Subakut Tiroidit Hastalarinda Anemi Sıklığı Ve Hastalık Aktivitesi İle İlişkisi

Year 2018, Volume: 81 Issue: 2, 46 - 50, 29.05.2018

Nurdan Gül

Abstract

DOI: 10.26650/IUITFD.382521

Amaç: Subakut tiroidit hastalarında, tanı
konduğu anda ve klinik bulgular ile akut faz yanıtı geriledikten sonra anemi
sıklığını ve inflamasyon bulguları ile ilişkisini araştırmak.

Gereç ve Yöntem: İstanbul Tıp Fakültesi, İç
Hastalıkları Anabilim Dalı, Endokrinoloji ve Metabolizma Hastalıkları Bilim
Dalı Polikliniği’nde kayıtlı olan ve subakut tiroidit tanısı doğrulanan
hastalardan, hastalığın aktif olduğu dönemdeki ve klinik bulguları düzeldikten
ve/veya akut faz yanıtlarında düşme gözlendikten sonraki hemogram değerlerine
ulaşılabilen hastalar çalışma grubunu oluşturdu. Hasta kayıtları retrospektif
olarak incelendi. İstatistik incelemeler için eşleşmiş Student t testi ve ANOVA
testi kullanıldı.

Bulgular: Subakut tiroidit tanısı konan 60
hastanın 37’sinde (%65) anemi saptandı. Anemiye yönelik herhangi bir tedavi
yapılmaksızın, klinik bulguları düzelen hastaların 17’sinde (%28,3) anemi
bulundu. Klinik ve inflamasyon bulguları düzeldikten sonra hemoglobin
(1,08±0,98 g/dl) ve hematokrit değerlerinde (3,45±2,9) anlamlı artışlar
saptandı, ortalama eritrosit hacmi değerlerinde değişiklik olmadı. Klinik
bulgular düzeldiğinde kalıcı hipotiroidi gelişen 20 hastada (%33,3) başlangıç
ve klinik yanıt sonrası hemoglobin ve hematokrit değerleri ise diğer
hastalardan anlamlı olarak daha düşüktü.

Sonuç: Subakut tiroidit hastalarında
hastalık aktivitesi ile ilişkili olarak anemi gelişmekte ve klinik ve
inflamasyon bulgularının düzelmesi ile anlamlı bir düzelme saptanabilmektedir.
Bu nedenle, subakut tiroidit hastalarında anemiye yönelik gereksiz
incelemelerden kaçınılmalı ve ileri tetkikler için klinik ve inflamasyon
bulgularının düzelmesi beklenmelidir.

Keywords

Subakut tiroidit, anemi, inflamasyon, kronik hastalık anemisi, interlökin 6

Frequency Of Anemia And Its Association With Disease Activity In Subacute Thyroiditis

Abstract

DOI: 10.26650/IUITFD.382521

Objective: To investigate the frequency of
anemia and its association with inflammation in patients with subacute
thyroiditis (ST) during diagnosis and after the resolution of clinical findings
and acute-phase response.

Materials and Methods: We retrospectively
reviewed the charts of patients with confirmed diagnosis of ST, followed at the
Endocrinology and Metabolism Outpatient Clinic of Istanbul Faculty of Medicine
(Turkey). The study cohort comprised those with acute-phase response and
hemogram results during diagnosis and after the resolution of clinical and
inflammation findings. Hemoglobin levels of <12 and <13 g/dl for females
and males, respectively, were defined as anemia.

Results: Anemia was detected in 37 of 60 ST
patients (65%) studied during diagnosis, and its frequency reduced to 28.3%
following the resolution of clinical and laboratory findings without additional
treatment. Notably, although a significant increase was observed in terms of
hemoglobin (1.08 ± 0.98 g/dl) and hematocrit (3.45 ± 2.9) levels, no change was
detected in terms of MCV values. During diagnosis and following the clinical
improvement, hemoglobin and hematocrit values of 20 patients (33.3%) who developed
permanent hypothyroidism following the resolution of clinical findings were
significantly lower than those of the remaining patients.

Conclusion: Anemia can develop in 65% of
patients with ST. A significant improvement can be observed following resolution
of clinical and laboratory findings. Therefore, further studies investigating
the causes of anemia should be avoided in patients with ST until clinical
findings and acute-phase response have been improved.

Keywords

Subacute thyroiditis, anemia, inflammation, anemia associated with chronic diseases, interleukin 6

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