Primary haemostasis in thyroid disease

Myrup, B.; Bregengård, C; Faber, Jens

doi:10.1111/j.1365-2796.1995.tb00899.x

Cited by 71 publications

(47 citation statements)

References 14 publications

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“…Hypothyroidism can also lead to abnormal sodium metabolism, increased sympathetic nervous system activity and a decreased glomerular filtration rate, which may contribute to the development of hypertension. [25][26][27] Blood pressure salt sensitivity was also one of the critical factors for hypertension in hypothyroid patients. 28 The study by Gumieniak et al 25 showed that the relationship between free thyroxine index (FTI) and salt sensitivity is partly mediated by the vascular action of the thyroid hormone.…”

Section: Discussionmentioning

confidence: 99%

Blood pressure levels in patients with subclinical thyroid dysfunction: a meta-analysis of cross-sectional data

2011

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The relationship between subclinical thyroid dysfunction and blood pressure is controversial and has received insufficient attention. The aim of this study was to assess whether blood pressure levels in patients with subclinical thyroid dysfunction differ from those of euthyroid subjects. A meta-analysis of all cross-sectional studies was performed to compare the blood pressure levels in patients with subclinical thyroid dysfunction with those of healthy controls. A computer-based online retrieval of databases (MEDLINE and EMBASE) and manual searches were undertaken to identify articles that addressed the association between subclinical thyroid dysfunction and blood pressure levels and were published through 2010, using no language restrictions. The meta-analysis was performed using STATA 11 (Stata). Seven cross-sectional studies were examined. In patients with subclinical hypothyroidism, the pooled estimate of the weighted mean difference (WMD) of increased blood pressure revealed a significant difference in both systolic blood pressure (SBP; WMD with 95% confidence interval (CI) 1.89 mm Hg (0.98-2.80), Po0.05) and diastolic blood pressure (DBP; WMD with 95% CI 0.75 mm Hg (0.24-1.27), Po0.05). However, in patients with subclinical hyperthyroidism, the pooled estimate of the WMD of increased blood pressure revealed no significant difference in SBP (WMD with 95% CI À0.75 mm Hg (À1.81 to 0.31)) or DBP (WMD with 95% CI À0.64 mm Hg (À2.36 to 1.08)). The present meta-analysis indicates that subclinical hypothyroidism is associated with increased SBP and DBP, whereas subclinical hyperthyroidism is not. Further investigation is needed to confirm blood pressure levels in patients with subclinical thyroid dysfunction.

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Section: Discussionmentioning

confidence: 99%

Blood pressure levels in patients with subclinical thyroid dysfunction: a meta-analysis of cross-sectional data

2011

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“…Qualitative platelet abnormalities have also been reported in patients with hypothyroidism (23)(24)(25). Palareti et al (26) studied 21 patients with acquired hypothyroidism after thyroidectomy, and observed an impaired platelet reactivity not only to ristocetin but also to collagen and adrenalin, which was rapidly normalized after thyroid hormone replacement therapy.…”

Section: Hypothyroidismmentioning

confidence: 94%

“…Myrup et al (23) reported a significant prolongation of bleeding time, an impaired agglutination response to ristocetin, and an increased platelet aggregation in response to ADP in 19 hypothyroid patients as compared to euthyroid controls. Notably, these hemostatic abnormalities normalized after L-thyroxine (L-T 4 ) therapy, suggesting that the prolonged primary hemostasis seen in overt hypothyroidism may be a direct consequence of the hormonal dysfunction (23).…”

Section: Hypothyroidismmentioning

confidence: 99%

Hemostatic abnormalities in endocrine and metabolic disorders

Franchini¹,

Lippi²,

Manzato³

et al. 2010

European Journal of Endocrinology

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The hemostatic balance is a complex system where the delicate equilibrium is regulated by several factors, including hormones. This review summarizes current knowledge of the effects of most frequent endocrine and metabolic diseases (such as hypothyroidism, hyperthyroidism, Cushing's syndrome, GH-related pituitary dysfunctions, pituitary prolactin-producing adenomas, polycystic ovary syndrome, primary hyperparathyroidism, and metabolic syndrome) on coagulation and fibrinolysis. Overt hypothyroidism appears to be associated with a bleeding tendency, whereas all other endocrine diseases appear to be associated with a thrombotic tendency. Globally, the disorders of coagulation and fibrinolysis usually range from mild to moderate, and, rarely, to severe laboratory abnormalities (for example, bleeding diathesis in overt hypothyroidism mainly due to an acquired von Willebrand's disease type 1). Further larger and high-quality studies are needed to provide more definitive information on the effects of endocrine disorders on coagulation and fibrinolysis.

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“…Most abnormalities have been attributed to decreased synthesis or activity of clotting factors, including von Willebrand factor (VWF) and factor VIII (FVIII:C), or to decreased response to adrenergic stimulation (enhanced VWF release from endothelial cells) due to thyroid hormone deficiency (1,6,7). Other authors have suggested that autoimmunity may be involved (20,21).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the respective influence of thyroid hormones and TSH on blood coagulation parameters after total thyroidectomy

Yango¹,

Alexopoulou²,

Eeckhoudt

et al. 2011

European Journal of Endocrinology

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Background: Several hemostatic abnormalities have been described in hypothyroidism, such as modification of coagulation proteins and bleeding tendency. Although thyroid hormone deficiency is considered to be responsible for these changes, the underlying mechanisms have not yet been established. Objective: To evaluate the respective influence of peripheral thyroid hormones (free thyroxine) and TSH on blood clotting by assessing coagulation parameters in patients with a history of total thyroidectomy for thyroid cancer, under three different conditions: induced hypothyroidism, euthyroid state, and following recombinant human TSH (rhTSH) administration. Methods: Coagulation parameters (platelet count, fibrinogen, international normalized ratio, prothrombin time, thrombin time, activated partial thromboplastin time (APTT), factor VIII activity ((FVIII:C), as well as von Willebrand factor antigen (VWF:Ag) and VWF activity using collagen binding assay (VWF:CBA)) were measured in patients with severe hypothyroidism following withdrawal of thyroid hormone replacement therapy, and in the same patients with euthyroidism after restoring replacement treatment (group A), and before and after administering rhTSH (group B). Results: FVIII:C, VWF:Ag, and VWF:CBA were significantly decreased (P!0.001), whereas APTT was significantly increased (P!0.001) in patients with severe hypothyroidism compared with patients in the euthyroid state. No changes in clotting parameters were observed in patients who received rhTSH therapy.Conclusion: This prospective study shows that severe short-term hypothyroidism is associated with significantly lower levels of VWF:Ag, VWF:CBA, and FVIII:C. Administration of exogenous TSH has no effect on coagulation parameters. These findings suggest that thyroid hormone deficiency is likely to be the main cause of coagulation alterations in patients with hypothyroidism.

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Primary haemostasis in thyroid disease

Abstract: We found that changed primary haemostasis is a general feature of hypothyroidism, and that it is resolved after levothyroxine treatment.

Cited by 71 publications

References 14 publications

Blood pressure levels in patients with subclinical thyroid dysfunction: a meta-analysis of cross-sectional data

Blood pressure levels in patients with subclinical thyroid dysfunction: a meta-analysis of cross-sectional data

Hemostatic abnormalities in endocrine and metabolic disorders

Evaluation of the respective influence of thyroid hormones and TSH on blood coagulation parameters after total thyroidectomy

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