An Overview of the Hematological Picture with Antithyroid Therapy in Graves' Disease

 

Aksanur Gokce¹, Tulay Omma², Ismail Arslanc³, Mustafa Çelikc³, Işılay Taşkaldıran²

 

¹Department of Family Medıcıne, University of Amasya,
Serefeddin Sabuncuoğlu Training and Research Hospital, Amasya, Turkey 
²Department of Endocrinology and Metabolism, University of Health Sciences,
Ankara Training and Research Hospital, Ankara, Turkey 
³Department of Family Medıcıne, University of Health Sciences,
Ankara Training and Research Hospital, Turkey

 

 SUMMARY

 

Aim: Graves' disease is an autoimmune thyroid disease that is the most common cause of hyperthyroidism. Peripheral blood cell parameters such as neutrophils, lymphocytes, and platelets play a role in inflammation control. Several studies have proven that neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio and platelet-lymphocyte ratio are indicators of chronic subclinical inflammation in various diseases. In our study, we aimed to review the peripheral blood picture by evaluating these parameters before and after antithyroid treatment in patients with Graves' disease.

Patients and methods: A total of 120 patients (93 female, 27 male) between the ages of 18 - 65 were included. Demographic data, hemogram and biochemical data of the patients were recorded retrospectively at the time of diagnosis and after euthyroidism was achieved with medical treatment.

Results: During the treatment, there was an increase in hemoglobin, lymphocytes, neutrophils and red cell distribution width, while a decrease in monocytes was observed. There was no significant difference between white blood cell, platelet and mean platelet volume. In addition, while there was no statistically significant difference between neutrophil-lymphocyte ratio  (p = 0.8) and thrombocyt-lymphocyte ratio (p = 0.078) after euthyroid state, a statistically significant difference was found in favor of a decrease in monocyte-lymphocyte ratio (p = 0.006).

Conclusion: Changes in hematopoiesis are relatively common in patients with newly diagnosed Graves' disease, and initiation of antithyroid therapy leads to improvement in these parameters. Although neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio and platelet-lymphocyte ratio are accepted as new, non-invasive markers in clinical evaluation, in our study only a significant decrease in monocyte-lymphocyte ratio levels was observed after euthyroidism was achieved with antithyroid treatment.

 

Keywords: Graves’ disease, neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio, platelet-lymphocyte ratio, mean platelet volume

 

Corresponding author:

Aksanur Gokce

e-mail: aksanurgokce@gmail.com