An auxiliary diagnostic strategy for distinguishing Guillain–Barré syndrome and chronic inflammatory demyelinating polyneuropathy: combining platelet-to-lymphocyte ratio and cerebrospinal fluid interleukin-8 levels
Simin Song,
Yunfei Bai,
Haoran Mu,
Jianru Xiao,
Wei Li,
Yuying Zhao,
Chuanzhu Yan,
Jinfan Zheng,
Caijing Wang,
Qinzhou Wang
Affiliations
Simin Song
Department of Neurology, Shandong Key Laboratory of Mitochondrial Medicine and Rare Diseases, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University
Yunfei Bai
Department of Neurology, Qilu Hospital (Qingdao), Shandong University
Haoran Mu
Department of Neurology, Shandong Key Laboratory of Mitochondrial Medicine and Rare Diseases, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University
Jianru Xiao
Department of Neurology, Shandong Key Laboratory of Mitochondrial Medicine and Rare Diseases, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University
Wei Li
Department of Neurology, Shandong Key Laboratory of Mitochondrial Medicine and Rare Diseases, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University
Yuying Zhao
Department of Neurology, Shandong Key Laboratory of Mitochondrial Medicine and Rare Diseases, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University
Chuanzhu Yan
Department of Neurology, Shandong Key Laboratory of Mitochondrial Medicine and Rare Diseases, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University
Jinfan Zheng
Department of Neurology, Shandong Key Laboratory of Mitochondrial Medicine and Rare Diseases, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University
Caijing Wang
Baotuquan Campus Hospital of Shandong University
Qinzhou Wang
Department of Neurology, Shandong Key Laboratory of Mitochondrial Medicine and Rare Diseases, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University
Abstract Background Guillain–Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) are immune-mediated neuropathies with overlapping clinical and electrophysiological features but distinct treatment strategies. This study investigated whether the platelet-to-lymphocyte ratio (PLR) and cerebrospinal fluid (CSF) interleukin-8 (IL-8) levels can serve as auxiliary biomarkers to aid in distinguishing CIDP from GBS. Methods For 65 patients with GBS, 38 with typical CIDP, and 65 healthy controls (HCs), clinical, serological, and CSF data were collected. Inflammatory markers were analyzed. Binary logistic regression was performed to identify risk factors and establish a prediction model. Receiver operating characteristic (ROC) curves were used to assess diagnostic performance. Results The neutrophil-to-lymphocyte ratio (NLR), derived NLR, PLR, Systemic Inflammation Response Index, and Systemic Immune-Inflammation Index levels were significantly higher in the GBS than in the CIDP or HC groups (P < 0.05). The lymphocyte count was significantly higher in patients with CIDP than in those with GBS (P < 0.01). CSF IgG and IL-8 (both P < 0.001) were significantly higher in patients with GBS than in those with CIDP. ROC curve analysis showed that the area under the curve (AUC) of PLR was 0.746 and that of CSF IL-8 was 0.786. Combining PLR and CSF IL-8 levels improved the AUC to 0.827 (95% CI: 0.749–0.905), with a specificity of 0.973. Conclusion The combination of PLR and CSF IL-8 levels may serve as a useful adjunct to conventional clinical and electrophysiological assessments for differentiating CIDP from GBS. These findings also contribute to a better understanding of the immunological differences between acute and chronic inflammatory neuropathies.
