Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratios as an Inflammation Marker in Children and Adolescents with Euthyroid Hashimoto Thyroiditis

Öz

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.

Anahtar Kelimeler

• Hashimoto thyroiditis
• euthyroid
• children
• neuthrophil/lymphocyte ratio
• platelet/lymphocyte ratio

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

Öz

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.

Anahtar Kelimeler

• Hashimoto tiroiditi
• ötiroid
• çocuk
• nötrofil/lenfosit oranı
• platelet/lenfosit oranı

Kaynakça

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