Alkhouri et al used the ratio of the neutrophil-to-lymphocyte count to evaluate a patient with non-alcoholic steatohepatitis (NASH). This is an inexpensive test that can be used to screen or to monitor patients. The authors are from the Cleveland Clinic.



(1) neutrophil count

(2) lymphocyte count


ratio =

= (neutrophil count) / (lympocyte count)



< 1.9

significant NASH unlikely

1.9 to 2.3

significant NASH without significant fibrosis

> 2.3

fibrosis stage 3 or 4 likely



• Other conditions affecting the bone marrow, neutrophil count or lymphocyte count would affect the ratio. Ideally the patient should be stable with no other active condition.


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