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Higher mean platelet volume is accompanied with hyperthyroidism in patients with Graves’ disease

Year 2020, Volume: 45 Issue: 1, 181 - 185, 31.03.2020
https://doi.org/10.17826/cumj.634145

Abstract

Purpose: Graves’ disease (GD) is an autoimmune disease that is the most common cause of thyrotoxicosis. Thyrotoxicosis can cause a decrease in platelet survival time. Inflammation is an important stimulus for platelets and mean platelet volume (MPV) could be used a diagnostic marker which is an important determinant of platelet activity. In this study we aimed to evaluate whether MPV would be a useful inflammatory marker for evaluation of disease activity in patients with Graves’ disease.
Materials and Methods: Two hundred twenty-nine patients (GD patients (Group 1); n=102 and patients with euthyroid nodular goiter (Group 2); n= 127) were included in this retrospective study. Serum TSH, fT3, fT4 and MPV levels were recorded at presentation and at first euthyroid period under ATD treatment in GD patients and at presentation in patients with euthyroid nodular goiter.
Results: The mean age was 40.3±13.5 in Group 1 and 50.2±11.6 in Group 2. Mean initial MPV level did not differ between groups; 8.3±1.2 fL and 8.3±1.1 fL, respectively (p=0.9). We found that mean initial MPV was higher than the first euthyroid period MPV in Group 1; Graves’ group (8.3±1.2 fL vs 8.0±1.3 fL, p= 0.02). Conclusion: Higher initial MPV levels in Graves patients and significant drop following the restoration of hyperthyroidism may be due to hypermetabolism of hyperthyroidism. 

References

  • 1- Rosenbaum JT, Choi D, Wong A, Wilson DJ, Grossniklaus HE, Harrington CA et al. The Role of the Immune Response in the Pathogenesis of Thyroid Eye Disease: A Reassessment. PLoS One. 2015;15:10.
  • 2- Penta L, Muzi G, Cofini M, Leonardi A, Lanciotti L, Esposito S. Corticosteroids in Moderate-To-Severe Graves’ Ophthalmopathy: Oral or Intravenous Therapy? Int. J. Environ. Res. Public Health. 2019;16:155.
  • 3- Song RH, Qin Q, Wang X, Yan N, Meng S, Shi XH, et al. Differential cytokine expression detected by protein microarray screening in peripheral blood of patients with refractory Graves' disease. Clin Endocrinol (Oxf) 2015;84:402-7.
  • 4- Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016;26:1343-1421.
  • 5- Okada M, Kamiya Y, Ito J, Yoshimata T, Kawaguchı M, Shibata H, et al. Platelet Epidermal Growth Factor in Thyroid Disorders. Endocr J. 1998;45:83-8.
  • 6- Panzer S, Haubenstock A, Minar E. Platelets in hyperthyroidism: studies on platelet counts, mean platelet volume, 111-indium-labeled platelet kinetics, and platelet-associated immunoglobulins G and M. J Clin Endocrinol Metab. 1990;70:491-96.
  • 7- Erdogan Yucel E, Demiral Sezer S. Relationship Between the Neutrophil to Lymphocyte Ratio and the Presence and Size of Thyroid Nodules. Cureus. 2019;11:e3866.
  • 8- Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26:1-133.
  • 9- Russ G, Bonnema SJ, Erdogan MF, Durante C, Ngu R, Leenhardt L. European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS. Eur Thyroid J. 2017;6:225-37.
  • 10- Park BJ, Shim JY, Lee HR, Jung DH, Lee JH, Lee YJ. The relation ship of platelet count, mean platelet volume with metabolic syndrome according to the criteria of the American Association of Clinical Endocrinologists: a focus on gender differences. Platelets. 2012;23:45–50.
  • 11- Demir Y, Üçler R, Sürücü E, Mahfuz T, Zekeriya B, Tarık Ş. Temporary changes in neutrophil-to-lymphocyte, platelet-to-lymphocyte ratios, and mean platelet volume reflecting the inflammatory process after radioiodine therapy. Nucl Med Commun. 2016;37:393-98.
  • 12- Carlioglu A, Timur O, Durmaz SA, Ayhan ME. Mean platelet volume in euthyroid patients with Hashimoto's thyroiditis. Blood Coagul Fibrinolysis. 2015;26:282-4.
  • 13- Chute JP, Ross JR, McDonnell DP: Minireview: nuclear receptors, hematopoiesis, and stem cells. Mol Endocrinol. 2010;24:1-10.
  • 14- Ijaz SH, Jamal SM, Qayyum R. Relationship Between Thyroid Hormone Levels and Mean Platelet Count and Volume: Quantitative Assessment. Cureus. 2018;8;10:e3421.
  • 15- Davies T, Laurberg P, Bahn R. Hyperthyroid Disorders, Graves Disease. In Williams Textbook of Endocrinology (Eds Melmed S, Polonsky K, Larsen P, Kronenberg H:373-95. Philadelphia, Elsevier-Saunders, 2016.
  • 16- Bahn RS. Graves' ophthalmopathy. N Engl J Med. 2010;362:726–38.
  • 17- Morshed SA, Latif R, Davies TF. Delineating the autoimmune mechanisms in Graves' disease. Immunol Res. 2012;54:191-203.
  • 18- Bayhan Z, Zeren S, Ozbay I, Kahraman C, Yaylak F, Tiryaki C, et al. Mean Platelet Volume as a Biomarker for Thyroid Carcinoma. Int Surg. 2016;101:50–3.
  • 19- Baldane S, Ipekci S, Sozen M, Kebapcilar L. Mean Platelet Volume Could be a Possible Biomarker for Papillary Thyroid Carcinomas. Asian Pac J Cancer Prev. 2015;16:2671-74.
  • 20- Yaylaci S, Tosun O, Sahin O, Genc AB, Aydin E, Demiral G, et al. Lack of Variation in Inflammatory Hematological Parameters between Benign Nodular Goiter and Papillary Thyroid Cancer. Asian Pac J Cancer Prev. 2016;17:2321-3.
  • 21- Bagir GS, Haydardedeoglu FE, Bakiner OS, Bozkirli E, Ertorer ME. Mean Platelet Volume in Graves' disease: A Sign of Hypermetabolism Rather than Autoimmunity? Pak J Med Sci. 2017;33:871-75.
  • 22- Simsek E, Timur O, Carlioglu A, Durmaz S, Demirci M, Sevimli H. Mean Platelet Volume in Hyperthyroid Toxic Adenoma Patients after Radioactive 131I Treatment. Advances in Endocrinology, Volume 2015, Article ID 436768

Yüksek ortalama platelet hacmi Graves hastalarında hipertiroidizme eşlik etmektedir

Year 2020, Volume: 45 Issue: 1, 181 - 185, 31.03.2020
https://doi.org/10.17826/cumj.634145

Abstract

Amaç: Graves hastalığı, tirotoksikozun en sık nedeni olup, otoimmün bir hastalıktır. Tirotoksikoz, trombosit yaşam süresinde azalmaya neden olan bir durumdur. İnflamasyonun trombositler için önemli bir uyaran olduğu bilinmektedir. Ortalama trombosit hacmi (MPV) ise trombosit fonksiyonlarının önemli bir belirleyicisi olup, çeşitli inflamatuar hastalıklarda tanısal bir belirteç olarak kullanılabileceği söylenmektedir. Bu çalışmada MPV’nin, Graves hastalarında, hastalık aktivitesini değerlendirmede yararlı bir inflamatuar belirteç olup olmadığnı değerlendirmeyi amaçladık.
Gereç ve Yöntem: Bu retrospektif çalışmaya 229 hasta (Graves hastalığı olanlar (Grup 1); n=102 ve ötiroid nodüler guatr hastaları (Grup 2); n= 127) dahil edildi. Graves hastalarında başlangıçta ve antitiroid ilaç tedavisi ile ilk ötiroid oldukları anda, ötiroid noduler guatr hastalarında ise başlangıçta ölçülen serum TSH, fT3, fT4 and MPV değerleri kaydedildi.
Bulgular: Hastaların ortalama yaşı Grup 1’de 40.3±13.5 ve Grup 2’de 50.2±11.6 idi. Başvuru anındaki ortalama MPV düzeyi gruplar arasında farklı değildi; sırasıyla 8.3±1.2 fL ve 8.3±1.1 fL, (p=0.9). Graves hastalarında (Grup 1), başlangıç MPV düzeyini, ilk ötiroid oldukları andaki MPV düzeyine göre daha yüksek olarak saptadık (8.3±1.2 fL vs 8.0±1.3 fL, p= 0.02).
Sonuç: Graves hastalarında başvuru anındaki yüksek MPV düzeyinde hipertiroidizmin düzelmesi ile izlenen anlamlı düşüş, hipertiroidizm ilişkili platelet yıkımının artışına bağlı olabilir. 

References

  • 1- Rosenbaum JT, Choi D, Wong A, Wilson DJ, Grossniklaus HE, Harrington CA et al. The Role of the Immune Response in the Pathogenesis of Thyroid Eye Disease: A Reassessment. PLoS One. 2015;15:10.
  • 2- Penta L, Muzi G, Cofini M, Leonardi A, Lanciotti L, Esposito S. Corticosteroids in Moderate-To-Severe Graves’ Ophthalmopathy: Oral or Intravenous Therapy? Int. J. Environ. Res. Public Health. 2019;16:155.
  • 3- Song RH, Qin Q, Wang X, Yan N, Meng S, Shi XH, et al. Differential cytokine expression detected by protein microarray screening in peripheral blood of patients with refractory Graves' disease. Clin Endocrinol (Oxf) 2015;84:402-7.
  • 4- Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016;26:1343-1421.
  • 5- Okada M, Kamiya Y, Ito J, Yoshimata T, Kawaguchı M, Shibata H, et al. Platelet Epidermal Growth Factor in Thyroid Disorders. Endocr J. 1998;45:83-8.
  • 6- Panzer S, Haubenstock A, Minar E. Platelets in hyperthyroidism: studies on platelet counts, mean platelet volume, 111-indium-labeled platelet kinetics, and platelet-associated immunoglobulins G and M. J Clin Endocrinol Metab. 1990;70:491-96.
  • 7- Erdogan Yucel E, Demiral Sezer S. Relationship Between the Neutrophil to Lymphocyte Ratio and the Presence and Size of Thyroid Nodules. Cureus. 2019;11:e3866.
  • 8- Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26:1-133.
  • 9- Russ G, Bonnema SJ, Erdogan MF, Durante C, Ngu R, Leenhardt L. European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS. Eur Thyroid J. 2017;6:225-37.
  • 10- Park BJ, Shim JY, Lee HR, Jung DH, Lee JH, Lee YJ. The relation ship of platelet count, mean platelet volume with metabolic syndrome according to the criteria of the American Association of Clinical Endocrinologists: a focus on gender differences. Platelets. 2012;23:45–50.
  • 11- Demir Y, Üçler R, Sürücü E, Mahfuz T, Zekeriya B, Tarık Ş. Temporary changes in neutrophil-to-lymphocyte, platelet-to-lymphocyte ratios, and mean platelet volume reflecting the inflammatory process after radioiodine therapy. Nucl Med Commun. 2016;37:393-98.
  • 12- Carlioglu A, Timur O, Durmaz SA, Ayhan ME. Mean platelet volume in euthyroid patients with Hashimoto's thyroiditis. Blood Coagul Fibrinolysis. 2015;26:282-4.
  • 13- Chute JP, Ross JR, McDonnell DP: Minireview: nuclear receptors, hematopoiesis, and stem cells. Mol Endocrinol. 2010;24:1-10.
  • 14- Ijaz SH, Jamal SM, Qayyum R. Relationship Between Thyroid Hormone Levels and Mean Platelet Count and Volume: Quantitative Assessment. Cureus. 2018;8;10:e3421.
  • 15- Davies T, Laurberg P, Bahn R. Hyperthyroid Disorders, Graves Disease. In Williams Textbook of Endocrinology (Eds Melmed S, Polonsky K, Larsen P, Kronenberg H:373-95. Philadelphia, Elsevier-Saunders, 2016.
  • 16- Bahn RS. Graves' ophthalmopathy. N Engl J Med. 2010;362:726–38.
  • 17- Morshed SA, Latif R, Davies TF. Delineating the autoimmune mechanisms in Graves' disease. Immunol Res. 2012;54:191-203.
  • 18- Bayhan Z, Zeren S, Ozbay I, Kahraman C, Yaylak F, Tiryaki C, et al. Mean Platelet Volume as a Biomarker for Thyroid Carcinoma. Int Surg. 2016;101:50–3.
  • 19- Baldane S, Ipekci S, Sozen M, Kebapcilar L. Mean Platelet Volume Could be a Possible Biomarker for Papillary Thyroid Carcinomas. Asian Pac J Cancer Prev. 2015;16:2671-74.
  • 20- Yaylaci S, Tosun O, Sahin O, Genc AB, Aydin E, Demiral G, et al. Lack of Variation in Inflammatory Hematological Parameters between Benign Nodular Goiter and Papillary Thyroid Cancer. Asian Pac J Cancer Prev. 2016;17:2321-3.
  • 21- Bagir GS, Haydardedeoglu FE, Bakiner OS, Bozkirli E, Ertorer ME. Mean Platelet Volume in Graves' disease: A Sign of Hypermetabolism Rather than Autoimmunity? Pak J Med Sci. 2017;33:871-75.
  • 22- Simsek E, Timur O, Carlioglu A, Durmaz S, Demirci M, Sevimli H. Mean Platelet Volume in Hyperthyroid Toxic Adenoma Patients after Radioactive 131I Treatment. Advances in Endocrinology, Volume 2015, Article ID 436768
There are 22 citations in total.

Details

Primary Language English
Subjects Endocrinology
Journal Section Research
Authors

Gülay Şimsek Bağır 0000-0001-5747-407X

Melek Eda Ertörer This is me 0000-0001-7357-8709

Publication Date March 31, 2020
Acceptance Date January 1, 2020
Published in Issue Year 2020 Volume: 45 Issue: 1

Cite

MLA Şimsek Bağır, Gülay and Melek Eda Ertörer. “Higher Mean Platelet Volume Is Accompanied With Hyperthyroidism in Patients With Graves’ Disease”. Cukurova Medical Journal, vol. 45, no. 1, 2020, pp. 181-5, doi:10.17826/cumj.634145.