Evaluation of hemogram parameters pre and post treatment in thyrotoxic patients

Objective: The objective of the study was to investigate and compare the changes in hemogram parameters pre and post treatment in patients with thyrotoxicosis diagnosed with subacute thyroiditis (SAT), Graves disease (GD), toxic multinodular goiter (TMNG) and toxic adenoma (TA) and the use of these parameters in the differential diagnosis of these diseases. Materials and Methods: Study conducted a qualitative analysis of patients with thyrotoxicosis. The data of 201 patients who were followed up with the diagnosis of thyrotoxicosis in the Endocrinology and Metabolic Diseases outpatient clinic of Karadeniz Technical University between 2010 and 2020 were retrospectively analyzed. A ten-year longitudinal study was conducted in patients with thyrotoxicosis. In the study, the demographic characteristics of the patients, their laboratory and clinical findings, and the on going treatments were recorded. The diseases that cause thyrotoxicosis are divided into four groups as subacute thyroiditis, Graves disease, TMNG, and toxic adenoma. The changes in hemogram parameters with treatment between these four groups were examined in three stages. Findings: This study was conducted with 201 patients with a mean age of 47.7, 65.2% (131) female and 34.8% (70) male. The most common disease was Graves disease, which was observed in 79 (39.3%) patients. The most frequently described symptom was palpitation and it was detected in 85 patients. After all thyrotoxicosis patients were evaluated pre and post treatment, a drastically decrease was observed in the mean neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) ratio with treatment. Also subacute thyroiditis patients were evaluated pre and post treatment, a significant decrease was observed in the mean NLR, MLR, PLR values and T4/T3 ratio. On the other hand, the mean platelet volume (MPV) values were evaluated pre and post treatment, in all patient groups, no significant correlation was found. Besides in Graves patients, a significant decrease was observed in the mean MLR, PLR values and T4/T3 ratio in the pre- and post-treatment evaluations. Results: In our study, the findings were mostly similar to the literature. However, there is no study in literature evaluating post-treatment hemogram parameters in thyrotoxic patients. Therefore, our study has shown that hemogram parameters can be used as an auxiliary parameter to support the diagnosis of subgroups of thyrotoxicosis and to evaluate treatment response, as it as an easily accessible and inexpensive method.