Evaluation of NLR and PLR in Immune Thrombocytopenic Purpura; Is it Worth Doing?
Aisha Arshad1, Samina Naz Mukry1* and Tahir Shamsi2
1Department of Transplant Immunology and Applied Microbiology, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan
2Department of Clinical Haematology, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan
*Corresponding Author: Chamari M Hettiarachchi, Department of Chemistry, Faculty of Science, University of Colombo, Sri Lanka.
July 29, 2022; Published: September 29, 2022
Background: Immune thrombocytopenia (ITP) is an autoimmune disorder. The clinical biomarkers like Neutrophils to lymphocytes ratio (NLR) and platelet to lymphocytes ratio (PLR) can be used as differential diagnostic tool in ITP. The current study was planned to evaluate utility of NLR and PLR in ITP diagnosis and their association with disease prognosis and response to treatment.
Methods: A case control study (1:1) was conducted from January 2015 to December 2017 with 111 ITP patients and 111 healthy controls. Peripheral blood was collected and CBC were recorded using Sysmex XN-1000.The calculation of NLR and PLR was done using absolute value of neutrophils, lymphocytes and platelets counts. The significant difference (p = <0.05) between ITP patients and healthy control groups was determined by Kruskal wallis test, Dunn’s test and spearman’s correlation test was done to evaluate platelet count correlation with IPF using SPSS ver.23.
Results: Low hemoglobin and platelet counts with high total leucocyte count (TLC) and IPF were detected in ITP patients as compared to healthy individuals (p = <0.05).Among all groups of ITP patients, very low platelet count with median(IQR) of 2(3.8)x109/l was observed in ND-ITP group. The NLR was high with prognosis of disease as higher levels were observed in P-ITP. The PLR was significantly low in ND-ITP, P-ITP, C-ITP, R-ITP and compared to controls with p = <0.001.
Conclusion: The simple, reliable and calculated NLR and PLR ratios can be used in predicting prognosis and response to treatment in ITP and to some extend the severity of disease
Keywords: Immune Thrombocytopenic Purpura (ITP); Neutrophils to Lymphocytes Ratio (NLR); Platelet to Lymphocytes Ratio (PLR); Immature Platelet Fraction (IPF)
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