Value of Serum Protein Electrophoresis and Its Relation to Treatment Response in Adult Egyptian Chronic Idiopathic Thrombocytopenic Purpura Patients

Background: Idiopathic thrombocytopenic purpura (ITP), also known as primary immune thrombocytopenic purpura is defined as isolated thrombocytopenia with normal bone marrow and in the absence of other causes of thrombocytopenia. Methods: This prospective observational study included 100 patients with ITP at Hematology Unit of Internal Medicine Department, Benha University Hospital. All studied cases were subjected to detailed history taking, full clinical examination: general examination, vital signs including, routine laboratory investigations [Platelet count, Total leukocyte count, SPE parameters (α1, α2, β1, β2, γ1, albumin %). Results Univariate and multivariate logistic regressions were done to predict non-response to steroids using SPEs controlling for age and gender. The model revealed that SPE α1 was associated with 2.6 times increased risk of non-response (OR = 2.617, 95% CI = 1.567 - 4.371, P = <0.001). Also, SPE α2 was associated with about 3 times increased risk of iron deficiency anemia (OR = 2.894, 95 CI% = 1.089 – 7.695, P = 0.033). Additionally, SPE β2 was associated with about 2 times increased risk of non-response (OR = 2.241, 95 CI% = 1.509 - 3.327, P = <0.001). Furthermore, SPE albumin % was associated with an increased risk for non-response to steroids (OR = 1.128, 95 CI% = 11.054 - 1.207, P = <0.001). Conclusion: SPE profiles, particularly α1, α2, β2 fractions, and albumin percentage, are significant predictors of steroid response in chronic ITP patients. Lower levels of α1, α2, β2, and albumin were associated with a better response to corticosteroids.