Subakut Tiroidit Hastalarinda Anemi Sıklığı Ve Hastalık Aktivitesi İle İlişkisi

Abstract

DOI: 10.26650/IUITFD.382521

Amaç: Subakut tiroidit hastalarında, tanı konduğu anda ve klinik bulgular ile akut faz yanıtı geriledikten sonra anemi sıklığını ve inflamasyon bulguları ile ilişkisini araştırmak.

Gereç ve Yöntem: İstanbul Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı Polikliniği’nde kayıtlı olan ve subakut tiroidit tanısı doğrulanan hastalardan, hastalığın aktif olduğu dönemdeki ve klinik bulguları düzeldikten ve/veya akut faz yanıtlarında düşme gözlendikten sonraki hemogram değerlerine ulaşılabilen hastalar çalışma grubunu oluşturdu. Hasta kayıtları retrospektif olarak incelendi. İstatistik incelemeler için eşleşmiş Student t testi ve ANOVA testi kullanıldı.

Bulgular: Subakut tiroidit tanısı konan 60 hastanın 37’sinde (%65) anemi saptandı. Anemiye yönelik herhangi bir tedavi yapılmaksızın, klinik bulguları düzelen hastaların 17’sinde (%28,3) anemi bulundu. Klinik ve inflamasyon bulguları düzeldikten sonra hemoglobin (1,08±0,98 g/dl) ve hematokrit değerlerinde (3,45±2,9) anlamlı artışlar saptandı, ortalama eritrosit hacmi değerlerinde değişiklik olmadı. Klinik bulgular düzeldiğinde kalıcı hipotiroidi gelişen 20 hastada (%33,3) başlangıç ve klinik yanıt sonrası hemoglobin ve hematokrit değerleri ise diğer hastalardan anlamlı olarak daha düşüktü.

Sonuç: Subakut tiroidit hastalarında hastalık aktivitesi ile ilişkili olarak anemi gelişmekte ve klinik ve inflamasyon bulgularının düzelmesi ile anlamlı bir düzelme saptanabilmektedir. Bu nedenle, subakut tiroidit hastalarında anemiye yönelik gereksiz incelemelerden kaçınılmalı ve ileri tetkikler için klinik ve inflamasyon bulgularının düzelmesi beklenmelidir.

Keywords

• Subakut tiroidit,anemi,inflamasyon,kronik hastalık anemisi,interlökin 6

Frequency Of Anemia And Its Association With Disease Activity In Subacute Thyroiditis

Abstract

DOI: 10.26650/IUITFD.382521

Objective: To investigate the frequency of anemia and its association with inflammation in patients with subacute thyroiditis (ST) during diagnosis and after the resolution of clinical findings and acute-phase response.

Materials and Methods: We retrospectively reviewed the charts of patients with confirmed diagnosis of ST, followed at the Endocrinology and Metabolism Outpatient Clinic of Istanbul Faculty of Medicine (Turkey). The study cohort comprised those with acute-phase response and hemogram results during diagnosis and after the resolution of clinical and inflammation findings. Hemoglobin levels of <12 and <13 g/dl for females and males, respectively, were defined as anemia.

Results: Anemia was detected in 37 of 60 ST patients (65%) studied during diagnosis, and its frequency reduced to 28.3% following the resolution of clinical and laboratory findings without additional treatment. Notably, although a significant increase was observed in terms of hemoglobin (1.08 ± 0.98 g/dl) and hematocrit (3.45 ± 2.9) levels, no change was detected in terms of MCV values. During diagnosis and following the clinical improvement, hemoglobin and hematocrit values of 20 patients (33.3%) who developed permanent hypothyroidism following the resolution of clinical findings were significantly lower than those of the remaining patients.

Conclusion: Anemia can develop in 65% of patients with ST. A significant improvement can be observed following resolution of clinical and laboratory findings. Therefore, further studies investigating the causes of anemia should be avoided in patients with ST until clinical findings and acute-phase response have been improved.

Keywords

• Subacute thyroiditis,anemia,inflammation,anemia associated with chronic diseases,interleukin 6

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