Evaluation of the hematologic indices in patients with thyrotoxicosis with distinct etiologies: a case-control study

Abstract

Aim: Thyrotoxicosis is a clinical state of inappropriately high levels of free T4 (thyroxine) and/or free T3 (tri-iodothyronine) in the body caused by distinct etiologies including Graves' disease (GD), subacute thyroiditis (SAT), toxic adenoma and toxic multinodular goiter (TMNG). Simple hematologic indices such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and mean platelet volume (MPV) have increasingly been mentioned as measures of presence and severity of thyrotoxicosis. In this study, we aimed to analyze whether there is a link between these peripheral blood parameters and the presence of thyrotoxicosis. Material and Method: A total of 46 GD, 46 TMNG, 39 TA and 45 SAT patients and 45 healthy controls were included. Laboratory parameters and NLR, PLR, and MPV values were recorded from peripheral blood complete blood cell counts for each patient. Results: This study showed that NLR and PLR levels are elevated in patients with SAT in comparison with other thyrotoxic patient groups and controls. The post hoc analysis of comparison of NLR and PLR in each study groups revealed that NLR and PLR were statistically different in the SAT group in comparison to the GD, TMNG, TA, and healthy controls. A significant decrease in the level of MPV was demonstrated in thyrotoxicosis patients (p<0.001). Conclusion: NLR, PLR and MPV that is routinely and automatically calculated from complete blood count plays an important diagnostic role in thyrotoxicosis.

Can eosinophil to monocyte ratio be a new marker for recurrence in graves' disease?

“…In the study of Çetin et al, NLR and PLR were found to be statistically significantly higher in SAT patients. However, no significant relationship was found between other thyrotoxicosis including GD [16]. In most of the studies, these ratios have been used in the differential diagnosis of thyrotoxicosis, and there is not enough study about the place of GD in the prognosis.…”