Effect of Hematologic Values in Determining the Resolution of Subacute Thyroiditis and Long-Term Hypothyroidism Risk
AbstractSubacute thyroiditis (SAT), which can be considered a disease with infectious signs and parameters, can affect humans and lead to permanent hypothyroidism. Haematological parameters play an essential role in SAT; these parameters begin to normalise after the thyrotoxic phase; however, there is still a gap in knowledge about how these parameters play a role in SAT prognosis. Therefore, we wanted to investigate haematological parameters and their impact on treatment response and recovery phase in patients with SAT. 51 SAT patients and 44 healthy controls were included in the study. ESR, CRP, NLR and MPV were recorded at the diagnosis and after resolution. The changes in these parameters were compared to determine the resolution phase. The ratio of permanent hypothyroidism after one year was studied, and its relevance with these parameters at the time of diagnosis was explored. 36 of 51 SAT patients were female in the study (70.5%). The mean age was 45.53 ± 11.46 years. In the acute phase, WBC, Neutrophil, platelet, ESR, N/L, and P/L were significantly higher (p<0.05). In the recovery phase, MPV and lymphocyte count were significantly higher (p: 0.002 and p=0.002). WBC, CRP, and ESR had the highest AUC values in ROC analysis (0.990, 0.959, 0.907, p<0.05). P/L and N/L ratios also had higher ratios for the acute phase (0.807, 0.98, p<0.05, respectively). Δ ESR, Δ CRP, Δ N/L, and Δ P/L had the highest AUC for the recovery phase (AUC= 0.990, 0.899, 0889,0.800, p<0.5, respectively). Permanent hypothyroidism after one year was 9/42 (21.4%). In addition to ESR and CRP, NLR, PLR and MPV were also successfully used to estimate SAT activity and response to treatment. Moreover, a decrease in NLR and PLR and an increase in MPV were associated with the treatment response and resolution phase. However, these parameters did not determine the long-term risk of hypothyroidism.
Arıman, A., & Merder, E. (2021). The prognostic importance of neutrophil-to-lymphocyte ratio in testicular cancer. Urologia, 88(3), 200–205. https://doi.org/10.1177/0391560321993584
Chim, S. T., Sanfilippo, P., O'Brien, T. J., Drummond, K. J., & Monif, M. (2021). Pre-treatment neutrophil-to-lymphocyte/monocyte-to-lymphocyte ratio as prognostic biomarkers in glioma patients. Journal of neuroimmunology, 361, 577754. https://doi.org/10.1016/j.jneuroim.2021.577754
de Jager, C. P., Wever, P. C., Gemen, E. F., Kusters, R., van Gageldonk-Lafeber, A. B., van der Poll, T., & Laheij, R. J. (2012). The neutrophil-lymphocyte count ratio in patients with community-acquired pneumonia. PloS one, 7(10), e46561. https://doi.org/10.1371/journal.pone.0046561
Desailloud, R., & Hober, D. (2009). Viruses and thyroiditis: an update. Virology journal, 6, 5. https://doi.org/10.1186/1743-422X-6-5
Fan, Z., & Tang, S. (2017). Mean Platelet Volume and Platelet Count are Elevated in Patients with Subacute Thyroiditis. Clinical laboratory, 63(9), 1487–1492. https://doi.org/10.7754/Clin.Lab.2017.170411
Görges, J., Ulrich, J., Keck, C., Müller-Wieland, D., Diederich, S., & Janssen, O. E. (2020). Long-term Outcome of Subacute Thyroiditis. Experimental and clinical endocrinology & diabetes: official journal, German Society of Endocrinology [and] German Diabetes Association, 128(11), 703–708. https://doi.org/10.1055/a-0998-8035
Koh, C. H., Bhoo-Pathy, N., Ng, K. L., Jabir, R. S., Tan, G. H., Lee, M. H., Jamaris, S., & Taib, N. A. (2015). Utility of pre-treatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic factors in breast cancer. British journal of cancer, 113(1), 150–158. https://doi.org/10.1038/bjc.2015.183
Kuzucu, İ., Güler, İ., Kum, R. O., Baklacı, D., & Özcan, M. (2020). Increased neutrophil-lymphocyte ratio and platelet lymphocyte ratio in malignant parotid tumours. Brazilian journal of otorhinolaryngology, 86(1), 105–110. https://doi.org/10.1016/j.bjorl.2019.02.009
Lagunas-Rangel F. A. (2020). Neutrophil-to-lymphocyte ratio and lymphocyte-to-C-reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. Journal of medical virology, 92(10), 1733–1734. https://doi.org/10.1002/jmv.25819
Liontos, M., Andrikopoulou, A., Koutsoukos, K., Markellos, C., Skafida, E., Fiste, O., Kaparelou, M., Thomakos, N., Haidopoulos, D., Rodolakis, A., Dimopoulos, M. A., & Zagouri, F. (2021). Neutrophil-to-lymphocyte ratio and chemotherapy response score as prognostic markers in ovarian cancer patients treated with neoadjuvant chemotherapy. Journal of ovarian research, 14(1), 148. https://doi.org/10.1186/s13048-021-00902-0
Mirna, M., Schmutzler, L., Topf, A., Hoppe, U. C., & Lichtenauer, M. (2021). Neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio predict the length of hospital stay in myocarditis. Scientific reports, 11(1), 18101. https://doi.org/10.1038/s41598-021-97678-6
Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., Rivkees, S. A., Samuels, M., Sosa, J. A., Stan, M. N., & Walter, M. A. (2016). 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid: official journal of the American Thyroid Association, 26(10), 1343–1421. https://doi.org/10.1089/thy.2016.0229
Samuels M. H. (2012). Subacute, silent, and postpartum thyroiditis. The Medical clinics of North America, 96(2), 223–233. https://doi.org/10.1016/j.mcna.2012.01.003
Seles, M., Posch, F., Pichler, G. P., Gary, T., Pummer, K., Zigeuner, R., Hutterer, G. C., & Pichler, M. (2017). Blood Platelet Volume Represents a Prognostic Novel Factor in Patients with Nonmetastatic Renal Cell Carcinoma and Improves the Predictive Ability of Established Prognostic Scores. The Journal of urology, 198(6), 1247–1252. https://doi.org/10.1016/j.juro.2017.07.036
Stasiak, M., Michalak, R., Stasiak, B., & Lewiński, A. (2020). Time-Lag Between Symptom Onset and Diagnosis of Subacute Thyroiditis - How to Avoid the Delay of Diagnosis and Unnecessary Overuse of Antibiotics. Hormone and metabolic research = Hormon - und Stoffwechselforschung = Hormones et metabolism, 52(1), 32–38. https://doi.org/10.1055/a-1033-7524
Taşkaldiran, I., Omma, T., Önder, Ç. E., Firat, S. N., Koç, G., Kiliç, M. K., Kuşkonmaz, Ş. M., & Çulha, C. (2019). Neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, and platelet-to lymphocyte ratio in different etiological causes of thyrotoxicosis. Turkish journal of medical sciences, 49(6), 1687–1692. https://doi.org/10.3906/sag-1901-116
Templeton, A. J., McNamara, M. G., Šeruga, B., Vera-Badillo, F. E., Aneja, P., Ocaña, A., Leibowitz-Amit, R., Sonpavde, G., Knox, J. J., Tran, B., Tannock, I. F., & Amir, E. (2014). A systematic review and meta-analysis is a proven role of neutrophil-to-lymphocyte ratio in solid tumours. Journal of the National Cancer Institute, 106(6), dju124. https://doi.org/10.1093/jnci/dju124
You, J., Zhu, G. Q., Xie, L., Liu, W. Y., Shi, L., Wang, O. C., Huang, Z. H., Braddock, M., Guo, G. L., & Zheng, M. H. (2016). The preoperative platelet to lymphocyte ratio is a valuable prognostic biomarker in patients with colorectal cancer. Oncotarget, 7(18), 25516–25527. https://doi.org/10.18632/oncotarget.8334
Zahorec R. (2021). Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratislavske lekarske listy, 122(7), 474–488. https://doi.org/10.4149/BLL_2021_078
Zhao, N., Wang, S., Cui, X. J., Huang, M. S., Wang, S. W., Li, Y. G., Zhao, L., Wan, W. N., Li, Y. S., Shan, Z. Y., & Teng, W. P. (2020). Two-Years Prospective Follow-Up Study of Subacute Thyroiditis. Frontiers in endocrinology, 11, 47. https://doi.org/10.3389/fendo.2020.00047
How to Cite
Copyright (c) 2022 Savas Karatas, Burcu Hacıoğlu, Gökhan Kalaycı
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Publishing your paper with Medical Laboratory Technology Journal (MLTJ) means that the author or authors retain the copyright in the paper. MLTJ granted an author(s) rights to put the paper onto a website, distribute it to colleagues, give it to students, use it in your thesis etc, even commercially. The author(s) can reuse the figures and tables and other information contained in their paper published by MLTJ in future papers or work without having to ask anyone for permission, provided that the figures, tables or other information that is included in the new paper or work properly references the published paper as the source of the figures, tables or other information, and the new paper or work is not direct at private monetary gain or commercial advantage.
MLTJ journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge. This journal is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. This license lets others remix, transform, and build upon the material for any purpose, even commercially. MLTJ journal Open Access articles are distributed under this Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA). Articles can be read and shared for All purposes under the following conditions:
BY: You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.SA: If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.