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THE ROLE OF NEUTROPHIL TO LYMPHOCYTE RATIO AND PLATELET TO LYMPHOCYTE RATION IN DIAGNOSIS OF SUBACUTE THYROIDITIS

Yıl 2022, Cilt: 4 Sayı: 1, 46 - 57, 30.04.2022

Çiğdem Tura Bahadır Merve Yılmaz Elif Kılıç Kan

https://doi.org/10.55895/sshs.1096999

Öz

Purpose: Patients with subacute thyroiditis (SAT) usually apply to clinics with thyrotoxicosis and neck pain. Hemogram is frequently applied tests in primary health care services, and it can warn physicians for SAT in a thyrotoxic patient. In our study, the role and usability of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in the diagnosis of SAT were evaluated.

Material and Methods: Between January 2015 and January 2020, 192 SAT patients who applied to endocrinology clinics and 85 healthy control were included in the study. Neutrophil (Neu), lymphocyte (Lym), platelet (PLT) leves were recorded.

Results: The median NLR and PLR values of SAT patients before treatment were 2.78 (0.91-11.33) and 168.3 (25.7-818.3), respectively, and were significantly higher than the control group (p<0.001). The optimum cut-off values for NLR and PLR for SAT were 1.84 (specificity 85.9% and sensitivity 90.1%; p<0.001; AUC=0.934; 95% CI: 0.905-0.964 ) and 140.2 (specificity 83.5% and sensitivity 77.1%, p<0.001, AUC=0.821 95% CI: 0.767-0.874), respectively. Pretreatment NLR, PLR, CRP, and ESR levels were significantly higher than the posttreatment levels (all p<0.001). Correlation analysis revealed positive linear relations between pretreatment PLR and CRP (p=0.002, r=0.220), pretreatment PLR and ESR (p=0.018, r=0.171), pretreatment NLR and CRP (p<0.001, r=0.330), and pretreatment NLR and ESR (p=0.001, r=0.242). Multiple linear regression analysis revealed a 0.008 unit of increment of NLR per 1 unit increase in CRP levels (B=0.008; p<0.001; %95 CI=0.004-0.012).

Conclusion: High NLR and PLR values accompanying thyrotoxicosis are both warning and helpful parameters for the diagnosis of SAT.

Anahtar Kelimeler

Neutrophil to lymphocyte ratio NLR painless subacute thyroiditis platelet to lymphocyte ratio PLR subacute thyroiditis

Kaynakça

  • Ahsen, A., Ulu, M. S., Yuksel, S., Demir, K., Uysal, M., Erdogan, M., & Acarturk, G. (2013). As a new inflammatory marker for familial Mediterranean fever: neutrophil-to-lymphocyte ratio. Inflammation, 36(6), 1357-1362. doi:10.1007/s10753-013-9675-2
  • Azab, B., Jaglall, N., Atallah, J. P., Lamet, A., Raja-Surya, V., Farah, B., . . . Widmann, W. D. (2011). Neutrophil-lymphocyte ratio as a predictor of adverse outcomes of acute pancreatitis. Pancreatology, 11(4), 445-452. doi:10.1159/000331494
  • Benbassat, C. A., Olchovsky, D., Tsvetov, G., & Shimon, I. (2007). Subacute thyroiditis: clinical characteristics and treatment outcome in fifty-six consecutive patients diagnosed between 1999 and 2005. J Endocrinol Invest, 30(8), 631-635. doi:10.1007/bf03347442
  • Calapkulu, M., Sencar, M. E., Sakiz, D., Duger, H., Ozturk Unsal, I., Ozbek, M., & Cakal, E. (2020). The prognostic and diagnostic use of hematological parameters in subacute thyroiditis patients. Endocrine, 68(1), 138-143. doi:10.1007/s12020-019-02163-w
  • Cengiz, H., Varim, C., Demirci, T., & Cetin, S. (2020). Hemogram parameters in the patients with subacute thyroiditis. Pak J Med Sci, 36(2), 240-245. doi:10.12669/pjms.36.2.1063
  • Desailloud, R., & Hober, D. (2009). Viruses and thyroiditis: an update. Virol J, 6, 5. doi:10.1186/1743-422x-6-5
  • Gabay, C., & Kushner, I. (1999). Acute-phase proteins and other systemic responses to inflammation. N Engl J Med, 340(6), 448-454. doi:10.1056/nejm199902113400607
  • Gasparyan, A. Y., Ayvazyan, L., Mukanova, U., Yessirkepov, M., & Kitas, G. D. (2019). The Platelet-to-Lymphocyte Ratio as an Inflammatory Marker in Rheumatic Diseases. Ann Lab Med, 39(4), 345-357. doi:10.3343/alm.2019.39.4.345
  • GU, X., WU, S., XU, J., HONG, Y., YANG, L., & LIN, Y. (2017). Implication of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in patients with thyrotoxicosis: significance in differential diagnosis. Chinese Journal of Endocrinology and Metabolism 33, 491-496. doi:10.3760/cma.j.issn.1000-6699.2017.06.007
  • Harrison, M. (2015). Erythrocyte sedimentation rate and C-reactive protein. Aust Prescr, 38(3), 93-94. doi:10.18773/austprescr.2015.034
  • Imtiaz, F., Shafique, K., Mirza, S. S., Ayoob, Z., Vart, P., & Rao, S. (2012). Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med, 5(1), 2. doi:10.1186/1755-7682-5-2
  • Irvine, W. J., Wu, F. C., Urbaniak, S. J., & Toolis, F. (1977). Peripheral blood leucocytes in thyrotoxicosis (Graves' disease) as studied by conventional light microscopy. Clin Exp Immunol, 27(2), 216-221.
  • Kilinc, F., Pekkolay, Z., Tuzcu, S. A., Gozel, N., Tuna, M. M., & Tuzcu, A. K. (2018). Elevated neutrophil-to-lymphocyte ratio in the diagnosis of subacute thyroiditis. Progress in Nutrition, 20(3), 510-515. doi:10.23751/pn.v20i3.7302
  • Kojima, M., Nakamura, S., Oyama, T., Sugihara, S., Sakata, N., & Masawa, N. (2002). Cellular composition of subacute thyroiditis. an immunohistochemical study of six cases. Pathol Res Pract, 198(12), 833-837. doi:10.1078/0344-0338-00344
  • Luo, H., He, L., Zhang, G., Yu, J., Chen, Y., Yin, H., . . . Zhang, L. (2019). Normal Reference Intervals of Neutrophil-To-Lymphocyte Ratio, Platelet-To-Lymphocyte Ratio, Lymphocyte-To-Monocyte Ratio, and Systemic Immune Inflammation Index in Healthy Adults: a Large Multi-Center Study from Western China. Clin Lab, 65(3). doi:10.7754/Clin.Lab.2018.180715
  • Mizukoshi, T., Noguchi, S., Murakami, T., Futata, T., & Yamashita, H. (2001). Evaluation of recurrence in 36 subacute thyroiditis patients managed with prednisolone. Intern Med, 40(4), 292-295. doi:10.2169/internalmedicine.40.292
  • Nishihara, E., Ohye, H., Amino, N., Takata, K., Arishima, T., Kudo, T., . . . Miyauchi, A. (2008). Clinical characteristics of 852 patients with subacute thyroiditis before treatment. Intern Med, 47(8), 725-729. doi:10.2169/internalmedicine.47.0740
  • Qin, B., Ma, N., Tang, Q., Wei, T., Yang, M., Fu, H., . . . Zhong, R. (2016). Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol, 26(3), 372-376. doi:10.3109/14397595.2015.1091136
  • Sproston, N. R., & Ashworth, J. J. (2018). Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immunol, 9, 754. doi:10.3389/fimmu.2018.00754
  • Stefaniuk, P., Szymczyk, A., & Podhorecka, M. (2020). The Neutrophil to Lymphocyte and Lymphocyte to Monocyte Ratios as New Prognostic Factors in Hematological Malignancies - A Narrative Review. Cancer Manag Res, 12, 2961-2977. doi:10.2147/cmar.S245928
  • Taşkaldiran, I., Omma, T., Önder Ç, E., Firat, S. N., Koç, G., Kiliç, M. K., . . . Çulha, C. (2019). Neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, and platelet-tolymphocyte ratio in different etiological causes of thyrotoxicosis. Turk J Med Sci, 49(6), 1687-1692. doi:10.3906/sag-1901-116
  • Turan, E. (2019). Evaluation of neutrophil-to-lymphocyte ratio and hematologic parameters in patients with Graves' disease. Bratisl Lek Listy, 120(6), 476-480. doi:10.4149/bll_2019_076
  • Zahorec, R. (2001). Ratio of neutrophil to lymphocyte counts rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy, 102(1), 5-14.

Yıl 2022, Cilt: 4 Sayı: 1, 46 - 57, 30.04.2022

Çiğdem Tura Bahadır Merve Yılmaz Elif Kılıç Kan

https://doi.org/10.55895/sshs.1096999

Öz

Kaynakça

  • Ahsen, A., Ulu, M. S., Yuksel, S., Demir, K., Uysal, M., Erdogan, M., & Acarturk, G. (2013). As a new inflammatory marker for familial Mediterranean fever: neutrophil-to-lymphocyte ratio. Inflammation, 36(6), 1357-1362. doi:10.1007/s10753-013-9675-2
  • Azab, B., Jaglall, N., Atallah, J. P., Lamet, A., Raja-Surya, V., Farah, B., . . . Widmann, W. D. (2011). Neutrophil-lymphocyte ratio as a predictor of adverse outcomes of acute pancreatitis. Pancreatology, 11(4), 445-452. doi:10.1159/000331494
  • Benbassat, C. A., Olchovsky, D., Tsvetov, G., & Shimon, I. (2007). Subacute thyroiditis: clinical characteristics and treatment outcome in fifty-six consecutive patients diagnosed between 1999 and 2005. J Endocrinol Invest, 30(8), 631-635. doi:10.1007/bf03347442
  • Calapkulu, M., Sencar, M. E., Sakiz, D., Duger, H., Ozturk Unsal, I., Ozbek, M., & Cakal, E. (2020). The prognostic and diagnostic use of hematological parameters in subacute thyroiditis patients. Endocrine, 68(1), 138-143. doi:10.1007/s12020-019-02163-w
  • Cengiz, H., Varim, C., Demirci, T., & Cetin, S. (2020). Hemogram parameters in the patients with subacute thyroiditis. Pak J Med Sci, 36(2), 240-245. doi:10.12669/pjms.36.2.1063
  • Desailloud, R., & Hober, D. (2009). Viruses and thyroiditis: an update. Virol J, 6, 5. doi:10.1186/1743-422x-6-5
  • Gabay, C., & Kushner, I. (1999). Acute-phase proteins and other systemic responses to inflammation. N Engl J Med, 340(6), 448-454. doi:10.1056/nejm199902113400607
  • Gasparyan, A. Y., Ayvazyan, L., Mukanova, U., Yessirkepov, M., & Kitas, G. D. (2019). The Platelet-to-Lymphocyte Ratio as an Inflammatory Marker in Rheumatic Diseases. Ann Lab Med, 39(4), 345-357. doi:10.3343/alm.2019.39.4.345
  • GU, X., WU, S., XU, J., HONG, Y., YANG, L., & LIN, Y. (2017). Implication of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in patients with thyrotoxicosis: significance in differential diagnosis. Chinese Journal of Endocrinology and Metabolism 33, 491-496. doi:10.3760/cma.j.issn.1000-6699.2017.06.007
  • Harrison, M. (2015). Erythrocyte sedimentation rate and C-reactive protein. Aust Prescr, 38(3), 93-94. doi:10.18773/austprescr.2015.034
  • Imtiaz, F., Shafique, K., Mirza, S. S., Ayoob, Z., Vart, P., & Rao, S. (2012). Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med, 5(1), 2. doi:10.1186/1755-7682-5-2
  • Irvine, W. J., Wu, F. C., Urbaniak, S. J., & Toolis, F. (1977). Peripheral blood leucocytes in thyrotoxicosis (Graves' disease) as studied by conventional light microscopy. Clin Exp Immunol, 27(2), 216-221.
  • Kilinc, F., Pekkolay, Z., Tuzcu, S. A., Gozel, N., Tuna, M. M., & Tuzcu, A. K. (2018). Elevated neutrophil-to-lymphocyte ratio in the diagnosis of subacute thyroiditis. Progress in Nutrition, 20(3), 510-515. doi:10.23751/pn.v20i3.7302
  • Kojima, M., Nakamura, S., Oyama, T., Sugihara, S., Sakata, N., & Masawa, N. (2002). Cellular composition of subacute thyroiditis. an immunohistochemical study of six cases. Pathol Res Pract, 198(12), 833-837. doi:10.1078/0344-0338-00344
  • Luo, H., He, L., Zhang, G., Yu, J., Chen, Y., Yin, H., . . . Zhang, L. (2019). Normal Reference Intervals of Neutrophil-To-Lymphocyte Ratio, Platelet-To-Lymphocyte Ratio, Lymphocyte-To-Monocyte Ratio, and Systemic Immune Inflammation Index in Healthy Adults: a Large Multi-Center Study from Western China. Clin Lab, 65(3). doi:10.7754/Clin.Lab.2018.180715
  • Mizukoshi, T., Noguchi, S., Murakami, T., Futata, T., & Yamashita, H. (2001). Evaluation of recurrence in 36 subacute thyroiditis patients managed with prednisolone. Intern Med, 40(4), 292-295. doi:10.2169/internalmedicine.40.292
  • Nishihara, E., Ohye, H., Amino, N., Takata, K., Arishima, T., Kudo, T., . . . Miyauchi, A. (2008). Clinical characteristics of 852 patients with subacute thyroiditis before treatment. Intern Med, 47(8), 725-729. doi:10.2169/internalmedicine.47.0740
  • Qin, B., Ma, N., Tang, Q., Wei, T., Yang, M., Fu, H., . . . Zhong, R. (2016). Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol, 26(3), 372-376. doi:10.3109/14397595.2015.1091136
  • Sproston, N. R., & Ashworth, J. J. (2018). Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immunol, 9, 754. doi:10.3389/fimmu.2018.00754
  • Stefaniuk, P., Szymczyk, A., & Podhorecka, M. (2020). The Neutrophil to Lymphocyte and Lymphocyte to Monocyte Ratios as New Prognostic Factors in Hematological Malignancies - A Narrative Review. Cancer Manag Res, 12, 2961-2977. doi:10.2147/cmar.S245928
  • Taşkaldiran, I., Omma, T., Önder Ç, E., Firat, S. N., Koç, G., Kiliç, M. K., . . . Çulha, C. (2019). Neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, and platelet-tolymphocyte ratio in different etiological causes of thyrotoxicosis. Turk J Med Sci, 49(6), 1687-1692. doi:10.3906/sag-1901-116
  • Turan, E. (2019). Evaluation of neutrophil-to-lymphocyte ratio and hematologic parameters in patients with Graves' disease. Bratisl Lek Listy, 120(6), 476-480. doi:10.4149/bll_2019_076
  • Zahorec, R. (2001). Ratio of neutrophil to lymphocyte counts rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy, 102(1), 5-14.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Çiğdem Tura Bahadır 0000-0001-6492-3064

Merve Yılmaz 0000-0002-3421-8548

Elif Kılıç Kan 0000-0002-9047-3121

Yayımlanma Tarihi 30 Nisan 2022
Gönderilme Tarihi 1 Nisan 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 4 Sayı: 1

Kaynak Göster

APA Tura Bahadır, Ç., Yılmaz, M., & Kılıç Kan, E. (2022). THE ROLE OF NEUTROPHIL TO LYMPHOCYTE RATIO AND PLATELET TO LYMPHOCYTE RATION IN DIAGNOSIS OF SUBACUTE THYROIDITIS. Sabuncuoglu Serefeddin Health Sciences, 4(1), 46-57. https://doi.org/10.55895/sshs.1096999