Blood Parameters in Patients with Neuromyelitis Optica Spectrum Disorders (NMO)

Document Type : Original Article(s)

Authors

1 Professor, Infectious Diseases and Tropical Medicine Research Center, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Professor of Neurology, Department of Neurology, School of Medicine, Neurosciences Research Center Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

3 School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 MD, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Neuromyelitis optica spectrum disorders (NMO) is a chronic, inflammatory, immune-mediated disease. This study aimed to determine blood parameters in patients with neuromyelitis optica spectrum disorders.
Methods: This cross-sectional study was conducted in outpatient MS clinic of Kashani Hospital. Seventy-five cases with NMOSD and 121 healthy control (HC) were recruited. We extracted data on the last blood test values just before commencement of treatment from database and hospital records. The blood parameters included white blood cell (WBC), red blood count (RBC), hemoglobin (Hb), platelet (PLT), lymphocyte (LYMP), neutrophil (NEUTP), red-cell distribution width (RDWCV). We also calculated neutrophil-to-lymphocyte-ratio (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil-to-WBC ratio (NWC), and lymphocyte-to-WBC ratio (LWR). Regression method was used for data analysis.
Findings: There were a higher level of MCH, MCHC, NLR and PLR in NMO patients compared to HC. However, patients with NMO had lower LYMP, NEUTP, NWR, and LWR than control group. A higher levels of RBC, Hb, HCT, MCV, MCH, and MCHC were observed among men. Higher EDSS score was associated with increased WBC. Patients with comorbidity had significantly higher MCV and MCH than those without comorbidity, whereas, RDWCV was lower.
Conclusion: Our results showed that blood indexes changed in NMOSD. Further studies are needed to elucidate the relation between these indexes with NMOSD.

Highlights

Azar Baradaran: Google Scholar 

Vahid Shaygannejad: Google Scholar 

Keywords

Main Subjects

References

  1. Lennon VA, Wingerchuk DM, Kryzer TJ, Pittock SJ, Lucchinetti CF, Fujihara K, et al. A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet 2004; 364(9451): 2106-12.
  2. Wingerchuk DM, Lennon VA, Lucchinetti CF, Pittock SJ, Weinshenker BG. The spectrum of neuromyelitis optica. Lancet Neurol 2007; 6(9): 805-15.
  3. Correale J, Fiol M. Activation of humoral immunity and eosinophils in neuromyelitis optica. Neurology 2004; 63(12): 2363-70.
  4. Jarius S, Wildemann B, Paul F. Neuromyelitis optica: clinical features, immunopathogenesis and treatment. Clin Exp Immunol 2014; 176(2): 149-64.
  5. Mitsdoerffer M, Kuchroo V, Korn T. Immunology of Neuromyelitis Optica: AT cell–B cell collaboration. Ann N Y Acad Sci 2013; 1283: 57.
  6. Saadoun S, Waters P, MacDonald C, Bell BA, Vincent A, Verkman A, et al. Neutrophil protease inhibition reduces neuromyelitis optica–immunoglobulin G–induced damage in mouse brain. Ann Neurol 2012; 71(3): 323-33.
  7. Hertwig L, Pache F, Romero-Suarez S, Stürner KH, Borisow N, Behrens J, et al. Distinct functionality of neutrophils in multiple sclerosis and neuromyelitis optica. Mult Scler 2016; 22(2): 160-73.
  8. Azab B, Bhatt VR, Phookan J, Murukutla S, Kohn N, Terjanian T, et al. Usefulness of the neutrophil-to-lymphocyte ratio in predicting short-and long-term mortality in breast cancer patients. Ann Surg Oncol 2012; 19(1): 217-24.
  9. Sen BB, Rifaioglu EN, Ekiz O, Inan MU, Sen T, Sen N. Neutrophil to lymphocyte ratio as a measure of systemic inflammation in psoriasis. Cutan Ocul Toxicol 2014; 33(3): 223-7.
  10. Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev Cardiovasc Ther 2013; 11(1): 55-9.
  11. Erre GL, Paliogiannis P, Castagna F, Mangoni AA, Carru C, Passiu G, et al. Meta‐analysis of neutrophil‐to‐lymphocyte and platelet‐to‐lymphocyte ratio in rheumatoid arthritis. Eur J Clin Invest 2019; 49(1): e13037.
  12. Olsson A, Gustavsen S, Gisselø Lauridsen K, Chenoufi Hasselbalch I, Sellebjerg F, Bach Søndergaard H, Bang Oturai A. Neutrophil‐to‐lymphocyte ratio and CRP as biomarkers in multiple sclerosis: a systematic review. Acta Neurol Scand 2021; 143(6): 577-86.
  13. Lin J, Xue B, Li J, Xu H, Huang X, Yao Z, et al. Neutrophil to lymphocyte ratio may be a helpful marker to evaluate disease activity in NMOSD. Neurol Sci 2017; 38(10): 1859-63.
  14. Benetou C, Berti F, Hemingway C, Hacohen Y, Lim M. Neutrophil-to-lymphocyte ratio correlates with disease activity in myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD) in children. Mult Scler Relat Disord 2020; 45: 102345.
  15. Carnero Contentti E, Delgado-García G, Criniti J, López PA, Pettinicchi JP, Cristiano E, et al. An Abnormally High Neutrophil-to-Lymphocyte Ratio Is Not an Independent Outcome Predictor in AQP4-IgG-Positive NMOSD. Front Immunol 2021; 12: 628024.
  16. Wingerchuk DM, Banwell B, Bennett JL, Cabre P, Carroll W, Chitnis T, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology 2015; 85(2): 177-89.
  17. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983; 33(11): 1444-52.
  18. Ye G-l, Chen Q, Chen X, Liu Y-y, Yin T-t, Meng Q-h, et al. The prognostic role of platelet-to-lymphocyte ratio in patients with acute heart failure: A cohort study. Sci Rep 2019; 9(1): 10639.

Balta S, Ozturk C. The platelet-lymphocyte ratio: a simple, inexpensive and rapid prognostic marker for cardiovascular events. Platelets 2015; 26(7): 680-1.

Journal of Isfahan Medical School
Volume 43, Issue 814
2nd Week, July
July and August 2025
Pages 488-494

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History

  • Receive Date: 26 April 2025
  • Accept Date: 08 June 2025

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