The Effect of Hormone Replacement Treatment on Thrombin-Activatable Fibrinolysis Inhibitor Activity Levels in Patients with Hashimoto Thyroiditis

Çetinkalp, Şevki; Töbü, Mahmut; Karadeniz, Muammer; Büyükkeçeci, Filiz; Yılmaz, Candeğer

doi:10.2169/internalmedicine.48.1758

Cited by 8 publications

(12 citation statements)

References 24 publications

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“…Circulating thyroid hormones may directly or indirectly influence the synthesis, release, or clearance of coagulation/fibrinolytic parameters or alter distribution among different intravascular pools. 33,55 Cetinkalp et al 18 obtained similar results, although in that study, high levels in TAFI activity in patients with hypothyroid Hashimoto thyroiditis compared with controls persisted after L-levothyroxine treatment. These results suggested fibrinolytic deficit or thrombotic tendency in these patients.…”

Section: Hypercoagulability In Hypothyroidismmentioning

confidence: 64%

“…22,23 A relationship between Graves' disease and antiphospholipid antibody syndrome has been demonstrated. 18,19 In summary, the following factors contribute to the hypercoagulability observed in hyperthyroidism 4,22,24 : (1) An increase in blood volume (as a consequence of increased erythropoietin production in response to increased oxygen needs), (2) an increase in hepatic protein synthesis and an increase in the levels of acute phase reactants, (3) a hyperfunctioning thyroid gland can produce large amounts of ''tissue factor,'' which is the major trigger for the extrinsic pathway of coagulation, (4) an increase in thrombin and plasmin activity (plasma fibrinopeptide A levels, which are a sensitive indicator of thrombin activity, and Bb 15-42 peptide levels, which are a sensitive indicator of plasmin activity, increase in hyperthyroidism; the fibrinolysis activity is a secondary phenomenon to the increase in fibrin production), (5) thyroid hormones increase the indicators of endothelial damage by affecting endothelial functions (high levels of thyroid hormones cause a shift to procoagulant state, which is one of the physiological antithrombotic properties of the endothelium), and (6) hypermetabolism results in excess fluid loss because of an increase in respiratory rate and sweating. (Despite this excess fluid loss, blood volume will increase as a consequence of an increased red blood cell mass in patients with hyperthyroidism.…”

Section: Hypercoagulability In Hyperthyroidismmentioning

confidence: 99%

“…6 Some studies reported that a hypercoagulability state may also be present in these patients, whereas a tendency toward bleeding is typically seen in patients with hypothyroidism. [15][16][17][18] Direct and indirect effects of excessive or insufficient thyroid hormones on thrombocyte maturation and Figure 1 A schematic diagram of the (A) coagulation and (B) fibrinolysis pathways. Ca 2 þ , calcium; F, factor; HMWK, high molecular weight kininogen; PAI, plasminogen activator inhibitor; PL, phospholipid; TAFI, thrombin-activatable fibrinolysis inhibitor; TFPI, tissue factor pathway inhibitor; tPA, tissue plasminogen activator.…”

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confidence: 99%

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Thyroid Disorders and Hypercoagulability

Erem

2011

Semin Thromb Hemost

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Various abnormalities of coagulation and fibrinolysis, ranging from subclinical laboratory abnormalities to clinically significant disorders of hemostasis, but rarely major hemorrhage or thromboembolism, may occur in patients with thyroid diseases. This review discusses the relationships between thyroid dysfunction and the coagulation/fibrinolytic system. According to the recent literature, most of the coagulation/fibrinolytic abnormalities associated with thyroid dysfunction are the consequences of direct effects of thyroid hormones on the synthesis of various hemostatic parameters. Thyroid autoimmunity may also modify the processes of secondary hemostasis. Hyperthyroidism is generally associated with hypercoagulability and hypofibrinolysis, whereas the hemostatic profile in hypothyroidism depends on the severity of the disease. Both hypercoagulable and hypocoagulable states including increased fibrinolytic activity have been reported in hypothyroidism. Few data are available on hemostasis in subclinical thyroid diseases. In conclusion, adequate further prospective clinical studies of high quality including a larges series of patients are needed to explain the degree and type of coagulation/fibrinolytic abnormalities in patients with thyroid diseases.

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Section: Hypercoagulability In Hypothyroidismmentioning

confidence: 64%

Section: Hypercoagulability In Hyperthyroidismmentioning

confidence: 99%

mentioning

confidence: 99%

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Thyroid Disorders and Hypercoagulability

Erem

2011

Semin Thromb Hemost

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“…Both an increased and decreased coagulopathy has been reported. Increases in fibrinogen and homocysteine level, thrombin activatable fibrinolysis inhibitor (TAFI), FVIII, Von Willebrand factor (vWF), FVIIC, carotid artery intima media thickness advocated a hypercoaguable state [1][2][3][4][5] . Alternately an increased bleeding tendency and a decreased fibrinogen and FVIII C in subclinical hypothyroid patients have been found 6 .Gullu et al reported decreased FVIII and vWF in both and increased BT, CT, APTT, PT in overt hypothyroid patients which reversed after treatment with levothyroxine 7 .…”

Section: Introductionmentioning

confidence: 99%

Haemostatic functions and metabolic profile of subclinical hypothyroid and hypothyroid patients.

Mahajan

Mahaur

Singh

et al. 2018

Bangladesh J Med Sci

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Objectives: Both hypercoagulable and hypocoagulable states have been proposed for hypothyroidism, whether in overt or subclinical spectrum. The status of haemostatic functions, metabolic profile and their relationship in hypothyroid disorders need to be evaluated.Methods and Material: This prospective case control study was undertaken in 30- 50 years old female subclinical and hypothyroid patients. Haemostatic functions like bleeding time (BT), clotting time (CT), prothrombin time (PT), activated partial thromboplastin time (APTT), platelet count and metabolic parameters like plasma glucose and lipid levels and clinical variables like blood pressure and body mass index were noted and compared. In addition the strength of correlation of TSH, T4, T3, lipid profile with the haemostatic functions was evaluated.Results: Both groups of patients were obese, normotensive with normal haemostatic parameters. The platelet count correlated with TSH in subclinical hypothyroid patients and with T4 levels in hypothyroid patients. Although within normal range, total cholesterol and LDL cholesterol levels were higher and postprandial plasma glucose (PPPG) levels lower in hypothyroid patients compared to subclinical hypothyroid patients. A positive correlation was seen between TSH and LDL, PPPG levels, between fT3 and BMI, and also of antiTPO with total cholesterol, LDL, Fasting plasma glucose (FPG) in hypothyroid patients. The BMI was negatively associated with fT3 levels in subclinical hypothyroid patients.Conclusion: This study found normal haemostatic and metabolic functions in both subclinical and hypothyroid patients. Although within normal range, hypothyroid patients had higher total and LDL cholesterol. TSH and antiTPO levels correlated with LDL levels in these patients. Correlation of platelet count with TSH in subclinical hypothyroid and T4 levels in hypothyroid patients advocate a difference in mechanism involved. Therefore it can be connoted that thyroid status influences metabolic profile, and platelet count.Bangladesh Journal of Medical Science Vol.17(4) 2018 p.532-536

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“…In areas where endemic iodide deficiency is not prevalent, it is the most frequent cause of hypothyroidism (2,3). It is observed more frequently in girls and in individuals with genetic tendency (4,5). The diagnosis of Hashimoto thyroiditis is made by determining increased thyroid antibodies in serum and/or findings of fine-needle aspiration biopsy (6).…”

Section: Introductionmentioning

confidence: 99%

Çocuk ve ergenlerde Hashimoto tiroiditi: klinik ve laboratuvar bulgularının değerlendirilmesi

Dündar¹,

Boyaci²,

Sangün³

et al. 2011

tpa

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Aim:The objective of this study was retrospective analysis of clinical and laboratory findings of children and adolescents with Hashimoto thyroiditis. Material and Method:We evaluated 78 patients with HT who were between 4-17 years of age. Physical examination and family history of the patients, thyroid functions, auto-antibody titers and USG scans were evaluated retrospectively. Results: Two (2.6%) patients presented with hyperthyroidism, while 10 (11.7%), 17 (21.8%) and 49 (62.8%) patients presented with hypothyroidism, subclinical hypothyroidism and euthyroidism, respectively. The major symptoms included nervousness, sweating, weight gain and loss of appetite. Sixty-three (80.8%) patients had goiter and 52 (66.7%) patients had positive anti-thyroid peroxidase antibody at the time of diagnosis. Among the 19 patients who were euthyroid initially, 2 patients became hyperthyroid, 1 became hypothyroid and 1 became subclinically hypothyroid during follow-up. Familial history of thyroid disease was found in 31 (39%) patients. Conclusions: Clinical and laboratory findings may vary at the time of diagnosis and during follow-up in children and adolescents with HT. Periodic monitoring of the patients is very important. (Turk Arch Ped 2011; 46: 309-13)

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The Effect of Hormone Replacement Treatment on Thrombin-Activatable Fibrinolysis Inhibitor Activity Levels in Patients with Hashimoto Thyroiditis

Cited by 8 publications

References 24 publications

Thyroid Disorders and Hypercoagulability

Thyroid Disorders and Hypercoagulability

Haemostatic functions and metabolic profile of subclinical hypothyroid and hypothyroid patients.

Çocuk ve ergenlerde Hashimoto tiroiditi: klinik ve laboratuvar bulgularının değerlendirilmesi

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