The neutrophil-to-lymphocyte ratio is associated with intubation in pediatric anti-NMDA receptor encephalitis: A retrospective study

• Type of Material: Article
• Authors: Nisha Kashyap, Children's Healthcare of Atlanta; Morgan Morris, Emory University; Leah B. Loerinc, Emory University; Macarthur Benoit, Children's Healthcare of Atlanta; Laura Blackwell, Emory University; Robyn Ann Howarth, Emory University; Grace Yoonheekim Gombolay, Emory University
• Language: English
• Date: 2022-07-15
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022 Elsevier B.V. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1016%2Fj.jneuroim.2022.577931
• Title of Journal or Parent Work: Journal of Neuroimmunology
• Volume: 370
• Start Page: 577931
• Grant/Funding Information: This work was supported by the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) under Award Numbers UL1TR002378 and KL2TR002381, United States, and the 2019 Pediatric Research Alliance Center for Clinical and Translational Research Pilot Grant, Atlanta, GA, United States.
• Keywords: Anti-NMDA receptor antibodies; Neutrophil to lymphocyte ratio; Autoimmune encephalitis; Pediatric autoimmune encephalitis; Anti-NMDA receptor encephalitis
• Research Categories: Health Sciences, Immunology

Abstract

Background The neutrophil-to-lymphocyte ratio (NLR) may predict poor outcomes in adult anti-NMDAR encephalitis (NMDARE). The association of NLR with outcomes in pediatric NMDARE was examined. Methods Pediatric NMDARE patients (N = 36) were retrospectively studied. Results High NLR (>6) had a higher proportion of tumors (43% versus 7%) and higher intubation rates (100% versus 38%, p = 0.008). Multivariate analyses showed that high NLR did not correlate with one-year outcomes, inpatient length of stay (LOS), or with tumor, but was associated with intubation and rehabilitation LOS. Conclusion NLR is associated with intubation and rehabilitation LOS. Further investigation is needed for prognostic biomarkers in NMDARE.