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Prognostic Implications of the Hemoglobin-Albumin-Lymphocyte-Platelet Index in Patients with Pemphigus
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DOI：10.1159/000550453.png)
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Abstract
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Introduction: Pemphigus is a chronic autoimmune blistering disease with substantial morbidity and mortality. Although the hemoglobin-albumin-lymphocyte-platelet (HALP) index, a composite marker reflecting inflammatory and nutritional status, exhibits prognostic value in various immune-related diseases, its potential in pemphigus remains elusive. In this study, we investigated prognostic significance of the HALP index in 69 patients with pemphigus diagnosed between 2001 and 2024. Methods: We calculated the HALP index at diagnosis and stratified using maximally selected rank statistics, identifying a cutoff value of 45.9. Using Cox proportional hazards models, patients with low HALP index (<= 45.9) had significantly poorer overall survival (OS) and lower remission rates than those with higher HALP. Results: Our multivariate analysis independently associated immunosuppressant use with improved OS (HR = 0.32; 95% CI: 0.13-0.79; p = 0.013), while a low HALP index was an independent predictor of mortality (HR = 2.84; 95% CI: 1.06-7.60; p = 0.038). Additionally, low HALP index was also independently associated with a longer time to remission (HR = 0.55; 95% CI: 0.31-0.97; p = 0.039). Conclusion: The HALP index represents a simple and readily available biomarker that independently predicts survival and remission outcomes in patients with pemphigus, potentially helping risk stratification and personalized management in clinical practice. Pemphigus is a rare skin disease that causes painful blisters and can be life-threatening. In this study, we used a simple blood test that combines four common laboratory values to help predict which patients might do better or worse over time. This score, called the hemoglobin-albumin-lymphocyte-platelet index (HALP index), can help doctors identify high-risk patients earlier and adjust treatment to improve outcomes. Because the test uses routine laboratory results, it can be applied easily in most hospitals. Our findings could lead to more personalized care and better quality of life for people living with this difficult condition.
Keywords:
Hemoglobin-albumin-lymphocyte-platelet index
Pemphigus
Prognosis
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