The Clinical Significance of the Neutrophil-to-Lymphocyte Ratio in Patients with Guillain-Barré Syndrome Independent of Infection

Geyik, Sırma; Bozkurt, Hakan; Neyal, Münife; Yıgıter, Remzi; Kuzudisli, Samiye; Kül, Seval

doi:10.17546/msd.90383

Cited by 6 publications

(26 citation statements)

References 18 publications

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“…In addition, our results revealed a significant positive correlation between the initial NLR values and the mean Hughes disability scale scores of both types of patients at presentation (p < 0.001), and at the end of follow-up (p < 0.001). Our findings agreed with those of Geyik et al [22] who concluded that NLR values positively and significantly correlated with disease severity, and the authors added that this ratio might be a promising marker in GBS. Sahin et al [20] reported that a high NLR was significantly related to initial disability in GBS patients.…”

Section: Discussionsupporting

confidence: 93%

“…In our study, we found that the initial serum NLR values were significantly higher in GBS patients than in controls (p < 0.001). These findings are consistent with the results of Geyik et al [22] and Ozler and Gunak, [23]. To highlight the relation between GBS and NLR, Hou et al [24] reported that GBS is an acute inflammatory disease caused by T cell-mediated autoimmunity to myelin proteins and autoantibody-mediated humoral immunity to myelin glycolipids.…”

Section: Discussionsupporting

confidence: 90%

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Neutrophil–lymphocyte ratio and response to plasmapheresis in Guillain–Barré syndrome: a prospective observational study

Hashim

Mohamed

Emad

2020

Egypt J Neurol Psychiatry Neurosurg

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Background: Guillain-Barré Syndrome (GBS) is one of the most severe neurological diseases that causes marked disability and even death. Aim: The aim of this study is to investigate the role of the neutrophil-lymphocyte ratio (NLR) as a prognostic marker for GBS and response to treatment with plasmapheresis. Methods: Seventy-five subjects (35 GBS patients and 40 healthy controls) were recruited. Complete general and neurological examinations were performed and Hughes disability scale score was evaluated for assessing functional motor deficits in GBS patients. In addition, NLR, erythrocyte sedimentation rate, and C-reactive protein level were calculated. Results: NLR was significantly higher in GBS patients than in controls (p < 0.001) and was significantly higher in axonal form than other demyelinating and mixed subtypes (p < 0.02). Patients with a poor outcome had a significantly high NLR than patients with a good outcome (p = 0.006). NLR was also positively correlated with Hughes disability scale score (p < 0.001). The cut-off value for NLR to predict a good response of patients to plasmapheresis was ≤ 4.4. Interpretation: NLR may be a rapid, simple, inexpensive biomarker for predicting the severity of GBS, outcome of patients, and their response to plasmapheresis.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 90%

Neutrophil–lymphocyte ratio and response to plasmapheresis in Guillain–Barré syndrome: a prospective observational study

Hashim

Mohamed

Emad

2020

Egypt J Neurol Psychiatry Neurosurg

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“… 3 – 6 In a study by Ozdemir 12 on GBS-A patients, there was no significant correlation between NLR and PLR and admission and discharge disability. In another study, Geyik et al 17 reported that NLR level at hospital admission showed a significant negative correlation with the posttreatment HDS. In this study, we found higher NLR levels at admission, discharge, and third-month control in the GBS-A group, whereas it was higher only at the third-month control in the GBS-P group.…”

Section: Discussionmentioning

confidence: 92%

Effect of serum inflammatory markers on the prognosis of adult and pediatric patients with Guillain–Barré syndrome

Ethemoğlu¹,

Çalık²

2018

NDT

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ObjectiveThe aim of this study was to evaluate blood neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), C-reactive protein (CRP), and albumin levels for their prognostic value in adult Guillain–Barré syndrome (GBS-A) and pediatric Guillain–Barré syndrome (GBS-P) patients.Patients and methodsWe retrospectively analyzed the medical records of 68 Guillain–Barré syndrome (GBS) patients (36 adults, 32 children) who were treated as inpatients at Harran University Faculty of Medicine, Neurology and Pediatric Neurology Departments. The pretreatment NLR, PLR, CRP, and albumin levels and Hughes scores at hospital admission, discharge, and third-month control were documented.ResultsIn GBS-A patients, the mean CRP and NLR levels at admission/discharge and third-month control were significantly higher, and the mean albumin level was significantly lower in the Hughes disability scale (HDS)≥3 group. In GBS-P group, the mean NLR level at third month was significantly higher in the HDS≥3 group. GBS-A patients had higher mean NLR, PLR, and CRP levels and lower mean albumin values than GBS-P patients. Both GBS-A and GBS-P patients had higher mean NLR, PLR, and CRP levels and lower mean albumin values than healthy controls. Only the albumin level of the GBS-A group was found to be a significant predictor of prognosis at discharge from hospital.ConclusionNLR, CRP, and albumin levels in the GBS-A group and NLR levels in the GBS-P group may be helpful in predicting the prognosis of the disease. The albumin level of GBS-A patients is an independent risk factor for prognosis at discharge from hospital.

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“…NLR may play a diagnostic and prognostic role in GBS, according to the results of these studies. NLR levels were found to be higher in patients with GBS compared to healthy controls in several studies [ 10 , 12 – 14 ]. On the other hand, one recent study found no significant alterations in this marker between GBS patients and controls [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, one recent study found no significant alterations in this marker between GBS patients and controls [ 11 ]. In addition, two previous studies declared that NLR could come into use when distinguishing between GBS subtypes [ 13 , 16 ], while other studies found totally opposite findings [ 10 – 12 ]. This introduces the concept that timing of the test may be important.…”

Section: Introductionmentioning

confidence: 99%

Role of the Neutrophil to Lymphocyte Ratio in Guillain Barré Syndrome: A Systematic Review and Meta-Analysis

Sarejloo

Khanzadeh

Hosseini

et al. 2022

Mediators of Inflammation

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In this study, we conducted a systematic review and meta-analysis regarding the role of the neutrophil to lymphocyte ratio (NLR) in Guillain Barré syndrome (GBS). The most recent update to the search was on July 18, 2022, through the databases of Web of Science, PubMed, Embase, and Scopus. The Newcastle-Ottawa scale was used for quality assessment of included studies. Finally, 14 studies were included in the review, and among them, ten studies were included in the meta-analysis. Our results showed that NLR levels were significantly increased in the patients with GBS compared with healthy controls ( SMD = 1.05 ; 95 % CI = 0.59 to 1.50, P < 0.001 ). After treatment, NLR levels were decreased to the extent that they became similar to healthy controls ( SMD = − 0.03 , 95 % CI = − 0.29 to 0.22, P = 0.204 ). Moreover, NLR was a stable predictor of outcome or response to treatment in such patients ( SMD = 1.01 , 95 % CI = 0.65 to 1.37, P < 0.001 ); the higher the NLR, the worse the outcome. In addition, patients who underwent mechanical ventilation had higher levels of NLR compared to those who did not ( SMD = 0.93 , 95 % CI = 0.05 to 1.82, P = 0.03 ). However, NLR levels were not different among distinct GBS subtypes, so it could not distinguish among them. In conclusion, our analysis indicates that the NLR levels are highly elevated in patients with GBS. Therefore, the NLR has the potential to be used as a biomarker to inform diagnosis, prognosis, or treatment responses in GBS, and future studies are warranted.

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The Clinical Significance of the Neutrophil-to-Lymphocyte Ratio in Patients with Guillain-Barré Syndrome Independent of Infection

Cited by 6 publications

References 18 publications

Neutrophil–lymphocyte ratio and response to plasmapheresis in Guillain–Barré syndrome: a prospective observational study

Neutrophil–lymphocyte ratio and response to plasmapheresis in Guillain–Barré syndrome: a prospective observational study

Effect of serum inflammatory markers on the prognosis of adult and pediatric patients with Guillain–Barré syndrome

Role of the Neutrophil to Lymphocyte Ratio in Guillain Barré Syndrome: A Systematic Review and Meta-Analysis

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The Clinical Significance of the Neutrophil-to-Lymphocyte Ratio in Patients with Guillain-Barré Syndrome Independent of Infection

Cited by 6 publications

References 18 publications

Neutrophil–lymphocyte ratio and response to plasmapheresis in Guillain–Barré syndrome: a prospective observational study

Neutrophil–lymphocyte ratio and response to plasmapheresis in Guillain–Barré syndrome: a prospective observational study

Effect of serum inflammatory markers on the prognosis of adult and pediatric patients with Guillain&ndash;Barr&eacute; syndrome

Role of the Neutrophil to Lymphocyte Ratio in Guillain Barré Syndrome: A Systematic Review and Meta-Analysis

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Effect of serum inflammatory markers on the prognosis of adult and pediatric patients with Guillain–Barré syndrome