Utility of Blood Neutrophil to Diagnose Bacterial Infections under Satralizumab Treatment for Aquaporin-4 Antibody-positive Neuromyelitis Optica Spectrum Disorder: A Report of Two Cases
Abstract
Satralizumab is an anti-interleukin-6 receptor biologic that may mask bacterial infections. We report two patients with neuromyelitis optica spectrum disorder who developed afebrile bacterial infections with normal C-reactive protein levels during satralizumab treatment. During non-infectious periods under satralizumab treatment, the neutrophil count and neutrophil-to-lymphocyte ratio decreased, whereas the neutrophil change ratio, defined as the ratio of present to previous neutrophil counts, did not. At the time of infection, these variables were elevated compared to the intra-individual confidence intervals during non-infectious periods. These cases indicate the utility of neutrophil-related parameters in diagnosing bacterial infections during satralizumab treatment.
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BibTeX
@article{kuroda2026utility,
title = {{Utility of Blood Neutrophil to Diagnose Bacterial Infections under Satralizumab Treatment for Aquaporin-4 Antibody-positive Neuromyelitis Optica Spectrum Disorder: A Report of Two Cases}},
author = {Hiroshi Kuroda and Kazuo Fujihara and Chikako Kaneko and Takayuki Sagae and Kengo Uryu and Teiji Yamamoto},
journal = {Internal Medicine},
year = {2026},
month = oct,
doi = {10.2169/internalmedicine.7658-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7658-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Utility of Blood Neutrophil to Diagnose Bacterial Infections under Satralizumab Treatment for Aquaporin-4 Antibody-positive Neuromyelitis Optica Spectrum Disorder: A Report of Two Cases
AU - Hiroshi Kuroda
AU - Kazuo Fujihara
AU - Chikako Kaneko
AU - Takayuki Sagae
AU - Kengo Uryu
AU - Teiji Yamamoto
PY - 2026
DA - 2026/10/15
JO - Internal Medicine
DO - 10.2169/internalmedicine.7658-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7658-26/_article
AB - Satralizumab is an anti-interleukin-6 receptor biologic that may mask bacterial infections. We report two patients with neuromyelitis optica spectrum disorder who developed afebrile bacterial infections with normal C-reactive protein levels during satralizumab treatment. During non-infectious periods under satralizumab treatment, the neutrophil count and neutrophil-to-lymphocyte ratio decreased, whereas the neutrophil change ratio, defined as the ratio of present to previous neutrophil counts, did not. At the time of infection, these variables were elevated compared to the intra-individual confidence intervals during non-infectious periods. These cases indicate the utility of neutrophil-related parameters in diagnosing bacterial infections during satralizumab treatment.
SN - 1349-7235
SN - 0918-2918
ER -