Yüksek ortalama platelet hacmi Graves hastalarında hipertiroidizme eşlik etmektedir

Amaç: Graves hastalığı, tirotoksikozun en sık nedeni olup, otoimmün bir hastalıktır. Tirotoksikoz, trombosit yaşam süresinde azalmaya neden olan bir durumdur. İnflamasyonun trombositler için önemli bir uyaran olduğu bilinmektedir. Ortalama trombosit hacmi (MPV) ise trombosit fonksiyonlarının önemli bir belirleyicisi olup, çeşitli inflamatuar hastalıklarda tanısal bir belirteç olarak kullanılabileceği söylenmektedir. Bu çalışmada MPV’nin, Graves hastalarında, hastalık aktivitesini değerlendirmede yararlı bir inflamatuar belirteç olup olmadığnı değerlendirmeyi amaçladık.Gereç ve Yöntem: Bu retrospektif çalışmaya 229 hasta (Graves hastalığı olanlar (Grup 1); n=102 ve ötiroid nodüler guatr hastaları (Grup 2); n= 127) dahil edildi. Graves hastalarında başlangıçta ve antitiroid ilaç tedavisi ile ilk ötiroid oldukları anda, ötiroid noduler guatr hastalarında ise başlangıçta ölçülen serum TSH, fT3, fT4 and MPV değerleri kaydedildi. Bulgular: Hastaların ortalama yaşı Grup 1’de 40.3±13.5 ve Grup 2’de 50.2±11.6 idi. Başvuru anındaki ortalama MPV düzeyi gruplar arasında farklı değildi; sırasıyla 8.3±1.2 fL ve 8.3±1.1 fL, (p=0.9). Graves hastalarında (Grup 1), başlangıç MPV düzeyini, ilk ötiroid oldukları andaki MPV düzeyine göre daha yüksek olarak saptadık (8.3±1.2 fL vs 8.0±1.3 fL, p= 0.02). Sonuç: Graves hastalarında başvuru anındaki yüksek MPV düzeyinde hipertiroidizmin düzelmesi ile izlenen anlamlı düşüş, hipertiroidizm ilişkili platelet yıkımının artışına bağlı olabilir.

Anahtar Kelimeler:

Graves’ disease, mean platelet volume, autoimmunity, thyrotoxicosis

Higher mean platelet volume is accompanied with hyperthyroidism in patients with Graves’ disease

Purpose: Graves’ disease (GD) is an autoimmune disease that is the most common cause of thyrotoxicosis. Thyrotoxicosis can cause a decrease in platelet survival time. Inflammation is an important stimulus for platelets and mean platelet volume (MPV) could be used a diagnostic marker which is an important determinant of platelet activity. In this study we aimed to evaluate whether MPV would be a useful inflammatory marker for evaluation of disease activity in patients with Graves’ disease.Materials and Methods: Two hundred twenty-nine patients (GD patients (Group 1); n=102 and patients with euthyroid nodular goiter (Group 2); n= 127) were included in this retrospective study. Serum TSH, fT3, fT4 and MPV levels were recorded at presentation and at first euthyroid period under ATD treatment in GD patients and at presentation in patients with euthyroid nodular goiter.Results: The mean age was 40.3±13.5 in Group 1 and 50.2±11.6 in Group 2. Mean initial MPV level did not differ between groups; 8.3±1.2 fL and 8.3±1.1 fL, respectively (p=0.9). We found that mean initial MPV was higher than the first euthyroid period MPV in Group 1; Graves’ group (8.3±1.2 fL vs 8.0±1.3 fL, p= 0.02). Conclusion: Higher initial MPV levels in Graves patients and significant drop following the restoration of hyperthyroidism may be due to hypermetabolism of hyperthyroidism.

Keywords:

Graves’ disease, mean platelet volume,

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