Evaluation of the hematological inflammatory parameters in the patients with immune thrombocytopenic purpura: A case-control study.

Background And Aims: Inflammation is one of the immune thrombocytopenic purpura (ITP)'s aggravating elements due to inflammatory cells' function. This study aims to identify and evaluate hematological inflammatory parameters, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and hemoglobin-to-platelet ratio (HPR), in patients with ITP compared to the control group.

Methods: We retrospectively analyzed the profile of 190 ITP patients from August 2019 to January 2021 at Imam Reza Hospital of Mashhad, Iran, along with 100 healthy individuals who had no ITP-related clinical or laboratory symptoms. Immune cell counts, NLR, PLR, and HPR were calculated using the complete blood count at the time of diagnosis and after the treatment. The results were analyzed through MedCalc, SPSS software, and the receiver operating characteristic curve.

Results: The result showed that white blood cell (WBC) and neutrophil counts were higher in ITP patients (WBC: : 0.001, neutrophil: : 0.001), and conversely, platelet and lymphocyte counts were higher in the control group compared to ITP patients (platelets: : 0.001, lymphocytes: : 0.001). The indices analysis between the two groups revealed that NLR was significantly increased in ITP patients (: 0.001), but PLR was significantly reduced in ITP patients (with the mean platelet count of 23.44 ± 35.26 × 10/L) compared to the control group (with the mean platelet count of 234.04 ± 55.88 × 10/L). The HPR index also significantly increased in ITP patients (: 0.001).

Conclusion: An increase in NLR, PLR, and a decrease in HPR can be considered a valuable diagnostic algorithm in patients with ITP.