New Data on Diagnosing Demyelinating Polyradiculoneuropathy

03/31/2022

The study covered in this summary was published on ResearchSquare.com as a preprint and has not yet been peer reviewed.

Key Takeaways

In patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), the lymphocyte to monocyte ratio (LMR) was lower than in healthy control subjects.
Furthermore, LMR was lower in patients with active disease compared with patients whose disease was in remission.
Correlation analyses indicated an association between the LMR and severity of CIDP.
Low LMR was highly predictive of the presence of CIDP.

Why This Matters

There is an unmet need for a biomarker that can identify patients with CIDP and monitor disease activity.
This study is the first to evaluate the role of LMR in patients with CIDP.

Study Design

Study investigators retrospectively analyzed medical records of patients with CIDP who had been treated in the Sir Run Run Shaw Hospital in Zhejiang, China, between 2017 and 2020. Of these patients, 23 had active disease, and for 13, disease was in remission.
The patients were age- and gender-matched with an equal number of healthy control subjects who had undergone a physical examination at the same hospital.
Results of blood work for the patients with CIDP were compared with those of the healthy controls.
Pearson and Spearman correlation analyses were used to evaluate the relationship between LMR and various other hematologic parameters.
To assess the diagnostic value of LMR for CIDP, the area under the curve (AUC) was determined using receiver operating characteristic (ROC) curve analysis.

Key Results

LMR was significantly lower for patients with CIDP compared with control subjects (3.92 ± 2.42 vs 5.80 ± 3.57; P < .001).
LMR was significantly lower for patients with active disease (2.51 ± 1.21) than for patients whose disease was in remission (3.65 ± 1.17; P = .009).
In patients with CIDP, a significant positive correlation was observed between LMR and hemoglobin levels (r = 0.357; P = .033), red blood cell counts (r = 0.472; P = .004), and albumin/globulin ratio (r = 0.362; P = .030). A negative correlation was observed between LMR and neutrophil to lymphocyte ratio (r = -0.606; P < .001), platelet to lymphocyte ratio (r = -0.459; P = .0048), and red cell distribution width (r = -0.366; P = .028). These correlations indicate an association between LMR and disease severity.
When analyzing clinical indicators of the presence of disease, LMR had an area under the ROC curve of 0.807 (95% CI, 0.705 – 0.908), with 77.78% sensitivity and 75.00% specificity.
The optimal cutoff value for LMR was determined to be 4.41.
Combining LMR with the erythrocyte sedimentation rate and albumin/globulin ratio resulted in an AUC of 0.885 (95% CI, 0.809 – 0.961), a sensitivity of 80.56%, and a specificity of 77.48%.

Limitations

The results of this study are limited by its retrospective study design and small sample size.
LMR is a nonspecific inflammatory marker, and further study is needed to validate its use as a predictive and prognostic biomarker.

Disclosures

The study received no commercial funding.
The authors have disclosed no relevant financial relationships.

This is a summary of a preprint research study, “The Role of Lymphocyte-Monocyte Ratio on Chronic Inflammatory Demyelinating Polyradiculoneuropathy Diagnosis and Disease Activity,” written by Zhenmei Hong from The Third Affiliated Hospital of Zhejiang Traditional Chinese Medicine University and colleagues on ResearchSquare.com and provided to you by Medscape. This study has not yet been peer reviewed. The full text of the study can be found on ResearchSquare.com.

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