Peripheral blood inflammatory cell ratios derived from complete blood count as predictors of multiple sclerosis disease activity and severity

Multiple sclerosis (MS) is an autoimmune disorder affecting the central nervous system. This retrospective cohort study analyzed medical records of 98 MS patients to evaluate the predictive role of neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) in disease activity and severity. High NLR exhibited the strongest predictive value, with a cutoff >2.681 yielding sensitivity of 97.6% and specificity of 85.7% for severe disease. Elevated MLR was also associated with disease severity and activity, though less predictive than NLR. PLR was predictive of high disease activity but not severity. In conclusion, NLR is a strong and readily available biomarker for predicting MS activity and severity, outperforming MLR and PLR, and may aid early risk stratification and clinical decisions.