Neutrophil and platelet to lymphocyte ratio in patients with hypothyroid Hashimoto's thyroiditis

Main Article Content

Erhan Onalan
Emir Dönder


hashimoto’s thyroiditis, platelet / lymphocyte ratio, neutrophil/ lymphocyte ratio.


Aim: Chronic lymphocytic thyroiditis is among the most common causes of hypothyroidism along with HT (Hashimoto’s thyroiditis) goitre, which is also named as autoimmune thyroiditis. Our study aims to determine the usefulness of PLR (platelet to lymphocyte ratio) and NLR (neutrophil to lymphocyte ratio), which can be obtained with a hemogram, at the clinical course or the severity of the disease in patients with Hashimoto’s thyroiditis. Materials and Methods: Our study is a retrospective cross-sectional study that included 121 hypothyroid or subclinical hypothyroid Hashimoto’s thyroiditis patients and a healthy control group comprised of 100 individuals. Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), anti-thyroid peroxidase (anti-TPO), complete blood count (CBC), and C-reactive protein (CRP) results were obtained from patient files for both HT patients and the control group, and we computed PLR and NLR for both groups. Results: PLR was lower in patients diagnosed with HT compared to the healthy control group, with statistical significance (respectively, 130.8±50.5 versus 145.3±58.5; p<0,05). NLR was higher in patients diagnosed with HT compared to the control group and a statistically significant relationship was determined (respectively, 2.43±0.94 versus 2,11±0,81; p<0,05). In addition to the present findings, we determined that PLR and NLR were correlated with anti-TPO, TSH, and FT4, although without statistical significance. Conclusion: As values that can be measured with an inexpensive and easily accessible routine hemogram, PLR and NLR can serve as practical and valuable markers at the clinical course or the severity of the disease and other diseases that are autoimmune and progress with chronic inflammation.


Download data is not yet available.
Abstract 804 | PDF Downloads 399


1. Ozsu E, R. G. Y. Mutlu, F. Cizmeci and S. Hatun, Characteristics of our patients with Hashimoto thyroiditis. Turk Pediatri Arsivi-Turkish Archives Of Pediatrics, 2011; 46(3): 252-5.

2. Gönç EN, Kandemir N. (2014). Guatr. Çocuk Endokrinolojisi, İstanbul: Nobel Tıp.

3. Cappa M, Bizzarri C, Crea F. (2011). Autoimmune thyroid diseases in children. J Thyroid Res, 2011, 675703.

4. Caturegli P, De Remigis A, Rose NR. (2014). Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmun Rev, 13 (4-5), 391-7.

5. Tutuncu, N. B. and T. Erbas, Factors associated with bone metabolism in acromegalic patients: hypogonadism and female gender. Exp Clin Endocrinol Diabetes. 2004;112(6):328-32.

6. Çorakçi A. Tiroid Hastalıklarına Yaklaşım. Turkiye Klinikleri Journal of Endocrinology. 2004; 2(1):1-3.
7. Van Zuuren EJ, Albusta AY, Fedorowicz Z, Carter B and Pijl H. Selenium Supplementation for Hashimoto's Thyroiditis: Summary of a Cochrane Systematic Review. EurThyroid J. 2014; 3(1):25-31.

8. Tulgar YK, Cakar S, Tulgar S, et al. The effect of smoking on neutrophil/lymphocyte and platelet/lymphocyte ratio and platelet indices: a retrospective study. Eur. Rev. Med. Pharmacol. Sci. 2016;20: 3112–8.

9. Koh C-H, Bhoo-Pathy N, Ng K-L, et al. Utility of pre-treatment neutrophil–lymphocyte ratio and platelet–lymphocyte ratio as prognostic factors in breast cancer. Br. J. Cancer. 2015;113:150–8.

10. Akdag S, Akyol A, Asker M, et al. Platelet-to-Lymphocyte Ratio May Predict the Severity of Calcific Aortic Stenosis. Med. Sci. Monit. 2015;21: 3395–3400.

11. Dündar B, Boyacı A, Sangün Ö and Dündar N. Çocuk ve ergenlerde Hashimoto tiroiditi: klinik ve laboratuvar bulgularının değerlendirilmesi. Türk Ped Arşiv. 2011;46: 318-21.

12. Dilek E, İşcan B, Ekuklu G and Tütüncüler F. Hashimoto Tiroiditi Tanısı Alan Vakaların Geriye Dönük Değerlendirilmesi. Journal of the Child/Cocuk Dergisi. 2011;11(2).

13. Setian NS. Hypothyroidism in children: diagnosis and treatment. J Pediatr (Rio J), 2007;83(5 Suppl):209-16.
14. Demirbilek H, Kandemir N, Gonc EN, Ozon A, Alikasifoglu A and Yordam N. Hashimoto's thyroiditis in children and adolescents: a retrospective study on clinical, epidemiological and laboratory properties of the disease. J Pediatr Endocrinol Metab. 2007;20(11):1199-205.

15. Duntas LH. Environmental factors and autoimmune thyroiditis. Nat Clin Pract Endocrinol Metab. 2008;4(8):454-60.

16. Motomura T , Shirabe K , Mano Y , Muto J , Toshima T , Umemoto Y , et al. The neutrophil-lymphocyte ratio reflects recurrence of hepatocellular carcinoma after liver transplantation via inflammatory micro-medium. J Hepatol. 2013; 58: 58 – 4.

17. Balta S, Aparcı M , Öztürk C , Demirkol S , Çelik T. Yararlı bir mortalite belirteci olarak nötrofil lenfosit oranı. J Emerg Med. 2014; 32 (12): 1546 - 7.

18. Hu ZD, Sun Y , Guo J, Huang YL, Qin BD, Gao Q, et al. Red blood cell distribution width and neutrophil / lymphocyte ratio are positively correlated with disease activity in primary Sjögren syndrome.Clin Biochem. 2014; 47 (18): 287 – 90.

19. Feng JF,Huang Y, Chen QX. Preoperative platelet lymphocyte ratio (PLR) is a predictive factor for neutrophil lymphocyte ratio (NLR) in patients with esophageal squamous cell carcinoma. World J Surg Oncol. 2014; 12: 58

20. Arpaci D, Gurol G, Ergenc H, Yazar H, Tocoglu AG, Ciftci IH, Tamer A. A Controversial New Approach to Address Hematological Parameters in Hashimoto's Thyroiditis. Clin Lab. 2016 Jul 1; 62(7):1225-1231. doi: 10.7754/Clin.Lab.2015.150927.

21. Bilge M, Yeşilova A, Adas M, Helvacı A. Neutrophil- and Platelet- to Lymphocyte Ratio in Patients with Euthyroid Hashimoto's Thyroiditis. Exp Clin Endocrinol Diabetes. 2018 Sep 28. doi: 10.1055/a-0723-3441.