The prognostic value of the systemic immune-inflammatory index and the systemic inflammation response index in pediatric immune thrombocytopenia

Abstract Background Inflammation plays a pivotal role in the persistence of immune thrombocytopenic purpura (ITP) through the activity of inflammatory cells. This study aimed to assess hematological inflammatory parameters, such as the systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) in patients with chronic ITP compared to those with newly diagnosed ITP. Methods A retrospective analysis was conducted on a cohort of 95 children diagnosed with ITP. Of these, 73 children were identified with newly diagnosed ITP, while the remaining 22 were classified as having chronic ITP. Results Patients with chronic ITP demonstrated significantly higher levels of SII, SIRI, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) compared to those with newly diagnosed ITP. A receiver operating characteristic (ROC) analysis revealed that the area under the curve (AUC) values for SII, SIRI, NLR, PLR, and MLR in predicting chronic ITP were 0.963, 0.752, 0.762, 0.934, and 0.792, respectively. Among these parameters, PLR and SII exhibited the highest predictive accuracy, with a sensitivity of 86.4% and specificities of 97.3% and 94.5%, respectively, as determined by the ROC curves. Conclusions Patients with chronic ITP exhibited significantly higher levels of SII and SIRI compared to those with newly diagnosed ITP. Additionally, the analysis of sensitivity and specificity demonstrated the predictive value of SII and SIRI in identifying patients at risk of progressing to chronic ITP, underscoring their potential as important prognostic biomarkers.