Plasminogen Activator Inhibitor-1 and Mean Platelet Volume as Potential Indicators of Prothrombotic State in Immune Thrombocytopenia: An Exploratory Study

Background: Immune thrombocytopenia (ITP) is an autoimmune hematological condition associated with isolated thrombocytopenia. Despite thrombocytopenia, converging evidence reveals a paradoxical increase in thrombotic events in ITP, which raises critical concerns about disease management among these patients. The current study aimed to explore hemostatic parameters such as plasminogen activator Inhibitor-1 (PAI-1) and D-dimer as potential indicators of prothrombotic state in patients with ITP. Methods: The plasma levels of PAI-1 and D-dimer were measured using commercially available ELISA in 36 individuals, including 18 patients with chronic ITP and 18 healthy controls. All participants’ complete blood count (CBC) was measured. Spearman’s rank correlation was used to evaluate the relationship between hemostatic parameters and CBC parameters, including platelet indices. Results: The levels of PAI-1, D-dimer, and mean platelet volume (MPV) were numerically higher in ITP than in healthy controls. PAI-1 showed a significantly stronger relationship with MPV (r = 0.7063, p = 0.0061) and a strong inverse correlation with WBC (r = −0.7941, p = 0.0004). D-dimer demonstrated a strong inverse correlation with platelet count (r = −0.7615, p = 0.0092). Conclusions: Though the patients do not have clinical thrombosis at the time of study, these findings suggest a paradoxical increase in prothrombotic state in ITP. The current study identifies PAI-1 and MPV as potential indicators for evaluating thrombotic state in ITP in future studies.