Acta Scientific MICROBIOLOGY (ISSN: 2581-3226) Volume 5 Issue 10 October 2022 Evaluation of NLR and PLR in Immune Thrombocytopenic Purpura; Is it Worth Doing? Aisha Arshad 1 , Samina Naz Mukry 1 * and Tahir Shamsi 2 1 Department of Transplant Immunology and Applied Microbiology, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan 2 Department of Clinical Haematology, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan *Corresponding Author: Samina Naz Mukry, Associate Professor, Department of Transplant Immunology and Applied Microbiology, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan. Research Article Received: July 29, 2022 Published: September 29, 2022 © All rights are reserved by Samina Naz Mukry., et al. Abstract 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 com- pared 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) Introduction Thrombocytes or platelets are non-nucleated and membrane disc like cells which activates the coagulation factors by activat- ing phospholipids in membrane during blood clotting due to blood vessels impairment [1]. Decreased platelets counts or thrombocy- topenia (i.e. <1,50000/mm 3 ) is commonly observed with autoim- mune diseases or microbial infections. Thrombocytopnia can be divided based on degree which is divided into mild (<100000/ mm 3 ), moderate (20000-50000/mm 3 ) and severe (<20000/mm 3 ). Thrombocytopenia usually occurs may due to i) elevated destruc- tion of platelets in diseases such as immune thrombocytopenia (ITP), disseminated intravascular coagulation (DIC), and throm- botic thrombocytopenic purpura (TTP) or ii) reduced platelet pro- duction as hypo-production thrombocytopenia are related with other bone marrow diseases [2]. DOI: 10.31080/ASMI.2022.05.1148 Citation: Samina Naz Mukry., et al. “Evaluation of NLR and PLR in Immune Thrombocytopenic Purpura; Is it Worth Doing?". Acta Scientific Microbiology 5.10 (2022): 24-30.