High blood neutrophil-lymphocyte ratio associated with poor outcomes in miliary tuberculosis

Abstract

Pre-treatment NLR at admission may be a useful biomarker for mortality and development of ARDS in patients with miliary TB.

Association between Neutrophil-to-Lymphocyte Ratio and Gut Microbiota in a Large Population: a Retrospective Cross-Sectional Study

“…NLR can be used as a prognostic marker in multiple diseases 12 – 14 , 17 – 19 , 22 , 23 . The value of NLR ranges from 0.78 to 3.53 in the healthy adult population 21 .…”

“…The value of NLR ranges from 0.78 to 3.53 in the healthy adult population 21 . Although there is controversy on the optimal NLR cut-off values, numerous studies have reported that the NLR cut-off value for mortality in specific diseases is between 3 and 5 17 , 23 – 25 . The cut-off value of NLR for disease severity and activity in inflammatory bowel disease (IBD) is slightly lower compared with other medical conditions, ranging from 2 to 3 26 – 28 .…”

The potential of CBC-derived ratios (Monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte) to predict or diagnose incident TB infection in Tanzanian adolescents 

“…Similarly, NLR has previously been associated with the subsequent development of TB disease (15) and the presence of active TB disease (including both pulmonary and extrapulmonary sites) (18)(19)(20)(21)(22)25), as well as the need for TB retreatment in previously-treated individuals (16), and development of acute respiratory distress syndrome (ARDS) in subjects with miliary tuberculosis (17). Most prior studies have reported that concurrent NLR is elevated in TB disease subjects relative to controls, but that NLR may be even further elevated in the setting of other acute respiratory infections (24).…”

“…A number of prior studies have evaluated CBC-derived ratios (MLR, NLR, and/or PLR) in the context of symptomatic TB disease, speci cally related to either predicting subsequent TB disease development, diagnosing TB disease, or monitoring disease response to antimicrobial therapy (5)(6)(7)(8)(9)(10)(11)(12)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). These studies were heterogeneous with respect to the geographic region from which participants originated, presence of comorbidities (such as HIV), age, concurrent use of TB therapy, and choice of control groups, making comparisons challenging.…”

“…The CBC ratios described here are hypothesized to represent markers of non-speci c in ammation, and have been evaluated in the context of TB disease (5)(6)(7)(8)(9)(10)(11)(12)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25), malignancy (26)(27)(28)(29)(30), and several other conditions that are hypothesized to have a pro-in ammatory component (31)(32)(33). Through the analysis of paired CBC and IGRA assays, we are able to report on the utility of baseline MLR, NLR, and PLR, as well as other CBC components, for predicting future development of asymptomatic TB infection and on the effect of incident TB infection on concurrent CBC values.…”