Can eosinophil to monocyte ratio be a new marker for recurrence in graves' disease?

Abstract

Prognostic parameters are crucial in the choice of treatment in Graves' disease (GD), thus,these parameters may not be easily achievable in all situations. However hematological parameters is important in inflammation and easy to obtain. In this study we aimed to elucidate whether these parameters could determine the prognosis in patients with Graves Disease. This retrospective analysis consisted of 114 individuals with a diagnosed with GD. The enrolled patients were treated with anti-thyroid drugs for an average of 14 months and the mean follow-up period after treatment discontinuation was 17.4 months. After the follow-up period subjects have been segmented to 2 groups as: Group 1 relapsed (n:61) and Group 2 non-relapsed (n:53). The neutrophil to lymphocyte ratio (NLR) of the relapsing individual was statistically significantly higher compared to other group, while the eosinophil to monocytes ratio (EMR) was lower. In the multiregression analysis, both parameters were found to be independent risk factors in predicting relapse [(OR=3.1, p:0.026 for NLR) (OR=1.5, p<0.001 for EMR)]. In addition, a value of 0.17 EMR had 70% sensitivity and 80% specificity in determining recurrence. EMR was found to be an independent predictor of prognosis with high specificity. The calculation of EMR before initiating treatment could provide beneficial outcomes for the choice of treatment in patients with GD.