The predictive value of inflammatory biomarkers in the detection of multiple sclerosis attacks

Multiple sclerosis (MS) is the most prevalent immune-mediated inflammatory demyelinating central nervous system disorder, with a diverse set of clinical signs and symptoms. This study aimed to investigate the diagnostic values of the monocyte/lymphocyte ratio (MLR), red cell distribution width/lymphocyte ratio (RLR), and systemic immune-inflammation index (SII) in detecting multiple sclerosis attacks in patients with Relapsing-remitting MS (RRMS) presenting to the emergency department (ED). This retrospective observational study was conducted among patients with RRMS presenting to the ED of a third-level hospital. The laboratory parameters of 165 patients were compared during the attack and non-attack periods. The paired t-test statistic was used to compare means of inflammatory biomarker measurements between attack and non-attack groups. The neutrophil/lymphocyte ratio (NLR), MLR, RLR, and SII mean of the patients in the MS attack periods were higher than those in the non-attack period. The mean difference of NLR, MLR, RLR, and SII between both groups was 5.40±7.25, 0.37±0.43, 7.77±11.61, 1469.19±1978.88, respectively (p<0.001). In ROC analysis, NLR, RLR, MLR, and SII had excellent diagnostic power in detecting MS relapse (AUC: 0.87, 0.81, 0.86, and 0.87, respectively). According to our findings, SII, MLR, NLR, and RLR may be beneficial in confirming the diagnosis of attack in patients with RRMS.