The Evaluation of Pretreatment and Posttreatment Platelet/Lymphocyte and Neutrophil/Lymphocyte Ratios in Patients with Hyperthyroidism

Öz

Background: Hyperthyroidism is defined as subnormal (usually undetectable) serum thyrotropin (TSH) with elevated serum levels of free triiodothyronine (free T3) and / or free thyroxine (free T4). Endogenous hyperthyroidism is most commonly due to Graves' disease (GD) or nodular thyroid disease. GD is an autoimmune disease that involves mostly the thyroid gland, the eyes and rarely the skin. The disease is generally recognized by symptoms related to hyperthyroidism. Anti-thyroid medications are used in its treatment, and these medications have anti-inflammatory features besides thyroid hormone synthesis. Thrombocyte/lymphocyte (TLR) and neutrophil/lymphocyte (NLR) rates are systemic inflammatory markers that are obtained from routine blood count, inexpensive and repeatable. It is aimed to evaluate the rates of TLR and NLR before and after treatment in hyperthyroidism.
Materials and Methods: The retrospective records of the patients who were admitted to Harran University Medical Faculty Endocrinology Polyclinic were examined, and patients who were diagnosed with hyperthyroidism and started medical treatment were included in the study. Patients with active infection and hemorrhagic pathology were excluded from the study. Laboratory results of the patients at the time of diagnosis and results after 3-6 months were evaluated. It was planned to compare NLR and TLR values before and after medical treatment.
Results: In the GD group, there was an increase in TSH, fT3, fT4 leukocyte, neutrophil, lymphocyte and hemoglobin levels before and after treatment, and this increase was statistically significant. Nevertheless, there was a significant increase in TSH, fT3, fT4 values in the toxic nodular goiter (TNG)/ multinodular goiter (MNG) group, while there was no significant difference in leukocyte, neutrophil, lymphocyte and hemoglobin levels before and after treatment. In the GD group, NLR of after treatment was significantly higher than before, but no significant difference was observed in the TLR.
Conclusions: GD, which is the most common cause of hyperthyroidism, can change hemotological parameters with various mechanisms. Antithyroid medications cause changes in blood count along with thyroid hormone levels.

Key words: 

Anahtar Kelimeler

• Graves' disease

Hipertiroidi Hastalarında Tedavi Öncesi ve Sonrası Trombosit/Lenfosit ve Nötrofil/Lenfosit Oranlarının Değerlendirilmesi

Öz

Amaç: Hipertiroidizm, yüksek serbest triiyodotironin (serbest T3) ve / veya serbest tiroksin düzeyleri (serbest T4) ile birlikte subnormal (genellikle saptanamayan) bir serum tirotropin (TSH) olarak tanımlanır. Endojen hipertiroidi en sık Graves hastalığı (GH) veya nodüler tiroid hastalığına bağlıdır. GH başta tiroid bezi olmak üzere, göz ve nadiren cildi tutan otoimmün bir hastalıktır. Hastalık genelde hipertiroidiye bağlı semptomlar ile tanınır. Tedavisinde anti-tiroid ilaçlar kullanılmakta olup, bu ilaçlar tiroid hormon sentezinin yanısıra anti-inflamatuar özelliklere de sahiptir. Trombosit/lenfosit (TLO) ve nötrofil/lenfosit (NLO) oranları ise rutin kan sayımından elde edilen, ucuz ve tekrarlanabilir, sistemik inflamasyon belirteçleridir. Hipertirodide tedavi öncesi ve tedavi sonrası TLO ve NLO’ nın değerlendirilmesi amaçlanmıştır.
Materyal ve Metod: Çalışmaya Harran Üniversitesi Tıp Fakültesi Endokrinoloji Polikliniği’ne başvuran hastaların geçmişe yönelik kayıtları incelenerek hipertiroidi tanısı alan ve medikal tedavi başlanan hastalar alındı. Aktif enfeksiyonu ve hematolojik patolojisi olan hastalar çalışmaya dahil edilmedi. Hastaların kayıtlarından tanı anındaki ve 3-6 ay sonraki laboratuvar sonuçları değerlendirildi. Medikal tedavi öncesi ve sonrası NLO ve TLO değerlerinin karşılaştırılması planlandı.
Bulgular: GH grubunda tedavi öncesi ve tedavi sonrası TSH, sT3, sT4, lökosit, nötrofil, lenfosit ve hemoglobin düzeylerinde artış vardı ve bu artış istatistiksel anlamlıydı. Bununla birlikte toksik nodüler guatr (TNG)/multınodüler guatr (MNG) grubunda TSH, sT3, sT4 değerlerinde anlamlı artış varken, lökosit, nötrofil, lenfosit ve hemoglobin düzeylerinde tedavi öncesi ve sonrası anlamlı bir fark yoktu. GH grubunda NLO tedavi sonrası öncesine göre anlamlı yüksekti ancak TLO’nda anlamlı fark gözlenmedi
Sonuç: Hipertiroidi özellikle en sık nedeni olan GH hemotolojik parametrelerde çeşitli mekanızmalarla değişiklik yapabilmektedir. Antitiroid ilaçlar tiroid hormon düzeyleriyle birlikte kan sayımında da değişikliklere neden olur

Anahtar Kelimeler

• graves hastalığı,nötrofil lenfosit oranı,trombosit lenfosit oranı

Kaynakça

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