The Systemic Inflammation Markers As Possible Indexes of Poor Prognosis in Patients with Myasthenia Gravis

Objective: A number of studies have proved that systemic inflammation markers were associated with the increase of morbidity and mortality of autoimmune disease. However, the potential effect of systemic inflammation markers in myasthenia gravis (MG) is not fully understood. Our study aimed to explore their relationship with clinical activity, respiratory failure and prognosis in MG patients.Methods: 117 MG patients and 120 healthy controls (HC) were enrolled in this study. Differences in the four immune-related markers of the two groups based on blood cell counts: neutrophil-to-lymphocyte ratio (NLR), platelet-to lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and systemic immune-infammation index (SII) were measured. The correlations between these systemic inflammation markers and clinical characteristics were analyzed. The predicitive factors for respiratory failure in MG patients were confirmed by logistic regression analysis and receiver operating characteristic curves (ROC). Moreover, Kaplan–Meier curve and multivariate COX regression models were applied to assess their predictive value for disease prognosis.Results: NLR, PLR and SII were significantly higher in MG patients than those in HC, but not LMR. Logistic regression analysis showed that PLR and SII were independent predictors of MG with respiratory failure. The ROC curve demonstrated that PLR and SII showed good sensitivity and specificity for the diagnosis of MG with respiratory failure. The multivariate COX regression models indicated that SII was a risk factor for poor outcome of MG.Conclusions: The systemic inflammation markers expressed abnormally in MG patients, in which PLR and SII may be independent predictors of respiratory failure in MG patients and SII is a vigorous instrument for predicting clinical outcome.