify independent predictors of poor short-term treatment response by Akaike information criterion backward stepwise method. RESULTS: A total of 31 patients were included in the final analysis, with 18 of them included in the poor-response group. In the univariable analysis, the poor-response group had a higher proportion of patients with a modified Rankin Scale (mRS) high score upon admission, female, epileptic seizures, or NLRs of 3.93 or higher than the good-response group (all p < 0.10). Furthermore, the multivariable logistic regression analysis revealed that the mRS score upon admission [OR: 5.51, 95% confidence intervals (CI): 1.29–23.50, p = 0.02], epileptic seizures (OR: 10.01, 95% CI: 1.16–86.66, p = 0.04), and NLRs of 3.93 or higher (OR: 11.37, 95% CI: 1.12–114.68, p = 0.04) were significantly associated with poor short-term treatment response. CONCLUSION: The NLR may play a supplementary role in predicting the short-term treatment response in patients diagnosed with definite or probable AE, including those with autoantibody-negative, or unknown status.
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spelling pubmed-106264932023-11-07 Predictive value of the neutrophil-to-lymphocyte ratio for treatment response in patients diagnosed with definite or probable autoimmune encephalitis/encephalopathy Ogami, Shuhei Koh, Jinsoo Miyamoto, Katsuichi Mori, Megumi Takahashi, Maiko Nakayama, Yoshiaki Sakata, Mayumi Hiwatani, Yasuhiro Kajimoto, Yoshinori Ishiguchi, Hiroshi Ito, Hidefumi Front Neurol Neurology INTRODUCTION: Autoimmune encephalitis/encephalopathy (AE) is a complex and heterogeneous disease, making it difficult to predict the prognosis. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a potential prognostic tool, but its usefulness remains a matter of debate. This study aimed to explore prognostic factors in cases of clinically definite or probable AE, including those with autoantibody-negative, or unknown status. METHODS: Data on patients diagnosed with definite or probable AE, including those with autoantibody-negative, or unknown status, were retrospectively collected from the admission records of our department between January 2013 and December 2022. These patients were then categorized into either a good- or poor-response group, based on their short-term treatment response. Clinical characteristics, auxiliary examinations, and treatments were compared between the two groups. A multivariable logistic regression model was constructed to identify independent predictors of poor short-term treatment response by Akaike information criterion backward stepwise method. RESULTS: A total of 31 patients were included in the final analysis, with 18 of them included in the poor-response group. In the univariable analysis, the poor-response group had a higher proportion of patients with a modified Rankin Scale (mRS) high score upon admission, female, epileptic seizures, or NLRs of 3.93 or higher than the good-response group (all p < 0.10). Furthermore, the multivariable logistic regression analysis revealed that the mRS score upon admission [OR: 5.51, 95% confidence intervals (CI): 1.29–23.50, p = 0.02], epileptic seizures (OR: 10.01, 95% CI: 1.16–86.66, p = 0.04), and NLRs of 3.93 or higher (OR: 11.37, 95% CI: 1.12–114.68, p = 0.04) were significantly associated with poor short-term treatment response. CONCLUSION: The NLR may play a supplementary role in predicting the short-term treatment response in patients diagnosed with definite or probable AE, including those with autoantibody-negative, or unknown status. Frontiers Media S.A. 2023-10-23 /pmc/articles/PMC10626493/ /pubmed/37936916 http://dx.doi.org/10.3389/fneur.2023.1284717 Text en Copyright © 2023 Ogami, Koh, Miyamoto, Mori, Takahashi, Nakayama, Sakata, Hiwatani, Kajimoto, Ishiguchi and Ito. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Ogami, Shuhei
Koh, Jinsoo
Miyamoto, Katsuichi
Mori, Megumi
Takahashi, Maiko
Nakayama, Yoshiaki
Sakata, Mayumi
Hiwatani, Yasuhiro
Kajimoto, Yoshinori
Ishiguchi, Hiroshi
Ito, Hidefumi
Predictive value of the neutrophil-to-lymphocyte ratio for treatment response in patients diagnosed with definite or probable autoimmune encephalitis/encephalopathy
title Predictive value of the neutrophil-to-lymphocyte ratio for treatment response in patients diagnosed with definite or probable autoimmune encephalitis/encephalopathy
title_full Predictive value of the neutrophil-to-lymphocyte ratio for treatment response in patients diagnosed with definite or probable autoimmune encephalitis/encephalopathy
title_fullStr Predictive value of the neutrophil-to-lymphocyte ratio for treatment response in patients diagnosed with definite or probable autoimmune encephalitis/encephalopathy
title_full_unstemmed Predictive value of the neutrophil-to-lymphocyte ratio for treatment response in patients diagnosed with definite or probable autoimmune encephalitis/encephalopathy
title_short Predictive value of the neutrophil-to-lymphocyte ratio for treatment response in patients diagnosed with definite or probable autoimmune encephalitis/encephalopathy
title_sort predictive value of the neutrophil-to-lymphocyte ratio for treatment response in patients diagnosed with definite or probable autoimmune encephalitis/encephalopathy
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626493/
https://www.ncbi.nlm.nih.gov/pubmed/37936916
http://dx.doi.org/10.3389/fneur.2023.1284717
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