Coagulation Profile in Patients with Autoimmune Thyroiditis: A Cross-sectional Exploratory Study

Abstract

Abstract Background: The association between the hemostatic system and thyroid diseases is a subject of investigation that can shed light on various abnormalities ranging from subclinical laboratory findings to thromboembolic events. Aim: The aim of this study was to evaluate the potential association between various thyroid disorders and coagulation profiles in patients with no apparent bleeding abnormalities. Materials and Methods: An analytical case–control study was carried out between April 2020 and November 2021. Adults presenting with symptoms suggestive of thyroid dysfunction/palpable goiter without any apparent bleeding disorder were included in the study. Thyroid function tests were categorized as euthyroid, hyperthyroid, and hypothyroid. Antithyroid antibodies, prothrombin time, activated partial thromboplastin time, fibrinogen, factor VIII, and D-dimer were assessed. Comparison of cases and controls and between various subgroups of cases was carried out by Student’ t-test and P ≤ 0.05 was considered significant. Results: We recruited 20 controls and 46 cases, including 18 with overt hypothyroidism, 13 with overt hyperthyroidism, 3 with subclinical hyperthyroidism, and 12 with subclinical hypothyroidism. On comparison with controls, those with overt hypothyroidism showed a hypocoagulable state with decreased fibrinogen, factor VIII, and raised D-dimer values. The converse was true in patients with hyperthyroidism and subclinical hypothyroidism, both, showing a hypercoagulable state. Only factor VIII and fibrinogen values showed statistically significant differences (P ≤ 0.05 for both) between the subgroups of cases and between those who were antibody-positive versus negative. Conclusion: Our findings support the assertion that there is a deranged coagulation profile in autoimmune thyroiditis.