Abstract
Objective:To evaluate the impact of mean platelet volume (MPV) on predicting disease course among patients with Graves’ disease (GD).Methods:This retrospective study was performed between 2013-2016 at the Outpatient Endocrinology Clinic of Baskent University Faculty of Medicine, Adana hospital on 65 patients with GD. Among participants, 30 cases experienced thyrotoxicosis again during the first six months after discontinuing anti-thyroid drug (ATD) sessions that had been carried out for at least 12 months prior to stopping (Relapse group). We also observed 35 patients who exhibited normal thyroid functions within six months following ATD withdrawal (Remission group). MPV levels and thyroid function tests were recorded and total duration of ATD therapy was calculated for all participants.Results:The mean MPV level that was measured at the time of drug withdrawal did not differ between groups, being 8.0±1.2 fL in the Relapse group vs. 8.0±1.0 fL in the Remission group (p=0.81). However, we found that the relapse MPV was higher than the withdrawal MPV in the Relapse group (9.2±1.3 fL) than it was in the Remission group (8.0±1.2 fL, p=0.00).Conclusions:Higher relapse MPV in Relapse group but similar MPV levels in both groups at ATD withdrawal may be attributed to hypermetabolism or hyperthyroidism rather than autoimmunity of GD.Abbreviations:BMI: Body mass indexGD: Graves’ diseaseMPV: Mean platelet volumeTSH: Thyroid-stimulating hormoneTRAbs: Thyrotropin receptor antibodiesATD: Anti-thyroid drugfT4: Free thyroxinefT3: Free triiodothyronineCBC: Complete blood countPTC: Papillary thyroid carcinoma
Highlights
Graves’ disease (GD) is an autoimmune thyroid disorder characterized by thyrotoxicosis, frequent infiltrative orbitopathy, and occasional infiltrative dermopathy.[1,2,3] Thyrotoxicosis can cause some alterations in various body systems
We aimed to investigate the relationship between Mean platelet volume (MPV) and disease course in patients with GD
After careful consideration of these factors, we proposed that MPV measured at anti-thyroid drug (ATD) withdrawal will be higher in relapse GD
Summary
Graves’ disease (GD) is an autoimmune thyroid disorder characterized by thyrotoxicosis, frequent infiltrative orbitopathy, and occasional infiltrative dermopathy.[1,2,3] Thyrotoxicosis can cause some alterations in various body systems. In the hematopoietic system, red blood cell mass is increased due to the direct effect of thyroid hormones on the erythroid marrow and increased erythropoietin production. Platelet levels and intrinsic clotting mechanism are normal, but the concentration of factor VIII is often increased.[4,5] an increase in megakaryocytes and a decrease in platelet survival time can be observed in hyperthyroid patients. There are three effective therapeutic options for GD: anti-thyroid drug (ATD), surgery and radioactive iodine therapy. A long term medical therapy lasting at least 12 months is usually administered and withdrawn if serum thyroid stimulating hormone (TSH) levels return to normal.[6] The average rate of remission is between 30% and 50% after ATD withdrawal.[2,7]
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