Clinical utility of complete blood count indices in pediatric MOG antibody-associated disease

The purpose of this study was to analyze the utility of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in pediatric myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD).

Retrospective review of medical record was performed to analyze association among complete blood count (CBC) indices and clinical characteristics of pediatric MOGAD patients.

61 patients were included in the analysis. In 24 subjects with matched CBC samples, NLR, PLR, and monocyte-to-lymphocyte ratio (MLR) were higher during disease relapse than in remission. In the receiver operating characteristics (ROC) curve analysis, the optimal cutoff values were 2.55 and 179.4 for NLR and PLR, respectively. The area under curve (AUC) was 0.809 and 0.658 for NLR and PLR, respectively. At disease onset, NLR and PLR were higher in patients in the relapsing group. In the ROC curve analysis, the optimal cutoff values were 3.35 and 183.8 with the AUC of 0.739 and 0.700 for NLR and PLR, respectively. In logistic regression analysis, NLR and PLR elevation were statistically significant after adjusting for age, sex, and phenotype. The pooled analysis of all clinical attacks in the relapsing group revealed that NLR and PLR are lower in the isolated optic neuritis (ON) compared to the other phenotypes.

This study shows that in pediatric MOGAD patients, NLR and PLR are useful for prompt recognition of disease relapse and prediction of relapsing course at disease onset. NLR and PLR are also associated with clinical phenotypes in pediatric MOGAD.