Evaluation of Hemato-Inflammatory Parameters NLR, PLR and HPR in Patients with Immune Thrombocytopenic Purpura (ITP) in South-East Iran: A Retrospective Study

Background Immune thrombocytopenic purpura (ITP) is an autoimmune hematologic disorder characterized by thrombocytopenia and clinical manifestations such as petechiae, ecchymosis, and bleeding. Recently, simple and accessible inflammatory indices including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and hemoglobin-to-platelet ratio (HPR) have been proposed as potential biomarkers for disease assessment. The aim of this study was to evaluate the diagnostic and clinical value of NLR, PLR, and HPR in patients with ITP in Southeast Iran. Methods This retrospective cross-sectional study included 114 ITP patients and 115 control. Hematologic parameters and inflammatory indices (NLR, PLR, HPR) were assessed before and after treatment. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curves. Results Significant differences were observed between patients and controls across all parameters. HPR was notably higher in ITP patients. Bleeding symptoms were associated with elevated NLR and HPR ( P < .001). After treatment, patients with petechiae showed decreased NLR ( P = .016). ROC analysis revealed high sensitivity and specificity for NLR, PLR, and HPR. Conclusion PLR and HPR may serve as supportive tools for the diagnosis and management of ITP when combined with clinical and hematologic features. NLR should be interpreted cautiously and used alongside other markers. Further large-scale studies are warranted to validate these findings.