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High mobility group box 1 protein (HMGB1) is a non-histone chromosomal protein with dual activity. First within the nucleus, binds to DNA and acts as a regulator and second, outside the cell, interacts with receptors for inflammation as a signal molecule. We aimed to investigate and contribute to the value of extracellular HMGB1 in clinical context of ITP and to flourish future clinical directions to this biomarker.

50 newly diagnosed and treatment naive patients with ITP and 30 healthy controls were enrolled in our study.

Age or gender were not related with HMGB1 levels in patients and controls. Platelet levels were significantly related with HMGB1. Especially in patients with platelet counts below 30.000/mm3 highest levels of HMGB1 were observed. Regarding clinical presentation, bleeding was related with low platelet counts and high HMGB1 levels. Response to corticosteroids was observed to be better in patients with high HMGB1 levels.

As a sample of autoinflammatory disorders, we observed a relation with extracellular HMGB1 levels and platelet levels in ITP patients. Corticosteroid response and HMGB1 relation supports the assumption of the value of HMGB1 as a potential surrogate of inflammation. This view should be evaluated with larger scale studies.