Research Papers:

The correlation of neutrophil-to-lymphocyte ratio with the presence and activity of myasthenia gravis

De-Hao Yang _, Mei-Zi Qian, Mao-Mao Wei, Jia Li, Meng-Meng Yu, Xue-Mian Lu, Hong Yang, Hai Lin, Xiang Li, Jun-Yan Zhu and Xu Zhang

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Oncotarget. 2017; 8:76099-76107. https://doi.org/10.18632/oncotarget.18546

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De-Hao Yang1,*, Mei-Zi Qian2,*, Mao-Mao Wei3,*, Jia Li4, Meng-Meng Yu5, Xue-Mian Lu1, Hong Yang1, Hai Lin1, Xiang Li4, Jun-Yan Zhu3 and Xu Zhang4

1Department of Endocrinology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China

2Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China

3School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou 325000, China

4Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China

5Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China

*Co-first authors

Correspondence to:

De-Hao Yang, email: [email protected]

Keywords: neutrophil-to-lymphocyte ratio, myasthenia gravis, disease activity, new predictor, MGFA

Received: November 30, 2016     Accepted: June 02, 2017     Published: June 16, 2017


Though the pathogenesis of myasthenia gravis (MG) is not fully understood, the role of inflammation has been well appreciated in the development of MG. We aimed to investigate the role of neutrophil-to-lymphocyte ratio (NLR) in MG patients and the relationship between the NLR and the activity of the disease. A total number of 172 MG patients and 207 healthy controls (HC) were enrolled in this study. The MG patients were divided into tertiles according to NLR (low NLR < 1.58, n = 57; intermediate NLR 1.58–2.33, n = 57 and high NLR > 2.33, n = 58). The disease activity assessment was performed according to the standard criteria established by the Myasthenia Gravis Foundation of America. Patients with MG had significantly higher NLR when compared with the HC group (P < 0.0001). The NLR levels were higher in the MG patients with severe disease activity than those with mild disease activity (P < 0.001), meanwhile, median NLR was statistically higher in MG patients with myasthenic crisis (MC) than those without MC (P < 0.001). Incidences of severe disease activity and MC were both higher in the high NLR group, compared to low and intermediate NLR groups (both P < 0.001). Multivariate logistic regression analysis suggested that elevated NLR was an independent predictor of severe disease activity (odds ratio = 13.201, CI% = 1.418–122.938, P = 0.023). These results indicate that NLR may be a simple and useful potential marker in indicating disease activity in patients with MG.

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