Page 1 of 13
Accepted Preprint first posted on 30 January 2015 as Manuscript EJE-14-0801
1
Prothrombotic changes due to an increase in thyroid hormone levels
2
Jiri Horacek1, Jaroslav Maly1, Ioannis Svilias1, Lukas Smolej1, Jitka Cepkova1, Jaroslav Vizda2, Petr Sadilek1,
3
Ilona Fatorova1, Pavel Zak1
4 5
1 th
4 Department of Internal Medicine – Haematology and 2Department of Nuclear Medicine, Charles University
6
in Prague, Faculty of Medicine and University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
7 8
Corresponding author: Prof. Jiri Horacek, MD, PhD, 14th Department of Internal Medicine – Haematology,
9
Charles University in Prague, Faculty of Medicine and University Hospital Hradec Kralove, Sokolska 581,
10
50005 Hradec Kralove, Czech Republic; email: [email protected]
11 12
Short title: Prothrombotic changes due to levothyroxine
13 14
Keywords: levothyroxine; hyperthyroidism; haemostasis; coagulation; fibrinolysis
15 16
Word count: 4485
17
Copyright © 2015 European Society of Endocrinology.
Page 2 of 13
1
Abstract
2 3
Objective
4
With increasing free thyroxine levels, a gradually rising risk of venous thromboembolism has been described in
5
case-control studies. However, reports on the influence of thyroid hormones on haemostasis, while suggesting a
6
hypercoagulable state in thyrotoxicosis, have often been inconclusive. The present study evaluates multiple
7
markers of haemostasis and fibrinolysis in a paired design, making it more sensitive to changes in thyroid
8
hormone levels.
9
Design
10
We analysed multiple variables in patients who shifted from severe hypothyroidism to mild hyperthyroidism
11
during thyroid cancer treatment. Those with possible residual disease were excluded.
12
Methods
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Ninety patients following total thyroidectomy were tested on two occasions: (a) before radioiodine remnant
14
ablation and (b) 6 weeks later, on levothyroxine suppression treatment, and the results were compared using the
15
Wilcoxon test for paired data.
16
Results
17
During levothyroxine treatment, significant increases (all p
Accepted Preprint first posted on 30 January 2015 as Manuscript EJE-14-0801
1
Prothrombotic changes due to an increase in thyroid hormone levels
2
Jiri Horacek1, Jaroslav Maly1, Ioannis Svilias1, Lukas Smolej1, Jitka Cepkova1, Jaroslav Vizda2, Petr Sadilek1,
3
Ilona Fatorova1, Pavel Zak1
4 5
1 th
4 Department of Internal Medicine – Haematology and 2Department of Nuclear Medicine, Charles University
6
in Prague, Faculty of Medicine and University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
7 8
Corresponding author: Prof. Jiri Horacek, MD, PhD, 14th Department of Internal Medicine – Haematology,
9
Charles University in Prague, Faculty of Medicine and University Hospital Hradec Kralove, Sokolska 581,
10
50005 Hradec Kralove, Czech Republic; email: [email protected]
11 12
Short title: Prothrombotic changes due to levothyroxine
13 14
Keywords: levothyroxine; hyperthyroidism; haemostasis; coagulation; fibrinolysis
15 16
Word count: 4485
17
Copyright © 2015 European Society of Endocrinology.
Page 2 of 13
1
Abstract
2 3
Objective
4
With increasing free thyroxine levels, a gradually rising risk of venous thromboembolism has been described in
5
case-control studies. However, reports on the influence of thyroid hormones on haemostasis, while suggesting a
6
hypercoagulable state in thyrotoxicosis, have often been inconclusive. The present study evaluates multiple
7
markers of haemostasis and fibrinolysis in a paired design, making it more sensitive to changes in thyroid
8
hormone levels.
9
Design
10
We analysed multiple variables in patients who shifted from severe hypothyroidism to mild hyperthyroidism
11
during thyroid cancer treatment. Those with possible residual disease were excluded.
12
Methods
13
Ninety patients following total thyroidectomy were tested on two occasions: (a) before radioiodine remnant
14
ablation and (b) 6 weeks later, on levothyroxine suppression treatment, and the results were compared using the
15
Wilcoxon test for paired data.
16
Results
17
During levothyroxine treatment, significant increases (all p
