Evaluation of Neutrophil to Lymphocyte Ratio as a Biomarker in Children with Exacerbated Asthma

Zahran, Mahmoud Mohammed; Mohamed, Hussein Ishak; Abd Elmouttaleb, Ashraf Taha; Nabih, Mostafa Mohamed Samir

doi:10.21608/aimj.2025.446452

Evaluation of Neutrophil to Lymphocyte Ratio as a Biomarker in Children with Exacerbated Asthma

Document Type : Original Article

Authors

¹ Pediatrics, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

² Medical Biochemistry, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

10.21608/aimj.2025.446452

Abstract

Background: Asthma is a chronic inflammation of the airways, defined by varying respiratory symptoms and variable expiratory airflow limitations, which may become persistent over time.
Aim: To evaluate correlation between neutrophil to lymphocyte ratio (NLR) and asthma exacerbation and how we can use them as biomarkers.
Patients and methods: This was a case-control study has been carried out on 150 participants, divided into two groups. The first group included 100 asthmatic kids presenting with acute exacerbations of asthma. The second group included 50 apparently healthy kids presenting to the outpatient clinic who served as the control group at Bab Al-Sharia University Hospital.
Results: The AUC for the absolute neutrophil count was 1 (p-value less than 0.001), indicating a perfect predictive ability. The optimal cutoff point for the absolute neutrophil count was 2.65, with 100% sensitivity and a 63% specificity. The AUC for the absolute lymphocyte count was 0.17 (p-value less than 0.001), indicating a poor predictive ability. The optimal cutoff point for the absolute lymphocyte count was 2.35, with 40% sensitivity and 97% specificity. The AUC for the neutrophil-to-lymphocyte ratio was 1 (p-value less than 0.001), indicating a perfect predictive ability. The optimal cutoff point for the neutrophil-to-lymphocyte ratio was 0.95, with 100% sensitivity and 91% specificity.
Conclusion: The neutrophil to lymphocyte ratio and PLR were significantly elevated throughout acute asthma exacerbations in kids. The results indicate that these variables may serve as markers for acute exacerbation in childhood asthma cases.
Background: Asthma is a chronic inflammation of the airways, defined by varying respiratory symptoms and variable expiratory airflow limitations, which may become persistent over time.
Aim: To evaluate correlation between neutrophil to lymphocyte ratio (NLR) and asthma exacerbation and how we can use them as biomarkers.
Patients and methods: This was a case-control study has been carried out on 150 participants, divided into two groups. The first group included 100 asthmatic kids presenting with acute exacerbations of asthma. The second group included 50 apparently healthy kids presenting to the outpatient clinic who served as the control group at Bab Al-Sharia University Hospital.
Results: The AUC for the absolute neutrophil count was 1 (p-value less than 0.001), indicating a perfect predictive ability. The optimal cutoff point for the absolute neutrophil count was 2.65, with 100% sensitivity and a 63% specificity. The AUC for the absolute lymphocyte count was 0.17 (p-value less than 0.001), indicating a poor predictive ability. The optimal cutoff point for the absolute lymphocyte count was 2.35, with 40% sensitivity and 97% specificity. The AUC for the neutrophil-to-lymphocyte ratio was 1 (p-value less than 0.001), indicating a perfect predictive ability. The optimal cutoff point for the neutrophil-to-lymphocyte ratio was 0.95, with 100% sensitivity and 91% specificity.
Conclusion: The neutrophil to lymphocyte ratio and PLR were significantly elevated throughout acute asthma exacerbations in kids. The results indicate that these variables may serve as markers for acute exacerbation in childhood asthma cases.

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