https://doi.org/10.4081/ecj.2023.11314

The predictive value of inflammatory biomarkers in the detection of multiple sclerosis attacks

Vol. 19 No. 2 (2023): In Memory of Barbara Capovani
Submitted: 14 March 2023
Accepted: 23 April 2023
Published: 23 June 2023
Multiple sclerosis, monocyte-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, systemic immune inflammation index, red cell distribution width-to-lymphocyte ratio
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Authors

Nafis Vural
42nafisvural@gmail.com
https://orcid.org/0000-0002-3551-201X
Department of Emergency Medicine, Ereğli State Hospital, Konya, Turkey.
Murat Duyan
https://orcid.org/0000-0002-6420-3259
Department of Emergency Medicine, Antalya Training and Research Hospital, Antalya, Turkey.
Ali Saridas
Department of Emergency Medicine, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey.
Elif Ertas
Department of Biostatistics, Mersin University, Mersin, Turkey.
Asım Kalkan
Department of Emergency Medicine, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey.

Multiple sclerosis (MS) is the most prevalent immune-mediated inflammatory demyelinating central nervous system disorder, with a diverse set of clinical signs and symptoms. This study aimed to investigate the diagnostic values of the monocyte/lymphocyte ratio (MLR), red cell distribution width/lymphocyte ratio (RLR), and systemic immune-inflammation index (SII) in detecting multiple sclerosis attacks in patients with Relapsing-remitting MS (RRMS) presenting to the emergency department (ED). This retrospective observational study was conducted among patients with RRMS presenting to the ED of a third-level hospital. The laboratory parameters of 165 patients were compared during the attack and non-attack periods. The paired t-test statistic was used to compare means of inflammatory biomarker measurements between attack and non-attack groups. The neutrophil/lymphocyte ratio (NLR), MLR, RLR, and SII mean of the patients in the MS attack periods were higher than those in the non-attack period. The mean difference of NLR, MLR, RLR, and SII between both groups was 5.40±7.25, 0.37±0.43, 7.77±11.61, 1469.19±1978.88, respectively (p<0.001). In ROC analysis, NLR, RLR, MLR, and SII had excellent diagnostic power in detecting MS relapse (AUC: 0.87, 0.81, 0.86, and 0.87, respectively). According to our findings, SII, MLR, NLR, and RLR may be beneficial in confirming the diagnosis of attack in patients with RRMS.

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How to Cite

Vural, N., Duyan, M., Saridas, A., Ertas, E., & Kalkan, A. (2023). The predictive value of inflammatory biomarkers in the detection of multiple sclerosis attacks. Emergency Care Journal, 19(2). https://doi.org/10.4081/ecj.2023.11314
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