Comparison of neutrophil-to-lymphocyte ratio between myelin oligodendrocyte glycoprotein antibody-associated disease and aquaporin-4 antibody-positive neuromyelitis optica spectrum disorders in adults

The neutrophil-to-lymphocyte ratio (NLR) is a biomarker for evaluating disease activity in systemic autoimmune diseases. However, few studies have discussed NLR changes in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). This study aimed to explore the NLR difference between MOGAD, aquaporin-4 antibody (AQP4-Ab)-positive neuromyelitis optica spectrum disorders (NMOSD), and healthy controls (HCs) and evaluate the clinical value of NLR in the differential diagnosis. We included 15 patients with MOGAD, 28 patients with AQP4-Ab-positive NMOSD, and 68 HCs. Their NLRs were calculated, and statistical analysis was performed, with statistical significance set at P < 0.05. In pairwise comparisons between three groups, P < 0.017 was considered statistically significant under Bonferroni correction. NLR was higher during the acute attack in MOGAD patients than HCs but lower than in AQP4-Ab-positive NMOSD patients. NLR was correlated with Expanded Disability Status Scale (EDSS) in MOGAD and AQP4-Ab-positive NMOSD patients. Also, there were no statistical differences in intracranial pressure between MOGAD and AQP4-Ab-positive NMOSD patients and HCs. The cut-off value was 2.86, and the sensitivity and specificity were 0.750 and 0.867, respectively. In conclusion, our results suggest that NLR may be a helpful marker to evaluate disease severity and differentiate between both diseases at a cut-off value of > 2.86 when patients have clinical symptoms like optic neuritis or myelitis.