Biochemical and Hematological Assessment in Patients With Thyroid Dysfunction
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Published:
Mar 8, 2024
Keywords:
Biochemical, Hematology, Kidney, Liver, Thyroid
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Abstract
This investigation conducted for biochemical and hematological assessment in patients with thyroid dysfunction. The research was carried out at a laboratory in Baghdad, Iraq, and it is a case-control study. The sample was gathered from February 2023 through the years 2021 and 2022. About 250 individuals were a part of this study; 100 were hypothyroid, 100 were hyperthyroid, and 50 had normal thyroid function and complete blood counts. A total of three millilitres of whole blood and two millilitres of EDTA were obtained from each subject in an aseptic manner for the CBC. Also, 2 ml of blood was drawn for serum separation, these sera were used for evaluation T3, T4, TSH, AST, ALT, Urea and Creatinine by using kits purchased from Linear company, the procedures for all were done according to manufacturer instructions. The control group had considerably greater mean RBC, Hb, HCT, and MCH concentrations, while the hypothyroid group had significantly lower values. The hyperthyroid group showed no significant difference between MCV and MCH. There were no statistically significant MCHC results in either the hypothyroid or hyperthyroid groups compared to the control group. There was little difference in total lymphocyte and platelet counts between the control, hyperthyroid, and hypothyroid groups. Differential leukocyte count showed statistically significant differences between the hypothyroid and hyperthyroid groups. As seen in Table 2, the hypothyroid group had higher serum TSH levels (p<0.05), in contrast to the hyperthyroid group which exhibited lower levels (p<0.05). Alternatively, when contrasted with the control group, the hypothyroid group had lower T3 and T4 levels (p<0.05), whereas the hyperthyroid group had higher levels (p<0.05). Improvements in hepatic and kidney functions were seen in patients with hypo or hyperthyroidism as compared to the control group in this investigation. In conclusion, both hypothyroidism as well as hyperthyroidism affects on hematological and biomarkers for thyroid, liver and kidney
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Kadhum, N. H. (2024). Biochemical and Hematological Assessment in Patients With Thyroid Dysfunction. Medicra (Journal of Medical Laboratory Science/Technology), 7(1), 1-5. https://doi.org/10.21070/medicra.v7i1.1740
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References
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Ashraf, T. S. (2017). Chronic anemia and thyroid function. Acta Biomed.: Atenei Parmensis, 88(1), 119-127. Doi: 10.23750/abm.v88i1.6048
Chandel, R. S., Chatterjee, G., & Abichandani, L. G. (2015). Impact of subclinical hypothyroidism on iron status and hematological parameters. Ann Pathol Lab Med, 2(1), 21– 25. Retrieved from https://www.pacificejournals.com/journal/index.php/apalm/article/view/161
Cinemre, H. (2009). Hematologic effects of levothyroxine in iron-deficient subclinical hypothyroid patients: a randomized, double-blind, controlled study. J. Clin. Endocrinol. Metabol, 94(1), 151–156. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18984662/
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Dorgalaleh, A., Mahmoodi, M., Varmaghani, B., Node, F. K., Kia, O. S., & Alizadeh, S. (2013). Effect of thyroid dysfunctions on blood cell count and red blood cell indice. Iran J Pediatr Hematol Oncol, 3(2), 73–7. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3915449/
Erikci, A. A. (2009). The effect of subclinical hypothyroidism on platelet parameters. Hematology, 14(2), 115–117. Doi: doi.org/10.1179/102453309X385124
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Geetha, J. P., & Srikrishna, R. (2012). Role of red blood cell distribution width (RDW) in thyroid dysfunction. Int J Biol Med Res, 3(2), 1476–8. Retrieved from https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=445acf176fd3821d4946627921304ab2336084ca
Gilbert, J. (2017). Thyrotoxicosis–investigation and management. Clinical Medicine, 17(3), 274-277. doi: 10.7861/clinmedicine.17-3-274
Golde, D. W., Bersch, N., Chopra, I. J., & Cline, M. J. (1977). Thyroid hormones stimulate erythropoiesis in vitro. Br J Haematol, 37(2), 1365-2141. Doi: doi.org/10.1111/j.1365-2141.1977.tb06833.x.
Gullu, S., Sav, H., & Kamel, N. (2005). Effects of levothyroxine treatment on biochemical and hemostasis parameters in patients with hypothyroidism. Eur. J. Endocrinol, 152(3), 355–361. Doi: doi.org/10.1530/eje.1.01857
Jafarzadeh, A. (2010). Immunological and hematological changes in patients with hyperthyroidism or hypothyroidism. Clin. Investig. Med, 271– 279. Doi: 10.25011/cim.v33i5.14352.
Kawa, M. P., Grymula, K., Paczkowska, E., Baskiewicz-Masiuk, M., Dabkowska E., Koziolek, M., Tarnowski, M., Kłos, P., Dziedziejko, V., Kucia, M., Syrenicz, A., Machalinski, B. (2010). Clinical relevance of thyroid dysfunction in human haematopoiesis: biochemical and molecular studies. Eur J Endocrinol, 162(2), 295–305. Retrieved from https://pubmed.ncbi.nlm.nih.gov/19903799/
Klecha, A. J., Genaro, A. M., & Gorelik, G. (2006). Integrative study of hypothalamus-pituitary-thyroidimmune system interaction: Thyroid hormone-mediated modulation of lymphocyte activity through the protein kinase C signaling pathway. J Endocrinol, 189(1), 45–55. Doi: doi.org/10.1677/joe.1.06137
Kumar, A. N. (2013). The effect of L-Throxine on metabolic parameters in newly diagnosed Primary hypothyroidism. J. Clin exp pharmacol, 3(3), 1-4. doi:10.4172/2161-1459.1000128
Ojamaa, K., Klemperer, J. D., & Klein, I. (1996). Acute effect of thyroid hormone on vascular smooth muscle. Thyroid, 6(5), 505-512. Doi: doi.org/10.1089/thy.1996.6.505
Organization, W. H. (2011). Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. World Health Organization.
Pandey, R., Jaiswal, S., Sah, J. P., Bastola, K. D., & S. (2013). Assessment of serum Enzymes level in patients with thyroid Alteration attending manipal teaching hospital pokhara. J of life sci, 3(1), 1-9. Retrieved from https://www.researchgate.net/publication/260252866_Assessment_of_Serum_Enzymes_Level_in_Patients_with_Thyroid_Alteration_Attending_Manipal_Teaching_Hospital_Pokhara
Qasim, B. (2018). Dyslipidemia in subclinical hypothyroidism: a case-control study. J Endocrinol Diab 5(1): 1-6. DOI: 10.15226/2374-6890/5/1/00192
Qasim, B. A., Mohammed, A. A., & Ahmed, M. J. (2019). Lipid profile IN subclinical hypothyroidism: a two centers experience. Duhok Medical Journal, 13(1), 56-65. doi: doi.org/10.31386/dmj.2019.13.1.6
Saini, v., Yadav, A., Arora, M., Arora, S., Singh, R., & Bhattacharjee, J. (2012). Correlation of creatinnine with TSH levels over hypothyroidism-arequirment for monitoring of renal function in hypothyroid patients. Clin Biochem. 45(3), 212–214. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0009912011026981?via%3Dihub
Schindhelm, R. K. (2013). Thyroid hormones and erythrocyte indices in a cohort of euthyroid older subjects. Eur. J. Intern. Med, 24(3), 241–244. DOI: doi.org/10.1016/j.ejim.2012.12.004
Serakides, R., Ocarino, N. M., & Cardoso, T. G. S. (2005). Response of parathyroid to the plasmatic of calcium and phosphorus variations in hyperthyroidism and hypogonadism in the rat. Arq Bras Med Vet Zootec, 57(1), 48-54. Retrieved from https://www.researchgate.net/publication/289302196_Response_of_parathyroid_to_the_plasmatic_of_calcium_and_phosphorus_variations_in_hyperthyroidism_and_hypogonadism_in_the_rat
Szczepanek-Parulska, E., Hernik, A., & Ruchala, M. (2017). Anemia in thyroid diseases, Pol. Arch. Intern. Med, 127(5), 352–360. Doi: 10.20452/pamw.3985
Tayal, D., Chawla, R., Arora, S., Gupta, V., Sohi, J., & Mallika, V. (2009). Dynamic changes in Biochemical markers of renal function with thyroid status-a study in Indian population.Int. J . Med, 4(2):36-41. Doi: doi.org/10.4314/ijmu.v4i2.43842
Tefferi, A. (2003). Anemia in adults: a contemporary approach to diagnosis. Mayo Clinic Proceedings. Elsevier, 78(10), 1274-1280 Doi: doi.org/10.4065/78.10.1274
Wedaatalla, Ma. A., & A. (2012). Assessment of plasma uric acid level among sudanse female with thyroid dysfunction. Sudanese J of Public Health, 7(3), 89–92.
Yadav, A., Arora, M. S., Saini, M. V, Arora, M. M. K., Singh, M. R., & Bhattacharjee. (2013). Influence of thyroid hormones on biochemical parameters of liver function: a case control study in north Indian population. Int. J. Med, 8(1), 4–8. Retrieved from https://www.ajol.info/index.php/ijmu/article/view/85164
Yokogoshi, Y., & Saito, S. (1996). Abnormal serum uric acid level in endocrine disorders. J Nippon, o.54(12):3360-3363 Retrieved from https://pubmed.ncbi.nlm.nih.gov/8976120/
Altaher, W. H., Ahemd, E. M., & Ismail, A. (2013). Assessment of lipids profile in hyperthyroidism Sudanese patients in North Kordofan State In Sudan. Natural and Medical Sciences, 14(1), 1-7. Retrieved from https://www.researchgate.net/publication/274640357_Assessment_of_Lipid_Profile_in_Hyperthyroidism_Sudanese_Patients_in_North_Kordofan_State_Sudan
Arora, S., Chawla, R., Tayal, D., Gupta, V. K., Sohi, J. S., & Mallika, V. (2009). Markers of liver and Kidney function are influenced by thyroid function .A case-controlled follow up study in Indian hypothyroid subjects.Indian. J. Clin. Biochemistry, 24(4), 370-374. Doi: 10.1007/s12291-009-0067-1
Ashraf, T. S. (2017). Chronic anemia and thyroid function. Acta Biomed.: Atenei Parmensis, 88(1), 119-127. Doi: 10.23750/abm.v88i1.6048
Chandel, R. S., Chatterjee, G., & Abichandani, L. G. (2015). Impact of subclinical hypothyroidism on iron status and hematological parameters. Ann Pathol Lab Med, 2(1), 21– 25. Retrieved from https://www.pacificejournals.com/journal/index.php/apalm/article/view/161
Cinemre, H. (2009). Hematologic effects of levothyroxine in iron-deficient subclinical hypothyroid patients: a randomized, double-blind, controlled study. J. Clin. Endocrinol. Metabol, 94(1), 151–156. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18984662/
Das, K. C., Mukherjee, M., & Sarkar, T. K. (1975). Erythropoiesis and erythropoietin in hypo and hyperthyroidism. J Clin Endocrinol Metab, 40(2), 211–20. Retrieved from https://pubmed.ncbi.nlm.nih.gov/1117976/
Dorgalaleh, A., Mahmoodi, M., Varmaghani, B., Node, F. K., Kia, O. S., & Alizadeh, S. (2013). Effect of thyroid dysfunctions on blood cell count and red blood cell indice. Iran J Pediatr Hematol Oncol, 3(2), 73–7. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3915449/
Erikci, A. A. (2009). The effect of subclinical hypothyroidism on platelet parameters. Hematology, 14(2), 115–117. Doi: doi.org/10.1179/102453309X385124
Fadel, B. M.; Ellahham, S.; Lindsay JR, J.; Ringel, M. D.; Wartofsky, L. and Burman, K. D. (2000). Hyperthyroid heart disease. Clinical Cardiology, 23(6), 402–408. Doi: 10.1002/clc.4960230605
Geetha, J. P., & Srikrishna, R. (2012). Role of red blood cell distribution width (RDW) in thyroid dysfunction. Int J Biol Med Res, 3(2), 1476–8. Retrieved from https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=445acf176fd3821d4946627921304ab2336084ca
Gilbert, J. (2017). Thyrotoxicosis–investigation and management. Clinical Medicine, 17(3), 274-277. doi: 10.7861/clinmedicine.17-3-274
Golde, D. W., Bersch, N., Chopra, I. J., & Cline, M. J. (1977). Thyroid hormones stimulate erythropoiesis in vitro. Br J Haematol, 37(2), 1365-2141. Doi: doi.org/10.1111/j.1365-2141.1977.tb06833.x.
Gullu, S., Sav, H., & Kamel, N. (2005). Effects of levothyroxine treatment on biochemical and hemostasis parameters in patients with hypothyroidism. Eur. J. Endocrinol, 152(3), 355–361. Doi: doi.org/10.1530/eje.1.01857
Jafarzadeh, A. (2010). Immunological and hematological changes in patients with hyperthyroidism or hypothyroidism. Clin. Investig. Med, 271– 279. Doi: 10.25011/cim.v33i5.14352.
Kawa, M. P., Grymula, K., Paczkowska, E., Baskiewicz-Masiuk, M., Dabkowska E., Koziolek, M., Tarnowski, M., Kłos, P., Dziedziejko, V., Kucia, M., Syrenicz, A., Machalinski, B. (2010). Clinical relevance of thyroid dysfunction in human haematopoiesis: biochemical and molecular studies. Eur J Endocrinol, 162(2), 295–305. Retrieved from https://pubmed.ncbi.nlm.nih.gov/19903799/
Klecha, A. J., Genaro, A. M., & Gorelik, G. (2006). Integrative study of hypothalamus-pituitary-thyroidimmune system interaction: Thyroid hormone-mediated modulation of lymphocyte activity through the protein kinase C signaling pathway. J Endocrinol, 189(1), 45–55. Doi: doi.org/10.1677/joe.1.06137
Kumar, A. N. (2013). The effect of L-Throxine on metabolic parameters in newly diagnosed Primary hypothyroidism. J. Clin exp pharmacol, 3(3), 1-4. doi:10.4172/2161-1459.1000128
Ojamaa, K., Klemperer, J. D., & Klein, I. (1996). Acute effect of thyroid hormone on vascular smooth muscle. Thyroid, 6(5), 505-512. Doi: doi.org/10.1089/thy.1996.6.505
Organization, W. H. (2011). Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. World Health Organization.
Pandey, R., Jaiswal, S., Sah, J. P., Bastola, K. D., & S. (2013). Assessment of serum Enzymes level in patients with thyroid Alteration attending manipal teaching hospital pokhara. J of life sci, 3(1), 1-9. Retrieved from https://www.researchgate.net/publication/260252866_Assessment_of_Serum_Enzymes_Level_in_Patients_with_Thyroid_Alteration_Attending_Manipal_Teaching_Hospital_Pokhara
Qasim, B. (2018). Dyslipidemia in subclinical hypothyroidism: a case-control study. J Endocrinol Diab 5(1): 1-6. DOI: 10.15226/2374-6890/5/1/00192
Qasim, B. A., Mohammed, A. A., & Ahmed, M. J. (2019). Lipid profile IN subclinical hypothyroidism: a two centers experience. Duhok Medical Journal, 13(1), 56-65. doi: doi.org/10.31386/dmj.2019.13.1.6
Saini, v., Yadav, A., Arora, M., Arora, S., Singh, R., & Bhattacharjee, J. (2012). Correlation of creatinnine with TSH levels over hypothyroidism-arequirment for monitoring of renal function in hypothyroid patients. Clin Biochem. 45(3), 212–214. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0009912011026981?via%3Dihub
Schindhelm, R. K. (2013). Thyroid hormones and erythrocyte indices in a cohort of euthyroid older subjects. Eur. J. Intern. Med, 24(3), 241–244. DOI: doi.org/10.1016/j.ejim.2012.12.004
Serakides, R., Ocarino, N. M., & Cardoso, T. G. S. (2005). Response of parathyroid to the plasmatic of calcium and phosphorus variations in hyperthyroidism and hypogonadism in the rat. Arq Bras Med Vet Zootec, 57(1), 48-54. Retrieved from https://www.researchgate.net/publication/289302196_Response_of_parathyroid_to_the_plasmatic_of_calcium_and_phosphorus_variations_in_hyperthyroidism_and_hypogonadism_in_the_rat
Szczepanek-Parulska, E., Hernik, A., & Ruchala, M. (2017). Anemia in thyroid diseases, Pol. Arch. Intern. Med, 127(5), 352–360. Doi: 10.20452/pamw.3985
Tayal, D., Chawla, R., Arora, S., Gupta, V., Sohi, J., & Mallika, V. (2009). Dynamic changes in Biochemical markers of renal function with thyroid status-a study in Indian population.Int. J . Med, 4(2):36-41. Doi: doi.org/10.4314/ijmu.v4i2.43842
Tefferi, A. (2003). Anemia in adults: a contemporary approach to diagnosis. Mayo Clinic Proceedings. Elsevier, 78(10), 1274-1280 Doi: doi.org/10.4065/78.10.1274
Wedaatalla, Ma. A., & A. (2012). Assessment of plasma uric acid level among sudanse female with thyroid dysfunction. Sudanese J of Public Health, 7(3), 89–92.
Yadav, A., Arora, M. S., Saini, M. V, Arora, M. M. K., Singh, M. R., & Bhattacharjee. (2013). Influence of thyroid hormones on biochemical parameters of liver function: a case control study in north Indian population. Int. J. Med, 8(1), 4–8. Retrieved from https://www.ajol.info/index.php/ijmu/article/view/85164
Yokogoshi, Y., & Saito, S. (1996). Abnormal serum uric acid level in endocrine disorders. J Nippon, o.54(12):3360-3363 Retrieved from https://pubmed.ncbi.nlm.nih.gov/8976120/