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ÖTİROİD HASHİMOTO TİROİDİTLİ ÇOCUK VE ADÖLESANLARDA BİR İNFLAMASYON BELİRTECİ OLARAK NÖTROFİL/LENFOSİT VE PLATELET/LENFOSİT ORANLARI

Year 2021, , 293 - 299, 31.08.2021
https://doi.org/10.24938/kutfd.913616

Abstract

Amaç: Hashimoto tiroiditi, tiroit bezine karşı oluşmuş antikorlar aracılığıyla gelişen kronik inflamatuvar bir hastalıktır. Nötrofil/lenfosit oranı ve platelet/lenfosit oranı inflamasyonu göstermede kullanılan parametrelerdir. Bu çalışmada ötiroid Hashimoto tiroiditli çocuk ve adölesanlarda nötrofil/lenfosit oranı ve platelet/lenfosit oranı kullanılarak sistemik inflamasyonun değerlendirilmesi planlandı.
Gereç ve Yöntemler: Yaşları 8-18 arasında olan, 6 aydır ötiroid durumda olduğu bilinen 72 Hashimoto tiroiditli olgunun nötrofil/lenfosit ve platelet/lenfosit oranları bilinen ek hastalığı olmayan 50 kontrol ile karşılaştırıldı. Hashimoto tiroiditli olgular, kendi arasında levotiroksin tedavisiyle ötiroid olanlar ve tanıdan itibaren ilaçsız ötiroid olanlar ve tiroit stimulan hormon düzeyi <2.5 µU/mL ve 2.5-5.0 µU/mL olanlar şeklinde ayrıca gruplandırıldı.
Bulgular: Hashimoto tiroiditi tanılı olgularda (yaş ortalaması 13.87±2.88 yıl, %90.2’si kız) kontrol grubuna göre nötrofil/lenfosit oranında farklılık olmadığı ancak platelet/lenfosit oranının arttığı saptandı (138.61±44.28’e karşı 116.63±31.48, p=0.003). Olguların %61.2’si (n=44) levotiroksin tedavisiyle ötiroid iken geri kalanlar tanıdan itibaren ilaçsız ötiroiddi. Hashimoto tiroiditli olgular arasında levotiroksin tedavisi alma durumuna göre nötrofil/lenfosit ve platelet/lenfosit oranlarında farklılık gözlenmezken, tiroit stimulan hormon düzeyi 2.5-5.0 µU/mL olan Hashimoto tiroiditli olgularda nötrofil/lenfosit oranı daha düşük bulundu.
Sonuç: Ötiroid Hashimoto tiroiditli çocuk ve adölesanlarda kontrol grubuna göre platelet/lenfosit oranının artması inflamasyonun tiroit bezine lokalize kalmadığını düşündürmektedir.

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References

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  • 1. Mincer DL, Jialal I. Hashimoto Thyroiditis. Treasure Island (FL). StatPearls Publishing, 2021.
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  • 4. Yilmaz H, Ucan B, Sayki M, Unsal I, Sahin M, Ozbek M et al. Usefulness of the neutrophil-to-lymphocyte ratio to prediction of type 2 diabetes mellitus in morbid obesity. Diabetes Metab Syndr. 2015;9(4):299-304.
  • 5. Demirtas L, Degirmenci H, Akbas EM, Ozcicek A, Timuroglu A, Gurel A et al. Association of hematological indicies with diabetes, impaired glucose regulation and microvascular complications of diabetes. Int J Clin Exp Med. 2015;8(7):11420-7.
  • 5. Demirtas L, Degirmenci H, Akbas EM, Ozcicek A, Timuroglu A, Gurel A et al. Association of hematological indicies with diabetes, impaired glucose regulation and microvascular complications of diabetes. Int J Clin Exp Med. 2015;8(7):11420-7.
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  • 7. Azak E, Uçaktürk SA, Çetin İ, Gürsu HA, Mengen E, Pamuk U. Subclinical myocardial dysfunction demonstrated by speckle tracking echocardiography in children with euthyroid Hashimoto’s thyroiditis. J Clin Res Pediatr Endocrinol. 2019;11(4):410-8.
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  • 8. Yetkin DO, Dogantekin B. The lipid parameters and lipoprotein (A) excess in Hashimoto thyroiditis. Int J Endocrinol. 2015;2015:952729.
  • 9. Vatan MB, Varım C, Ağaç MT, Varım P, Çakar MA, Aksoy M et al. Echocardiographic evaluation of biventricular function in patients with euthyroid Hashimoto's thyroiditis. Med Princ Pract. 2016;25(2):143-9.
  • 9. Vatan MB, Varım C, Ağaç MT, Varım P, Çakar MA, Aksoy M et al. Echocardiographic evaluation of biventricular function in patients with euthyroid Hashimoto's thyroiditis. Med Princ Pract. 2016;25(2):143-9.
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  • 12. Weetman AP. An update on the pathogenesis of Hashimoto's thyroiditis. J Endocrinol Invest. 2021;44(5):883-90.
  • 13. Elsherbiny TM. Thyroid autoimmunity is associated with hypothyroid-like symptoms compared with nonautoimmune benign thyroid diseases using a thyroid-specific questionnaire. The Egyptian Journal of Internal Medicine. 2019;31(4):683-8.
  • 13. Elsherbiny TM. Thyroid autoimmunity is associated with hypothyroid-like symptoms compared with nonautoimmune benign thyroid diseases using a thyroid-specific questionnaire. The Egyptian Journal of Internal Medicine. 2019;31(4):683-8.
  • 14. Baser H, Can U, Baser S, Yerlikaya FH, Aslan U, Hidayetoglu BT. Assessment of oxidative status and its association with thyroid autoantibodies in patients with euthyroid autoimmune thyroiditis. Endocrine. 2015;48(3):916-23.
  • 14. Baser H, Can U, Baser S, Yerlikaya FH, Aslan U, Hidayetoglu BT. Assessment of oxidative status and its association with thyroid autoantibodies in patients with euthyroid autoimmune thyroiditis. Endocrine. 2015;48(3):916-23.
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  • 15. Shimada H, Takiguchi N, Kainuma O, Soda H, Ikeda A, Cho A et al. High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer. Gastric Cancer. 2010;13(3):170-6.
  • 16. Jung JY, Lee E, Suh CH, Kim HA. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are associated with disease activity in polymyalgia rheumatica. J Clin Lab Anal. 2019;33(9):e23000.
  • 16. Jung JY, Lee E, Suh CH, Kim HA. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are associated with disease activity in polymyalgia rheumatica. J Clin Lab Anal. 2019;33(9):e23000.
  • 17. Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H et al. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol. 2016;26(3):372-6.
  • 17. Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H et al. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol. 2016;26(3):372-6.
  • 18. Acarturk G, Acay A, Demir K, Ulu MS, Ahsen A, Yuksel S. Neutrophil-to-lymphocyte ratio in inflammatory bowel disease - as a new predictor of disease severity. Bratisl Lek Listy. 2015;116(4):213-7.
  • 19. Ozmen S, Timur O, Calik I, Altinkaynak K, Simsek E, Gozcu H et al. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) may be superior to C-reactive protein (CRP) for predicting the occurrence of differentiated thyroid cancer. Endocr Regul. 2017;51(3):131-6.
  • 19. Ozmen S, Timur O, Calik I, Altinkaynak K, Simsek E, Gozcu H et al. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) may be superior to C-reactive protein (CRP) for predicting the occurrence of differentiated thyroid cancer. Endocr Regul. 2017;51(3):131-6.
  • 20. Cengiz H, Varim C, Demirci T, Cetin S. Hemogram parameters in the patients with subacute thyroiditis. Pak J Med Sci. 2020;36(2):240-5.
  • 20. Cengiz H, Varim C, Demirci T, Cetin S. Hemogram parameters in the patients with subacute thyroiditis. Pak J Med Sci. 2020;36(2):240-5.
  • 21. Aktas G, Sit M, Dikbas O, Erkol H, Altinordu R, Erkus E et al. Elevated neutrophil-to-lymphocyte ratio in the diagnosis of Hashimoto's thyroiditis. Rev Assoc Med Bras (1992). 2017;63(12):1065-8.
  • 21. Aktas G, Sit M, Dikbas O, Erkol H, Altinordu R, Erkus E et al. Elevated neutrophil-to-lymphocyte ratio in the diagnosis of Hashimoto's thyroiditis. Rev Assoc Med Bras (1992). 2017;63(12):1065-8.
  • 22. Bilge M, Yesilova A, Adas M, Helvaci A. Neutrophil- and platelet- to lymphocyte ratio in patients with euthyroid Hashimoto's thyroiditis. Exp Clin Endocrinol Diabetes. 2019;127(8):545-9.
  • 22. Bilge M, Yesilova A, Adas M, Helvaci A. Neutrophil- and platelet- to lymphocyte ratio in patients with euthyroid Hashimoto's thyroiditis. Exp Clin Endocrinol Diabetes. 2019;127(8):545-9.
  • 23. Onalan E, Dönder E. Neutrophil and platelet to lymphocyte ratio in patients with hypothyroid Hashimoto's thyroiditis. Acta Biomed. 2020;91(2):310-4.
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  • 27. Bavarsad K, Saadat S, Mohammadian Roshan N, Hadjzadeh MA, Boskabady MH. Effects of levothyroxine on lung inflammation, oxidative stress and pathology in a rat model of Alzheimer's disease. Respir Physiol Neurobiol. 2020;277:103437.
  • 27. Bavarsad K, Saadat S, Mohammadian Roshan N, Hadjzadeh MA, Boskabady MH. Effects of levothyroxine on lung inflammation, oxidative stress and pathology in a rat model of Alzheimer's disease. Respir Physiol Neurobiol. 2020;277:103437.
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Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratios as an Inflammation Marker in Children and Adolescents with Euthyroid Hashimoto Thyroiditis

Year 2021, , 293 - 299, 31.08.2021
https://doi.org/10.24938/kutfd.913616

Abstract

Objective: Hashimoto thyroiditis is a chronic inflammatory disease caused by antibodies against the thyroid gland. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio are parameters used to show inflammation. In this study, it was planned to evaluate systemic inflammation using neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in children and adolescents with euthyroid Hashimoto thyroiditis.
Material and Methods: The neutrophil/lymphocyte and platelet/lymphocyte ratios of 72 patients with Hashimoto thyroiditis between the ages of 8-18 years, known to be in the euthyroid state for 6 months, were compared with 50 controls without known additional disease. Patients with Hashimoto thyroiditis were also grouped among themselves as those who received and who did not receive levothyroxine treatment and those with a thyroid stimulating hormone level of <2.5 µU/mL or 2.5-5.0 µU/mL.
Results: Neutrophil/lymphocyte ratio was not different, but platelet/lymphocyte ratio was increased (138.61±44.28 vs 116.63±31.48, p = 0.003) in the Hashimoto thyroiditis group (mean age 13.87±2.88 years, 90.2% female). 61.2% (n = 44) of the cases were euthyroid with levothyroxine treatment and the rest were euthyroid without treatment since diagnosis. While there was no difference in neutrophil/lymphocyte and platelet/lymphocyte ratio according to the status of receiving levothyroxine treatment, neutrophil/lymphocyte ratio was found to be lower in patients with Hashimoto thyroiditis with a thyroid stimulating hormone level of 2.5-5.0 µU/mL.
Conclusion: The increase in the platelet/lymphocyte ratio in children and adolescents with euthyroid Hashimoto thyroiditis, compared to the control group, suggests that the inflammation is not localized to the thyroid gland.

Project Number

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References

  • 1. Mincer DL, Jialal I. Hashimoto Thyroiditis. Treasure Island (FL). StatPearls Publishing, 2021.
  • 1. Mincer DL, Jialal I. Hashimoto Thyroiditis. Treasure Island (FL). StatPearls Publishing, 2021.
  • 2. Penta L, Cofini M, Lanciotti L, Leonardi A, Principi N, Esposito S. Hashimoto's disease and thyroid cancer in children: are they associated? Front Endocrinol (Lausanne). 2018;9:565.
  • 2. Penta L, Cofini M, Lanciotti L, Leonardi A, Principi N, Esposito S. Hashimoto's disease and thyroid cancer in children: are they associated? Front Endocrinol (Lausanne). 2018;9:565.
  • 3. Rajamanickam R, Shanmugavelu L, Subramanian S, Prasad HK, Krishnamoorthy N. Hashimoto's thyroiditis in South Indian Centre. Indian J Pediatr. 2016;83(11):1227-31.
  • 3. Rajamanickam R, Shanmugavelu L, Subramanian S, Prasad HK, Krishnamoorthy N. Hashimoto's thyroiditis in South Indian Centre. Indian J Pediatr. 2016;83(11):1227-31.
  • 4. Yilmaz H, Ucan B, Sayki M, Unsal I, Sahin M, Ozbek M et al. Usefulness of the neutrophil-to-lymphocyte ratio to prediction of type 2 diabetes mellitus in morbid obesity. Diabetes Metab Syndr. 2015;9(4):299-304.
  • 4. Yilmaz H, Ucan B, Sayki M, Unsal I, Sahin M, Ozbek M et al. Usefulness of the neutrophil-to-lymphocyte ratio to prediction of type 2 diabetes mellitus in morbid obesity. Diabetes Metab Syndr. 2015;9(4):299-304.
  • 5. Demirtas L, Degirmenci H, Akbas EM, Ozcicek A, Timuroglu A, Gurel A et al. Association of hematological indicies with diabetes, impaired glucose regulation and microvascular complications of diabetes. Int J Clin Exp Med. 2015;8(7):11420-7.
  • 5. Demirtas L, Degirmenci H, Akbas EM, Ozcicek A, Timuroglu A, Gurel A et al. Association of hematological indicies with diabetes, impaired glucose regulation and microvascular complications of diabetes. Int J Clin Exp Med. 2015;8(7):11420-7.
  • 6. Aydin M, Yilmaz A, Donma MM, Tulubas F, Demirkol M, Erdogan M et al. Neutrophil/lymphocyte ratio in obese adolescents. Northern Clinics of İstanbul. 2015;2(2):87-91.
  • 6. Aydin M, Yilmaz A, Donma MM, Tulubas F, Demirkol M, Erdogan M et al. Neutrophil/lymphocyte ratio in obese adolescents. Northern Clinics of İstanbul. 2015;2(2):87-91.
  • 7. Azak E, Uçaktürk SA, Çetin İ, Gürsu HA, Mengen E, Pamuk U. Subclinical myocardial dysfunction demonstrated by speckle tracking echocardiography in children with euthyroid Hashimoto’s thyroiditis. J Clin Res Pediatr Endocrinol. 2019;11(4):410-8.
  • 7. Azak E, Uçaktürk SA, Çetin İ, Gürsu HA, Mengen E, Pamuk U. Subclinical myocardial dysfunction demonstrated by speckle tracking echocardiography in children with euthyroid Hashimoto’s thyroiditis. J Clin Res Pediatr Endocrinol. 2019;11(4):410-8.
  • 8. Yetkin DO, Dogantekin B. The lipid parameters and lipoprotein (A) excess in Hashimoto thyroiditis. Int J Endocrinol. 2015;2015:952729.
  • 8. Yetkin DO, Dogantekin B. The lipid parameters and lipoprotein (A) excess in Hashimoto thyroiditis. Int J Endocrinol. 2015;2015:952729.
  • 9. Vatan MB, Varım C, Ağaç MT, Varım P, Çakar MA, Aksoy M et al. Echocardiographic evaluation of biventricular function in patients with euthyroid Hashimoto's thyroiditis. Med Princ Pract. 2016;25(2):143-9.
  • 9. Vatan MB, Varım C, Ağaç MT, Varım P, Çakar MA, Aksoy M et al. Echocardiographic evaluation of biventricular function in patients with euthyroid Hashimoto's thyroiditis. Med Princ Pract. 2016;25(2):143-9.
  • 10. Caturegli P, De Remigis A, Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmun Rev. 2014;13(4-5):391-7. 11. Akamizu T, Amino N. Hashimoto’s thyroiditis. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dungan K et al., eds. Endotext. South Dartmouth (MA). MDText.com, Inc, 2000.
  • 12. Weetman AP. An update on the pathogenesis of Hashimoto's thyroiditis. J Endocrinol Invest. 2021;44(5):883-90.
  • 12. Weetman AP. An update on the pathogenesis of Hashimoto's thyroiditis. J Endocrinol Invest. 2021;44(5):883-90.
  • 13. Elsherbiny TM. Thyroid autoimmunity is associated with hypothyroid-like symptoms compared with nonautoimmune benign thyroid diseases using a thyroid-specific questionnaire. The Egyptian Journal of Internal Medicine. 2019;31(4):683-8.
  • 13. Elsherbiny TM. Thyroid autoimmunity is associated with hypothyroid-like symptoms compared with nonautoimmune benign thyroid diseases using a thyroid-specific questionnaire. The Egyptian Journal of Internal Medicine. 2019;31(4):683-8.
  • 14. Baser H, Can U, Baser S, Yerlikaya FH, Aslan U, Hidayetoglu BT. Assessment of oxidative status and its association with thyroid autoantibodies in patients with euthyroid autoimmune thyroiditis. Endocrine. 2015;48(3):916-23.
  • 14. Baser H, Can U, Baser S, Yerlikaya FH, Aslan U, Hidayetoglu BT. Assessment of oxidative status and its association with thyroid autoantibodies in patients with euthyroid autoimmune thyroiditis. Endocrine. 2015;48(3):916-23.
  • 15. Shimada H, Takiguchi N, Kainuma O, Soda H, Ikeda A, Cho A et al. High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer. Gastric Cancer. 2010;13(3):170-6.
  • 15. Shimada H, Takiguchi N, Kainuma O, Soda H, Ikeda A, Cho A et al. High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer. Gastric Cancer. 2010;13(3):170-6.
  • 16. Jung JY, Lee E, Suh CH, Kim HA. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are associated with disease activity in polymyalgia rheumatica. J Clin Lab Anal. 2019;33(9):e23000.
  • 16. Jung JY, Lee E, Suh CH, Kim HA. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are associated with disease activity in polymyalgia rheumatica. J Clin Lab Anal. 2019;33(9):e23000.
  • 17. Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H et al. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol. 2016;26(3):372-6.
  • 17. Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H et al. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol. 2016;26(3):372-6.
  • 18. Acarturk G, Acay A, Demir K, Ulu MS, Ahsen A, Yuksel S. Neutrophil-to-lymphocyte ratio in inflammatory bowel disease - as a new predictor of disease severity. Bratisl Lek Listy. 2015;116(4):213-7.
  • 19. Ozmen S, Timur O, Calik I, Altinkaynak K, Simsek E, Gozcu H et al. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) may be superior to C-reactive protein (CRP) for predicting the occurrence of differentiated thyroid cancer. Endocr Regul. 2017;51(3):131-6.
  • 19. Ozmen S, Timur O, Calik I, Altinkaynak K, Simsek E, Gozcu H et al. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) may be superior to C-reactive protein (CRP) for predicting the occurrence of differentiated thyroid cancer. Endocr Regul. 2017;51(3):131-6.
  • 20. Cengiz H, Varim C, Demirci T, Cetin S. Hemogram parameters in the patients with subacute thyroiditis. Pak J Med Sci. 2020;36(2):240-5.
  • 20. Cengiz H, Varim C, Demirci T, Cetin S. Hemogram parameters in the patients with subacute thyroiditis. Pak J Med Sci. 2020;36(2):240-5.
  • 21. Aktas G, Sit M, Dikbas O, Erkol H, Altinordu R, Erkus E et al. Elevated neutrophil-to-lymphocyte ratio in the diagnosis of Hashimoto's thyroiditis. Rev Assoc Med Bras (1992). 2017;63(12):1065-8.
  • 21. Aktas G, Sit M, Dikbas O, Erkol H, Altinordu R, Erkus E et al. Elevated neutrophil-to-lymphocyte ratio in the diagnosis of Hashimoto's thyroiditis. Rev Assoc Med Bras (1992). 2017;63(12):1065-8.
  • 22. Bilge M, Yesilova A, Adas M, Helvaci A. Neutrophil- and platelet- to lymphocyte ratio in patients with euthyroid Hashimoto's thyroiditis. Exp Clin Endocrinol Diabetes. 2019;127(8):545-9.
  • 22. Bilge M, Yesilova A, Adas M, Helvaci A. Neutrophil- and platelet- to lymphocyte ratio in patients with euthyroid Hashimoto's thyroiditis. Exp Clin Endocrinol Diabetes. 2019;127(8):545-9.
  • 23. Onalan E, Dönder E. Neutrophil and platelet to lymphocyte ratio in patients with hypothyroid Hashimoto's thyroiditis. Acta Biomed. 2020;91(2):310-4.
  • 23. Onalan E, Dönder E. Neutrophil and platelet to lymphocyte ratio in patients with hypothyroid Hashimoto's thyroiditis. Acta Biomed. 2020;91(2):310-4.
  • 24. Fawzy RM, Said EA, Mansour AI. Association of neutrophil to lymphocyte ratio with disease activity indices and musculoskeletal ultrasound findings in recent onset rheumatoid arthritis patients. The Egyptian Rheumatologist. 2017;39(4):203-6.
  • 25. Guclu F, Ozmen B, Kirmaz C, Kafesciler SO, Degirmenci PB, Taneli F et al. Down-regulation of the auto-aggressive processes in patients with hypothyroid Hashimoto's thyroiditis following substitutive treatment with L-thyroxine. Eur Cytokine Netw. 2009;20(1):27-32.
  • 25. Guclu F, Ozmen B, Kirmaz C, Kafesciler SO, Degirmenci PB, Taneli F et al. Down-regulation of the auto-aggressive processes in patients with hypothyroid Hashimoto's thyroiditis following substitutive treatment with L-thyroxine. Eur Cytokine Netw. 2009;20(1):27-32.
  • 26. Stuijver DJ, Elbers LP, van Zaane B, Dekkers OM, Spek CA, Gerdes VE, et al. The effect of levothyroxine on expression of inflammation-related genes in healthy subjects: a controlled randomized crossover study. Horm Metab Res. 2014;46(11):789-93.
  • 26. Stuijver DJ, Elbers LP, van Zaane B, Dekkers OM, Spek CA, Gerdes VE, et al. The effect of levothyroxine on expression of inflammation-related genes in healthy subjects: a controlled randomized crossover study. Horm Metab Res. 2014;46(11):789-93.
  • 27. Bavarsad K, Saadat S, Mohammadian Roshan N, Hadjzadeh MA, Boskabady MH. Effects of levothyroxine on lung inflammation, oxidative stress and pathology in a rat model of Alzheimer's disease. Respir Physiol Neurobiol. 2020;277:103437.
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There are 53 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Selin Elmaoğulları 0000-0003-4879-7859

Aslıhan Araslı Yılmaz 0000-0003-4403-2381

Şenay Savaş Erdeve 0000-0002-4164-5089

Semra Çetinkaya 0000-0003-3974-2872

Project Number -
Publication Date August 31, 2021
Submission Date April 13, 2021
Published in Issue Year 2021

Cite

APA Elmaoğulları, S., Araslı Yılmaz, A., Savaş Erdeve, Ş., Çetinkaya, S. (2021). ÖTİROİD HASHİMOTO TİROİDİTLİ ÇOCUK VE ADÖLESANLARDA BİR İNFLAMASYON BELİRTECİ OLARAK NÖTROFİL/LENFOSİT VE PLATELET/LENFOSİT ORANLARI. The Journal of Kırıkkale University Faculty of Medicine, 23(2), 293-299. https://doi.org/10.24938/kutfd.913616
AMA Elmaoğulları S, Araslı Yılmaz A, Savaş Erdeve Ş, Çetinkaya S. ÖTİROİD HASHİMOTO TİROİDİTLİ ÇOCUK VE ADÖLESANLARDA BİR İNFLAMASYON BELİRTECİ OLARAK NÖTROFİL/LENFOSİT VE PLATELET/LENFOSİT ORANLARI. Kırıkkale Üni Tıp Derg. August 2021;23(2):293-299. doi:10.24938/kutfd.913616
Chicago Elmaoğulları, Selin, Aslıhan Araslı Yılmaz, Şenay Savaş Erdeve, and Semra Çetinkaya. “ÖTİROİD HASHİMOTO TİROİDİTLİ ÇOCUK VE ADÖLESANLARDA BİR İNFLAMASYON BELİRTECİ OLARAK NÖTROFİL/LENFOSİT VE PLATELET/LENFOSİT ORANLARI”. The Journal of Kırıkkale University Faculty of Medicine 23, no. 2 (August 2021): 293-99. https://doi.org/10.24938/kutfd.913616.
EndNote Elmaoğulları S, Araslı Yılmaz A, Savaş Erdeve Ş, Çetinkaya S (August 1, 2021) ÖTİROİD HASHİMOTO TİROİDİTLİ ÇOCUK VE ADÖLESANLARDA BİR İNFLAMASYON BELİRTECİ OLARAK NÖTROFİL/LENFOSİT VE PLATELET/LENFOSİT ORANLARI. The Journal of Kırıkkale University Faculty of Medicine 23 2 293–299.
IEEE S. Elmaoğulları, A. Araslı Yılmaz, Ş. Savaş Erdeve, and S. Çetinkaya, “ÖTİROİD HASHİMOTO TİROİDİTLİ ÇOCUK VE ADÖLESANLARDA BİR İNFLAMASYON BELİRTECİ OLARAK NÖTROFİL/LENFOSİT VE PLATELET/LENFOSİT ORANLARI”, Kırıkkale Üni Tıp Derg, vol. 23, no. 2, pp. 293–299, 2021, doi: 10.24938/kutfd.913616.
ISNAD Elmaoğulları, Selin et al. “ÖTİROİD HASHİMOTO TİROİDİTLİ ÇOCUK VE ADÖLESANLARDA BİR İNFLAMASYON BELİRTECİ OLARAK NÖTROFİL/LENFOSİT VE PLATELET/LENFOSİT ORANLARI”. The Journal of Kırıkkale University Faculty of Medicine 23/2 (August 2021), 293-299. https://doi.org/10.24938/kutfd.913616.
JAMA Elmaoğulları S, Araslı Yılmaz A, Savaş Erdeve Ş, Çetinkaya S. ÖTİROİD HASHİMOTO TİROİDİTLİ ÇOCUK VE ADÖLESANLARDA BİR İNFLAMASYON BELİRTECİ OLARAK NÖTROFİL/LENFOSİT VE PLATELET/LENFOSİT ORANLARI. Kırıkkale Üni Tıp Derg. 2021;23:293–299.
MLA Elmaoğulları, Selin et al. “ÖTİROİD HASHİMOTO TİROİDİTLİ ÇOCUK VE ADÖLESANLARDA BİR İNFLAMASYON BELİRTECİ OLARAK NÖTROFİL/LENFOSİT VE PLATELET/LENFOSİT ORANLARI”. The Journal of Kırıkkale University Faculty of Medicine, vol. 23, no. 2, 2021, pp. 293-9, doi:10.24938/kutfd.913616.
Vancouver Elmaoğulları S, Araslı Yılmaz A, Savaş Erdeve Ş, Çetinkaya S. ÖTİROİD HASHİMOTO TİROİDİTLİ ÇOCUK VE ADÖLESANLARDA BİR İNFLAMASYON BELİRTECİ OLARAK NÖTROFİL/LENFOSİT VE PLATELET/LENFOSİT ORANLARI. Kırıkkale Üni Tıp Derg. 2021;23(2):293-9.

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