The Clinical Significance of the Neutrophil-to-Lymphocyte Ratio in Patients with Guillain-Barré Syndrome Independent of Infection

Abstract

Objective:  In the present study, we aimed to determine the predictive value of neutrophil-to-lymphocyte ratio (NLR) in the diagnosis of Guillain-Barré Syndrome (GBS).  Material and Methods: This retrospective study enrolled 94 GBS patients and a control group of 101 healthy subjects. Results: GBS patients had significantly higher NLR, C- Reactive Protein (CRP) and Erythrocyte  Sedimentation Rate (ESR) values at presentation than the healthy control group (p < 0.001, p < 0.001, p < 0.001, respectively). Patients unresponsive to IVIg therapy had significantly higher NLR values at the time of admission in comparison to responsive patients (p=0.001). NLR was significantly and positively correlated with the disease severity, CRP and ESR. A receiver operating characteristic (ROC) analysis of the ability of NLR to predict GBS showed a cutoff value of 3.5 (sensitivity 62.8%, specificity 90.1%). The cutoff value was 11 for CRP (sensitivity 52.7%, specificity 86%) and 12.3 for ESR (sensitivity 51.3%, specificity 82%). Exclusion of patients with signs of infection at presentation gave a NLR value of 3.2, which had a sensitivity of 61.6% and a specificity of 89.8% for predicting GBS. Conclusion:  Whereas ESR and CRP lost their significance in predicting GBS. Unlike ESR and CRP, NLR might be a promising marker in GBS regardless of infection.