The effect of Hashimoto's thyroiditis on platelets in terms of the their number, size, and distribution

Öz

Objective: The aim of our study was to investigate whether platelet indices were affected in patients with Hashimoto’s thyroiditis (HT).
Method: 11 patients (10 female, 1 male) with HT and 26 subjects with nodular goiters (19 female, 7 male) selected as control group were included in the study. All cases were examined for complete blood count parameters (leukocyte count, neutrophil count and percentage, lymphocyte count and percentage, platelet count, plateletcrit, platelet distribution width (PDW), and mean platelet volume (MPV)).
Results: Leukocyte count, neutrophil count and percentage, lymphocyte percentage, platelet count, plateletcrit, and MPV in the patient group were not statistically different from the control group. Lymphocyte count and PDW were significantly higher in patients with HT than in the control group.
Conclusion: Our results suggest that patients with HT have higher PDW levels. Increased PDW in HT may be helpful in diagnosis, floow-up, and prognosis of the disease. 

Anahtar Kelimeler

• Thyroid
• Hashimoto
• platelet

Hashimoto tiroiditinin trombositler üzerine sayı, büyüklük ve dağılım açısından etkisi

Öz

Amaç: Çalışmamızın amacı, Hashimoto tiroiditi olan hastalarda trombosit endekslerinin etkilenip etkilenmediğini
araştırmaktır.
Yöntemler: HT'li 11 hasta (10 kadın, 1 erkek) ve kontrol grubu olarak seçilen nodüler guatrlı 26 kişi (19 kadın, 7
erkek) çalışmaya dahil edildi. Tüm olguların tam kan sayımı parametreleri (lökosit sayısı, nötrofil sayısı ve yüzdesi,
lenfosit sayısı ve yüzdesi, trombosit sayısı, trombosit yüzdesi, trombosit dağılım genişliği (PDW) ve ortalama
trombosit hacmi (MPV)) incelendi.
Bulgular: Hasta grubunda lökosit sayısı, nötrofil sayısı ve yüzdesi, lenfosit yüzdesi, trombosit sayısı, platelet yüzdesi
ve MPV değerleri kontrol grubundan istatistiksel olarak farklı değildi. Lenfosit sayısı ve PDW, HT'li hastalarda kontrol
grubuna göre anlamlı derecede yüksekti.
Sonuç: Bulgularımız HT'li hastaların PDW düzeylerinin daha yüksek olduğunu göstermektedir. HT'de artmış PDW,
hastalığın tanısı, takibi ve prognozu açısından anlamlı olabilir. 

Anahtar Kelimeler

• Tiroid
• hashimoto
• trombosit

Kaynakça

1. 1. Lal G, Clark OH. Textbook of endocrine surgery. Philadelphia: Saunders; 2005.p.38–40.
2. 2. Kumar V, Robbins SL. Robbins basic pathology. Philadelphia, PA: Saunders/Elsevier; 2007:p.731–6.
3. 3. Ajjan RA, Weetman AP. The pathogenesis of Hashimoto's thyroiditis: further developments in our understanding. Horm Metab Res 2015; 47: 702-10.
4. 4. Effraimidis G, Wiersinga WM. Mechanisms in endocrinology: autoimmune thyroid disease: old and new players. Eur J Endocrinol 2014; 170: R241-52.
5. 5. Weetman AP. Cellular immune responses in autoimmune thyroid disease. Clin Endocrinol (Oxf) 2004; 61: 405-13.
6. 6. Volpe R. Suppressor T lymphocyte dysfunction is important in the pathogenesis of autoimmune thyroid disease: a perspective. Thyroid 1993; 3: 345-52.
7. 7. Thomas MR, Storey RF. The role of platelets in inflammation. Thromb Haemost 2015; 114: 449-58.
8. 8. Islamoğlu Y, Buyukkaya E, Kaya Z, et all. Effect of the hematological and biochemical parameters on outcomes of the patients with infective endocarditis. Dicle Med J. 2011; 38: 392-7.

9. 9. Kilic E, Rezvani A, Toprak AE, et all. Evaluation of Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios in Rheumatoid Arthritis. Dicle Med J. 2016; 43: 241- 7.
10. 10. Guvendi B, Kara F, Binnetoglu K, et all. Comparison of platelet indices in papillary thyroid carcinoma and microcarcinoma. J Turgut Ozal Med Cent. 2018; 25: 122- 4.
11. 11. Sit M, Kargi E, Aktas G, et all. Mean platelet volume should be a useful indicator in diagnosis of Hashimoto’s thyroiditis. Acta Medica Mediterranea 2014; 30: 1263-6.
12. 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. 13. Savas E, Sahin AZ, Aksoy SN, et all. Serum levels of inflammatory markers in patients with thyroid dysfunction and their association with autoimmunity status. Int J Clin Exp Med 2016; 9: 4485-90.
14. 14. Gorbach SL, Bartlett JG, Blacklow NR. Infectious diseases. Philadelphia: Lippincott Williams & Wilkins; 2004: 159.
15. 15. Aktas G, Sit M, Dikbas O, et all. Could red cell distribution width be a marker in Hashimoto’s thyroiditis? Experimental and Clinical Endocrinology & Diabetes. 2014; 122: 572-4.
16. 16. Atile NS, Bilir BE, Bilir B, Guldiken S. Mean platelet volume levels in patients with overt hypothyroidism before and after levothyroxine treatment. Acta Endocrinologica (Buc), 2012; 8: 607-14.
17. 17. Bilge M, Adas M, Yesilova A, Helvaci A. Mean platelet volume (MPV) and platelet distribution width (PDW) in euthyroid woman with Hashimoto’s Thyroiditis. Endocrine Abstracts 2016; 41: EP968.
18. 18. Zhu C, Ma J, Liu Y, et all. Increased frequency of follicular helper T cells in patients with autoimmune thyroid disease. J Clin Endocrinol Metab 2012; 97: 943-50.
19. 19. Spolski R, Leonard WJ. IL-21 and T follicular helper cells. Int Immunol 2010; 22: 7-12.
20. 20. El-Shenawy SZ, Hemi MH, Attia H. Serum levels of proinflammatory cytokines (interleukin 6 & interleukin 15) and adiponectin in Hashimoto’s thyroiditis with different thyroid function states. Journal of American Science 2011; 7: 1156-62.
21. 21. Rebuffat SA, Kammoun-Krichen M, Charfeddine I, et all. IL-1β and TSH disturb thyroid epithelium integrity in autoimmune thyroid diseases. Immunobiology 2013; 218: 285-91.
22. 22. Guan LJ, Wang X, Meng S, et all. Increased IL-21/IL-21R expression and its proinflammatory effects in autoimmune thyroid disease. Cytokine 2015; 72: 160-5.
23. 23. Benbarche S, Strassel C, Angenieux C, et all. Dual role of IL-21 in megakaryopoiesis and platelet homeostasis. Haematologica 2017; 102: 637-46.
24. 24. Cortin V, Garnier A, Pineault N, et all. Efficient in vitro megakaryocyte maturation using cytokine cocktails optimized by statistical experimental design. Exp Hematol. 2005; 33: 1182–91.
25. 25. Fox JG, Barthold S, Davisson M, et all. The mouse in biomedical research: normative biology, husbandry, and models. Amsterdam: Academic Press, 2006: 156.
26. 26. Danese S, Motte Cd Cde L, Fiocchi C. Platelets in inflammatory bowel disease: clinical, pathogenic, and therapeutic implications. Am J Gastroenterol. 2004; 99: 938- 45.