A relationship between subclinical hypothyroidism and hematologic parameters in patients with Down Syndrome

Abdullah Yazar; Alaaddin Yorulmaz; Esra Ture; Fatih Akin; Ahmet Sert

doi:10.22391/fppc.422181

Research Article

Down Sendromlu hastalarda subklinik hipotiroidizm ve hematolojik parametreler arasındaki ilişki

Year 2018, Volume: 3 Issue: 2, 92 - 97, 30.08.2018

Abdullah Yazar , Alaaddin Yorulmaz , Esra Ture , Fatih Akin , Ahmet Sert

https://doi.org/10.22391/fppc.422181

Cited By: 1

Abstract

Giriş: Trizomi 21 olarak tanımlanan Down sendromu
(DS) mental retardasyon, hipotoni, dismorfik yüz özellikleri ve diğer ayırt
edici fenotipik özellikleri ile karakterize en sık görülen kromozomal
defekttir. DS'de görülen tiroid bozukluğu prevalansı % 3'dür ve normal
popülasyona göre anlamlı derecede yüksektir. Bu çalışmada, subklinik
hipotiroidisi olan ve olmayan DS'lu çocukların hematolojik parametrelerini
araştırmayı ve bunları sağlıklı kontrollerle karşılaştırmayı amaçladık.

Yöntem: Çalışmaya genetik olarak tanısı konan ve takip edilen
DS’li 184 hasta dahil edildi. Hastaların tam kan sayımı, serum elektrolit
seviyeleri, glikoz, üre, karaciğer fonksiyon testleri ve tiroid fonksiyon
testleri gözden geçirildi.

Bulgular: DS'lu hastaların 102'si (% 55,4) erkek, 82'si (% 44,6)
kadındı. Yaş ortalaması 6,2 ± 4 yıl idi. Kontrol grubu, polikliniğimize
başvuran sağlıklı çocuklardan oluşturuldu. DS'lu hastalarda kan sayımı,
hemoglobin, hematokrit ve nötrofil sayıları anlamlı olarak düşük bulundu. Yine
DS'li hastalarda kontrol grubuna göre trombosit sayısı ve trombosit düzeyleri
daha yüksek bulunurken trombosit dağılım
genişliği daha düşük bulundu.

Sonuç: DS'li hastalarda hematolojik parametreler arasında
anlamlı farklar bulduk. Subklinik hipotiroidizm, eritrosit dağılım genişliğini,
trombosit sayısını ve MPV'yi etkiler. DS'li hastalarda hematolojik
anormalliklerin sıklığını ve şiddetini bilmek, klinik uygulamada takip
sırasında yararlı olacaktır.

Keywords

Çocuk , Down sendromu , hematolojik parametreler , hipotiroidizm

References

1. Lee B. Down Syndrome and Other Abnormalities of Chromosome Number. In: Kliegman RM, Stanton BF, St Geme III JW, Schor NF, editors. Nelson Textbook of Pediatrics. Philadelphia, PA: Elsevier; 2016. p. 610-6.
2. Dixon N, Kishnani PS, Zimmerman S. Clinical manifestations of hematologic and oncologic disorders in patients with Down syndrome. Am J Med Genet C Semin Med Genet 2006;142(3):149-57.
3. Henry E, Walker D, Wiedmeier SE. (2007) Hematological abnormalities during the first week of life among neonates with Down syndrome: data from a multihospital healthcare system. American Journal of Medical Genetics 2007;143:42–50.
4. Tonacchera M, Perri A, De Marco G et al. TSH receptor and Gs (alpha) genetic analysis in children with Down's syndrome and subclinical hypothyroidism. J Endocrinol Invest 2003;26:997-1000.
5. Van Trotsenburg AS, Vulsma T, van Santen HM et al. Lower neonatal screening thyroxine concentrations in Down Syndrome newborns. J Clin Endocrinol Metab 2003;88: 1512–5.
6. Prasher VP. Down syndrome and thyroid disorders-a review. Downs Syndr Res Pract 1999;6(1):25-42.
7. Das KC, Mukherjee M, Sarkar TK, Dash RJ, Rastogi GK. Erythropoiesis and erythropoietin in hypo- and hyperthyroidism. J Clin Endocrinol Metab 1975; 40(2):211-20.
8. Mackenzie GM. Anemia in hypothyroidism. JAMA 1926; 86(7):462-4.
9. Kawa MP, Grymuła K, Paczkowska E et al. Clinical relevance of thyroid dysfunction in human haematopoiesis: biochemical and molecular studies. Eur J Endocrinol 2010;162(2):295-305.
10. Miller M, Cosgriff JM. Hematological abnormalities in newborn infants with Down syndrome. Am J Med Genet 1983;16:173-7.
11. Hord JD, Gay JC, Whitlock JA. Thrombocytopenia in neonates with trisomy 21. Arch Pediatr Adolesc Med 1995;149: 824–5.
12. Kim DW, Kim HR, Shin MG. Distinctive hematological abnormalities in East Asian neonates and children with down syndrome. Int. Jnl. Lab. Hem 2011,33,369-77
13. Weinberger MM, Oleinick A. Congenital marrow dysfunction in Down’s syndrome. J Pediatr 1970;77:273-9.
14. Lappalainen J, Kouvalainen K. High hematocrits in newborns with Down’s syndrome: a hitherto undescribed finding. Clin Pediatr 1972;11: 472-4.
15. Widness JA. Elevated erythropoietin levels in cord blood of newborns with Down’s syndrome. Biol Neonate 1994;66:50-55.
16. Yu HM, Park KS, Lee JM. The value of red blood cell distribution width in subclinical hypothyroidism. Arq Bras Endocrinol Metabol. 2014;58(1):30-6.
17. Montagnana M, Lippi G, Targher G, Salvagno GL, Guidi GC. The red blood cell distribution width is associated with serum levels of thyroid stimulating hormone in the general population. Int J Lab Hematol. 2009;31(5):581-2.
18. Matsubara K, Nigami H, Yura K, et al. Serum thrombopoietin level and thrombocytopenia during the neonatal period in infants with Down’s syndrome. J Perinatol 2010;30(2):98-102.
19. Kivivuori SM, Rajantie J, Siimes MA. Peripheral blood cell counts in infants with Down’s syndrome. Clin Genet 1996;49:15-19.
20. Kater AP, Prins MH, Rosenstiel IA, et al. Transient thrombocytopenia after cardiac surgery in infants with Down Syndrome. J Pediatr Hematol Oncol 1999;21(2):170-1.
21. Celik T, Güler E, Atas Berksoy E, et al. Mean platelet volume as a negative marker of inflamma¬tion in children with rotavirus gastroenteritis, Iran J Pediatr 2014;24(5):617-22.
22. Ozdemir R, Karadeniz C, Doksoz O et al. Are mean platelet volume and platelet distribution width useful parameters in children with acute rheumatic carditis? Pediatr Cardiol 2014;35(1):53-6.
23. Gasparyan AY, Ayvazyan L, Mikhailidis DP, et al. Mean platelet volume: a link between thrombosis and inflammation? Curr. Pharm. Des. 2011;17:47-58.
24. Çoban E, Yazıcıoglu G, Ozdogan M. Platelet activation in subjects with subclinical hypothyroidism. Med Sci Monit 2007;13:211-14.
25. Yılmaz H, Ertuğrul Ö, Ertuğrul B et al. Mean platelet volume in patients with subclinical hypothyroidism. Platelets 2011; 22(2): 143–47
26. Vagdatli E, Gounari E, Lazaridou E, et al. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia, 2010;14(1):28
27. Farias MG, Schunck EG, Dal Bo S. Definition of reference ranges for the platelet distribution width (PDW): a local need. Clinical chemistry and laboratory medicine 2010;48(2):255-7.
28. Amin MA, Amin AP, Kulkarni HR. Platelet distribution width (PDW) is increased in vaso-occlusive crisis in sickle cell disease. Annals of hematology 2004;83(6):331-5.
29. Liu R, Gao F, Huo J et al. Study on the relationship between mean platelet volume and platelet distribution width with coronary artery lesion in children with Kawasaki disease. Platelets 2012;23(1):11-6.
30. Wiwanitkit V. Plateletcrit, mean platelet volume, platelet distribution width: its expected values and correlation with parallel red blood cell parameters. Clinical and applied thrombosis/hemostasis 2004;10(2):175-78.
31. Mohr R, Martinowitz U, Golan M et al. Platelet size and mass as an indicator for platelet transfusion after cardiopulmonary bypass. Circulation 1986;74(2):153.
32. Threatte GA. Usefulness of the mean platelet volume. Clinics in laboratory medicine 1993;13(4): 937.

A relationship between subclinical hypothyroidism and hematologic parameters in patients with Down Syndrome

Year 2018, Volume: 3 Issue: 2, 92 - 97, 30.08.2018

Abdullah Yazar , Alaaddin Yorulmaz , Esra Ture , Fatih Akin , Ahmet Sert

https://doi.org/10.22391/fppc.422181

Cited By: 1

Abstract

Introduction: Down syndrome (DS) which is defined as
trisomy 21 is the most common chromosomal defect characterized by mental
retardation, hypotonia, dysmorphic facial features, and other distinctive
phenotypic characteristics. The prevalence of thyroid disorders in DS is 3% and
is significantly higher than in the normal population. In this study we aimed to investigate hematologic parameters
of children with DS who had and hadn’t subclinical hypothyroidism and compare
them with healthy controls.

Methods:
This study included 184 patients who were followed up
with genetically diagnosed DS. Complete
blood count, levels of serum electrolytes, glucose, urea, liver function tests,
thyroid function tests were reviewed.

Results: 102 (55.4%)
of the patients with DS were male and 82 (44.6%) were female. Mean age was 6.2
± 4.0 years. Control group was constituted of outpatient
healthy children. White blood cell count, hemoglobin, hematocrit, and
neutrophil counts were found to be significantly lower in patients with DS. Platelet count and plateletcrit levels were
found to be higher and platelet distribution width was lower in patients with
DS than in the control group.

Conclusion: We found significant differences among
hematological parameters in patients with DS. Subclinical
hypothyroidism
influences red blood cell distribution width, platelet count and MPV. Knowing
the incidence and severity of hematologic abnormalities in patients with DS will
be beneficial during follow-up in clinical practice.

Keywords

child , Down syndrome , hematological parameters , hypothyroidism

References

1. Lee B. Down Syndrome and Other Abnormalities of Chromosome Number. In: Kliegman RM, Stanton BF, St Geme III JW, Schor NF, editors. Nelson Textbook of Pediatrics. Philadelphia, PA: Elsevier; 2016. p. 610-6.
2. Dixon N, Kishnani PS, Zimmerman S. Clinical manifestations of hematologic and oncologic disorders in patients with Down syndrome. Am J Med Genet C Semin Med Genet 2006;142(3):149-57.
3. Henry E, Walker D, Wiedmeier SE. (2007) Hematological abnormalities during the first week of life among neonates with Down syndrome: data from a multihospital healthcare system. American Journal of Medical Genetics 2007;143:42–50.
4. Tonacchera M, Perri A, De Marco G et al. TSH receptor and Gs (alpha) genetic analysis in children with Down's syndrome and subclinical hypothyroidism. J Endocrinol Invest 2003;26:997-1000.
5. Van Trotsenburg AS, Vulsma T, van Santen HM et al. Lower neonatal screening thyroxine concentrations in Down Syndrome newborns. J Clin Endocrinol Metab 2003;88: 1512–5.
6. Prasher VP. Down syndrome and thyroid disorders-a review. Downs Syndr Res Pract 1999;6(1):25-42.
7. Das KC, Mukherjee M, Sarkar TK, Dash RJ, Rastogi GK. Erythropoiesis and erythropoietin in hypo- and hyperthyroidism. J Clin Endocrinol Metab 1975; 40(2):211-20.
8. Mackenzie GM. Anemia in hypothyroidism. JAMA 1926; 86(7):462-4.
9. Kawa MP, Grymuła K, Paczkowska E et al. Clinical relevance of thyroid dysfunction in human haematopoiesis: biochemical and molecular studies. Eur J Endocrinol 2010;162(2):295-305.
10. Miller M, Cosgriff JM. Hematological abnormalities in newborn infants with Down syndrome. Am J Med Genet 1983;16:173-7.
11. Hord JD, Gay JC, Whitlock JA. Thrombocytopenia in neonates with trisomy 21. Arch Pediatr Adolesc Med 1995;149: 824–5.
12. Kim DW, Kim HR, Shin MG. Distinctive hematological abnormalities in East Asian neonates and children with down syndrome. Int. Jnl. Lab. Hem 2011,33,369-77
13. Weinberger MM, Oleinick A. Congenital marrow dysfunction in Down’s syndrome. J Pediatr 1970;77:273-9.
14. Lappalainen J, Kouvalainen K. High hematocrits in newborns with Down’s syndrome: a hitherto undescribed finding. Clin Pediatr 1972;11: 472-4.
15. Widness JA. Elevated erythropoietin levels in cord blood of newborns with Down’s syndrome. Biol Neonate 1994;66:50-55.
16. Yu HM, Park KS, Lee JM. The value of red blood cell distribution width in subclinical hypothyroidism. Arq Bras Endocrinol Metabol. 2014;58(1):30-6.
17. Montagnana M, Lippi G, Targher G, Salvagno GL, Guidi GC. The red blood cell distribution width is associated with serum levels of thyroid stimulating hormone in the general population. Int J Lab Hematol. 2009;31(5):581-2.
18. Matsubara K, Nigami H, Yura K, et al. Serum thrombopoietin level and thrombocytopenia during the neonatal period in infants with Down’s syndrome. J Perinatol 2010;30(2):98-102.
19. Kivivuori SM, Rajantie J, Siimes MA. Peripheral blood cell counts in infants with Down’s syndrome. Clin Genet 1996;49:15-19.
20. Kater AP, Prins MH, Rosenstiel IA, et al. Transient thrombocytopenia after cardiac surgery in infants with Down Syndrome. J Pediatr Hematol Oncol 1999;21(2):170-1.
21. Celik T, Güler E, Atas Berksoy E, et al. Mean platelet volume as a negative marker of inflamma¬tion in children with rotavirus gastroenteritis, Iran J Pediatr 2014;24(5):617-22.
22. Ozdemir R, Karadeniz C, Doksoz O et al. Are mean platelet volume and platelet distribution width useful parameters in children with acute rheumatic carditis? Pediatr Cardiol 2014;35(1):53-6.
23. Gasparyan AY, Ayvazyan L, Mikhailidis DP, et al. Mean platelet volume: a link between thrombosis and inflammation? Curr. Pharm. Des. 2011;17:47-58.
24. Çoban E, Yazıcıoglu G, Ozdogan M. Platelet activation in subjects with subclinical hypothyroidism. Med Sci Monit 2007;13:211-14.
25. Yılmaz H, Ertuğrul Ö, Ertuğrul B et al. Mean platelet volume in patients with subclinical hypothyroidism. Platelets 2011; 22(2): 143–47
26. Vagdatli E, Gounari E, Lazaridou E, et al. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia, 2010;14(1):28
27. Farias MG, Schunck EG, Dal Bo S. Definition of reference ranges for the platelet distribution width (PDW): a local need. Clinical chemistry and laboratory medicine 2010;48(2):255-7.
28. Amin MA, Amin AP, Kulkarni HR. Platelet distribution width (PDW) is increased in vaso-occlusive crisis in sickle cell disease. Annals of hematology 2004;83(6):331-5.
29. Liu R, Gao F, Huo J et al. Study on the relationship between mean platelet volume and platelet distribution width with coronary artery lesion in children with Kawasaki disease. Platelets 2012;23(1):11-6.
30. Wiwanitkit V. Plateletcrit, mean platelet volume, platelet distribution width: its expected values and correlation with parallel red blood cell parameters. Clinical and applied thrombosis/hemostasis 2004;10(2):175-78.
31. Mohr R, Martinowitz U, Golan M et al. Platelet size and mass as an indicator for platelet transfusion after cardiopulmonary bypass. Circulation 1986;74(2):153.
32. Threatte GA. Usefulness of the mean platelet volume. Clinics in laboratory medicine 1993;13(4): 937.

There are 32 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Original Research
Authors	Abdullah Yazar 0000-0003-0733-3943 Alaaddin Yorulmaz 0000-0001-5478-1197 Esra Ture 0000-0002-1015-1764 Fatih Akin 0000-0001-5725-3867 Ahmet Sert 0000-0002-1607-7569
Publication Date	August 30, 2018
Submission Date	May 9, 2018
Acceptance Date	August 17, 2018
Published in Issue	Year 2018 Volume: 3 Issue: 2

Cite

APA	Yazar, A., Yorulmaz, A., Ture, E., … Akin, F. (2018). A relationship between subclinical hypothyroidism and hematologic parameters in patients with Down Syndrome. Family Practice and Palliative Care, 3(2), 92-97. https://doi.org/10.22391/fppc.422181
AMA	Yazar A, Yorulmaz A, Ture E, Akin F, Sert A. A relationship between subclinical hypothyroidism and hematologic parameters in patients with Down Syndrome. Fam Pract Palliat Care. August 2018;3(2):92-97. doi:10.22391/fppc.422181
Chicago	Yazar, Abdullah, Alaaddin Yorulmaz, Esra Ture, Fatih Akin, and Ahmet Sert. “A Relationship Between Subclinical Hypothyroidism and Hematologic Parameters in Patients With Down Syndrome”. Family Practice and Palliative Care 3, no. 2 (August 2018): 92-97. https://doi.org/10.22391/fppc.422181.
EndNote	Yazar A, Yorulmaz A, Ture E, Akin F, Sert A (August 1, 2018) A relationship between subclinical hypothyroidism and hematologic parameters in patients with Down Syndrome. Family Practice and Palliative Care 3 2 92–97.
IEEE	A. Yazar, A. Yorulmaz, E. Ture, F. Akin, and A. Sert, “A relationship between subclinical hypothyroidism and hematologic parameters in patients with Down Syndrome”, Fam Pract Palliat Care, vol. 3, no. 2, pp. 92–97, 2018, doi: 10.22391/fppc.422181.
ISNAD	Yazar, Abdullah et al. “A Relationship Between Subclinical Hypothyroidism and Hematologic Parameters in Patients With Down Syndrome”. Family Practice and Palliative Care 3/2 (August2018), 92-97. https://doi.org/10.22391/fppc.422181.
JAMA	Yazar A, Yorulmaz A, Ture E, Akin F, Sert A. A relationship between subclinical hypothyroidism and hematologic parameters in patients with Down Syndrome. Fam Pract Palliat Care. 2018;3:92–97.
MLA	Yazar, Abdullah et al. “A Relationship Between Subclinical Hypothyroidism and Hematologic Parameters in Patients With Down Syndrome”. Family Practice and Palliative Care, vol. 3, no. 2, 2018, pp. 92-97, doi:10.22391/fppc.422181.
Vancouver	Yazar A, Yorulmaz A, Ture E, Akin F, Sert A. A relationship between subclinical hypothyroidism and hematologic parameters in patients with Down Syndrome. Fam Pract Palliat Care. 2018;3(2):92-7.