Araştırma Makalesi
Yıl 2023,
Cilt: 1 Sayı: 1, 17 - 25, 01.01.2023
Öz
Kaynakça
- Buluş AD and Andıran N , Thyroid disorders in childhood and adolescence. Türkiye Klinikleri. J Fam Med-Special Topics 2015; 6: 48-53.
- Ordookhani A. and Burman KD. Hemostasis in Hypothyroidism and Autoimmune Thyroid Disorders. Int J Endocrinol Metab 2017; 15: p. e42649.
- Squizzato A, Romualdi E, Büller H R, Gerdes VE. Clinical review: Thyroid dysfunction and effects on coagulation and fibrinolysis: a systematic review. J Clin Endocrinol Metab 2007; 92: p. 2415-20.
- Dalton RG, Dewar MS, Savidge GF, Kernoff PB, Matthews KB, Greaves M et al. Hypothyroidism as a cause of acquired von Willebrand's disease. Lancet 1987; 1; 1007-9.
- Ermantas N, Guldiken S, Demir M. and Tugrul A. Thrombin-activatable fibrinolysis inhibitor (TAFI) antigen and activity assay in patients with primary hypothyroidism. Clin Appl Thromb Hemost 2010; 16: 568-73.
- Erem CUO, Yilmaz M, Kocak M, Nuhoglu I, Ersoz HO. Increased thrombin-activatable fibrinolysis inhibitor and decreased tissue factor pathway inhibitor in patients with hypothyroidism. Endocrine 2009; 35:75–80.
- Federici AB. Acquired von Willebrand syndrome associated with hypothyroidism: A mild bleeding disorder to be further investigated. Semin Thromb Hemost 2011; 37: 35-40.
- Kaliebe H. Autochthone Sinusthrombose bei einem Falle von Morbus Basedow und Tabes. Med Klin 1913; 2:1929.
- Squizzato A, Gerdes VEA, Brandjes DPM, Büller HR, Stam J. Thyroid diseases and cerebrovascular disease. Stroke 2005; 36: 2302-10.
- Kurata Y, Nishioeda Y, Subakio T, Kitani T. Thrombocytopenia in Graves' disease: effect of T3 on platelet kinetics. Acta Haematol 1980; 63: 185-90.
- Cordiano I, Betterle C, Spadaccino CA, Soini B, Girolami A, Fabris F. Autoimmune thrombocytopenia (AITP) and thyroid autoimmune disease (TAD): overlapping syndromes? Clin Exp Immunol 1998; 113: 373-8.
- Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. Jama 2000; 283: 2008-12.
- Franchini M, Montagnana M, Manzato F, Vescovi PP. Thyroid dysfunction and hemostasis: an issue still unresolved. Semin Thromb Hemost 2009; 35: 288-94.
- Gao F. Varıatıon Tendency of Coagulatıon Parameters in Different Hypothyroıdısm Stages. Acta Endocrinol (Buchar) 2016; 12: 450-4.
- Gullu S, Sav H, Kamel N. Effects of levothyroxine treatment on biochemical and hemostasis parameters in patients with hypothyroidism. Eur J Endocrinol 2005; 152: 355-61.
- Chadarevian R, Jublanc C, Bruckert E, Giral P, Ankri A, Champman J. Effect of levothyroxine replacement therapy on coagulation and fibrinolysis in severe hypothyroidism. J Endocrinol Invest 2005; 28: 398-404.
- Chadarevian R, Ankri A, Beucler I, Giral P, Turpin G. Relationship and between thyroid hormones and plasma D-dimer levels. Thromb Haemost 1998; 79: 99–103.
- Ozcan MA, Çömlekçi A, Demirkıran F, Yüksel F, Sari İ, Demir T. Plasma levels of free tissue factor pathway inhibitor in patients with various thyroid disorders. Thromb Res 2003. 110:243-7.
- Gursoy A, Özduman CM, Kamel N, Gullu S, Which thyroid-stimulating hormone level should be sought in hypothyroid patients under L-thyroxine replacement therapy? Int J Clin Pract 2006; 60: 655-9
- Cantürk Z, Çetinarslan B, Tarkun I, Cantürk NZ, Ozden M, Duman C. Hemostatic system as a risk factor for cardiovascular disease in women with subclinical hypothyroidism. Thyroid 2003; 13: 971-7.
- Çakal B, Çakal E, Demirbaş B, Özkaya M, Karaahmetoğlu S, Serter R. Homocysteine and fibrinogen changes with L- thyroxine in subclinical hypothyroid patients. J Korean Med Scl 2007 June; 22: 431-5.
- Erem C, Kavgacı H, Ersöz HO, Hacihasanoğlu A, Ukinç K, Karti SS et al. Blood coagulation and fibrinolytic activity in hypothyroidism. Int J Clin Pract 2003; 57: 78-81.
- Işık BY, Ağladıoğlu S, Ağladıoğlu K, Kılıç TE, Özhan B, Polat A. Impaired Hemorheological Parameters and Increased Carotid Intima-Media Thickness in Children with Subclinical Hypothyroidism, Hormone Research Pediatrics 2016; 85:250-6.
- Beyan C. Trombofilili hastada tanısal yaklaşım. Türk Hematoloji Derneği - Temel Hemostaz Tromboz Kursu 2007; 68-75.
- Varga EA, Sturm AC, Misita CP, Moll S. Homocysteine and MTHFR mutations relation to thrombosis and coronary artery disease. Circulation 2005; 111: 289-93
- Şengül E, Çetinarslan B, Cantürk Z, Türemen E, Tarkun I, Homocysteine concentrations in subclinical hypothyroidism. Endocr Res 2004; 30: 351- 9.
- Müller B, Tsakiris D A, Roth C B, Guglielmetti M, Staub JJ, Marbet GA. Haemostatic profile in hypothyroidism as potential risk factor for vascular or thrombotic disease. Eur J Clin Invest 2001; 31;131–7.
- Bülent A, Nevin K, Enver Ş,Yıldız D. Increased Thrombin-Activatable Fibrinolysis Inhibitor and Decreased Tissue Factor Pathway Inhibitor and Thrombomodulin Levels in Children with Hypothyroidism. J Clin Res Pediatr Endocrinol 2012. 4: 146-150.
Are there any changes in the coagulation parameters before and after the treatment in children with hypothyroidia?
Öz
Objectives: Various coagulation and fibrinolysis disorders have been reported commonly in patients with thyroid dysfunction. Although it has been observed that bleeding time, prothrombin time (PT), activated partial thromboplastin time (aPTT), platelet count, fibrinogen, D-dimer, factor VIII, and von Willebrand factor have been investigated to examine the hemostatic profiles of patients with thyroid hormone disorders, studies on protein C, protein S, antithrombin 3 (ATIII), and homocysteine are rare.
Methods: The study included 25 healthy children without any hematological conditions and with normal renal and hepatic functions, as well as 25 children with hypothyroidism between the ages of 2 and 18 who were diagnosed in Pediatric Endocrinology outpatient clinics between March 2020 and June 2021, who had not yet received medical treatment, and whose TSH≥10 and fT4 levels were low for their age (significant hypothyroidism), thyroid autoantibodies were negative. Complete blood counts, PT, aPTT, international normalized ratio (INR), fibrinogen, D-dimer, protein C, protein S, ATIII, homocysteine tests, and thyroid function tests were investigated. Age-appropriate L-thyroxine therapy was administered to hypothyroid patients for a period of 12 weeks. The differences between the coagulation parameters before and after treatment were compared once thyroid function tests had returned to normal ranges.
Results: Pretreatment PT, INR, D-dimer, hemoglobin, and mean corpuscular volume (MCV) levels were found to be statistically similar between the control and study groups (p>0.05). In hypothyroid patients, PTT, fibrinogen, protein C, protein S, ATIII levels were found to be statistically significantly lower than the control group before treatment (p: 0.001). While there was no significant change in D-dimer and INR levels of the patients in the study group before and after treatment (p>0.05), there was a significant increase in PTT, fibrinogen, protein C, protein S, antithrombin 3, hemoglobin, and MCV levels (p: 0.001). There was no statistically significant difference between the groups in terms of PT, INR, D-dimer, hemoglobin, and MCV levels before treatment (p>0.05).
Conclusions: There is a general decrease in anticoagulant proteins in children with hypothyroidism. It is important to closely monitor the coagulation system and especially the anticoagulant system. Thyroid hormones should be checked, and hormone replacement therapy should be applied if necessary in patients who are followed up due to coagulation tendency.
Anahtar Kelimeler
Kaynakça
- Buluş AD and Andıran N , Thyroid disorders in childhood and adolescence. Türkiye Klinikleri. J Fam Med-Special Topics 2015; 6: 48-53.
- Ordookhani A. and Burman KD. Hemostasis in Hypothyroidism and Autoimmune Thyroid Disorders. Int J Endocrinol Metab 2017; 15: p. e42649.
- Squizzato A, Romualdi E, Büller H R, Gerdes VE. Clinical review: Thyroid dysfunction and effects on coagulation and fibrinolysis: a systematic review. J Clin Endocrinol Metab 2007; 92: p. 2415-20.
- Dalton RG, Dewar MS, Savidge GF, Kernoff PB, Matthews KB, Greaves M et al. Hypothyroidism as a cause of acquired von Willebrand's disease. Lancet 1987; 1; 1007-9.
- Ermantas N, Guldiken S, Demir M. and Tugrul A. Thrombin-activatable fibrinolysis inhibitor (TAFI) antigen and activity assay in patients with primary hypothyroidism. Clin Appl Thromb Hemost 2010; 16: 568-73.
- Erem CUO, Yilmaz M, Kocak M, Nuhoglu I, Ersoz HO. Increased thrombin-activatable fibrinolysis inhibitor and decreased tissue factor pathway inhibitor in patients with hypothyroidism. Endocrine 2009; 35:75–80.
- Federici AB. Acquired von Willebrand syndrome associated with hypothyroidism: A mild bleeding disorder to be further investigated. Semin Thromb Hemost 2011; 37: 35-40.
- Kaliebe H. Autochthone Sinusthrombose bei einem Falle von Morbus Basedow und Tabes. Med Klin 1913; 2:1929.
- Squizzato A, Gerdes VEA, Brandjes DPM, Büller HR, Stam J. Thyroid diseases and cerebrovascular disease. Stroke 2005; 36: 2302-10.
- Kurata Y, Nishioeda Y, Subakio T, Kitani T. Thrombocytopenia in Graves' disease: effect of T3 on platelet kinetics. Acta Haematol 1980; 63: 185-90.
- Cordiano I, Betterle C, Spadaccino CA, Soini B, Girolami A, Fabris F. Autoimmune thrombocytopenia (AITP) and thyroid autoimmune disease (TAD): overlapping syndromes? Clin Exp Immunol 1998; 113: 373-8.
- Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. Jama 2000; 283: 2008-12.
- Franchini M, Montagnana M, Manzato F, Vescovi PP. Thyroid dysfunction and hemostasis: an issue still unresolved. Semin Thromb Hemost 2009; 35: 288-94.
- Gao F. Varıatıon Tendency of Coagulatıon Parameters in Different Hypothyroıdısm Stages. Acta Endocrinol (Buchar) 2016; 12: 450-4.
- Gullu S, Sav H, Kamel N. Effects of levothyroxine treatment on biochemical and hemostasis parameters in patients with hypothyroidism. Eur J Endocrinol 2005; 152: 355-61.
- Chadarevian R, Jublanc C, Bruckert E, Giral P, Ankri A, Champman J. Effect of levothyroxine replacement therapy on coagulation and fibrinolysis in severe hypothyroidism. J Endocrinol Invest 2005; 28: 398-404.
- Chadarevian R, Ankri A, Beucler I, Giral P, Turpin G. Relationship and between thyroid hormones and plasma D-dimer levels. Thromb Haemost 1998; 79: 99–103.
- Ozcan MA, Çömlekçi A, Demirkıran F, Yüksel F, Sari İ, Demir T. Plasma levels of free tissue factor pathway inhibitor in patients with various thyroid disorders. Thromb Res 2003. 110:243-7.
- Gursoy A, Özduman CM, Kamel N, Gullu S, Which thyroid-stimulating hormone level should be sought in hypothyroid patients under L-thyroxine replacement therapy? Int J Clin Pract 2006; 60: 655-9
- Cantürk Z, Çetinarslan B, Tarkun I, Cantürk NZ, Ozden M, Duman C. Hemostatic system as a risk factor for cardiovascular disease in women with subclinical hypothyroidism. Thyroid 2003; 13: 971-7.
- Çakal B, Çakal E, Demirbaş B, Özkaya M, Karaahmetoğlu S, Serter R. Homocysteine and fibrinogen changes with L- thyroxine in subclinical hypothyroid patients. J Korean Med Scl 2007 June; 22: 431-5.
- Erem C, Kavgacı H, Ersöz HO, Hacihasanoğlu A, Ukinç K, Karti SS et al. Blood coagulation and fibrinolytic activity in hypothyroidism. Int J Clin Pract 2003; 57: 78-81.
- Işık BY, Ağladıoğlu S, Ağladıoğlu K, Kılıç TE, Özhan B, Polat A. Impaired Hemorheological Parameters and Increased Carotid Intima-Media Thickness in Children with Subclinical Hypothyroidism, Hormone Research Pediatrics 2016; 85:250-6.
- Beyan C. Trombofilili hastada tanısal yaklaşım. Türk Hematoloji Derneği - Temel Hemostaz Tromboz Kursu 2007; 68-75.
- Varga EA, Sturm AC, Misita CP, Moll S. Homocysteine and MTHFR mutations relation to thrombosis and coronary artery disease. Circulation 2005; 111: 289-93
- Şengül E, Çetinarslan B, Cantürk Z, Türemen E, Tarkun I, Homocysteine concentrations in subclinical hypothyroidism. Endocr Res 2004; 30: 351- 9.
- Müller B, Tsakiris D A, Roth C B, Guglielmetti M, Staub JJ, Marbet GA. Haemostatic profile in hypothyroidism as potential risk factor for vascular or thrombotic disease. Eur J Clin Invest 2001; 31;131–7.
- Bülent A, Nevin K, Enver Ş,Yıldız D. Increased Thrombin-Activatable Fibrinolysis Inhibitor and Decreased Tissue Factor Pathway Inhibitor and Thrombomodulin Levels in Children with Hypothyroidism. J Clin Res Pediatr Endocrinol 2012. 4: 146-150.
Toplam 28 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Research Articles |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Ocak 2023 |
| Gönderilme Tarihi | 18 Aralık 2022 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 1 Sayı: 1 |
Journal of Bursa Faculty of Medicine, hosted by Turkish JournalPark ACADEMIC, is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
2023