Neutrophil lymphocyte ratio as a marker of skin disease activity in older children with juvenile dermatomyositis
Authors' conclusion
Age-related variability in lymphocytes may complicate the interpretation and assessment of NLR in young children. NLR may serve as a cutaneous disease activity marker in older JDM patients.
Study context
- Population
- Juvenile dermatomyositis (JDM) patients (56.7% white, 71.1% female)
- Participants
- 97 patients
- Exposure
- Older vs younger children with JDM
- Outcome
- Correlation of NLR with JDM disease activity measures
Methodological detailsretrospective chart review, age-stratified (0-9 vs. 9-21 years), Spearman's correlation
- Retrospective chart review
- Age-stratified (0-9 vs. 9-21 years)
- Spearman's correlation
Main finding
As reported in the abstract
Correlation of NLR with skin disease activity
Older children: CDASI vs neutrophil to lymphocyte ratio (NLR), r
r = 0.39
p = 0.007
Older children: Physician global assessment (PGA) skin vs NLR, r
r = 0.52
p = 0.004
Younger children: skin involvement vs NLR, r
r=−0.41
p = 0.024
Observational data: associations, not effects.
Further findings
| Outcome | Older children | Younger children | P value |
|---|---|---|---|
| PGA | 2.0 | 4.0 | P = 0.015 |
| Lymphocyte count | 1700 | 2320 | P = 0.01 |
| MMT-8 | 80 | 73 | P < 0.001 |
| CMAS | 49 | 45 | P = 0.012 |
Correlation of NLR with muscle activity
- Childhood myositis assessment score (CMAS), older vs younger
- r = 0.021, p = 0.91 vs. r = 0.25, p = 0.22
- CK levels, older vs younger
- r = 0.23, p = 0.11 vs. r=−0.041, p = 0.79
- Manual muscle testing (MMT-8), older vs younger
- r = 0.152, p = 0.31 vs. r=−0.132, p = 0.377
- No associations with muscle activity in older or younger children
Original publication
Neutrophil lymphocyte ratio as a marker of skin disease activity in older children with juvenile dermatomyositis. Pediatr Rheumatol Online J. Published 24 November 2025. doi:10.
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