Alteration of Coagulation Profiles in Hypothyroid Patients

Background: Hypothyroidism is an underactive thyroid gland that results in too little thyroid hormones in circulation causing a slowdown in metabolism, therefor hypothyroid modifies physiological process of primary and secondary hemostasis and may lead to a higher bleeding risk.

Objectives: The aim of this study is to assess the coagulation profiles [Prothrombin Time (PT), International Normalize Ratio (INR), Activated Partial Thromboplastin Time (PTT)] in patients with hypothyroidism.

Methodology: This is a case-control hospital-based study carried out at the National Cancer Institute – University of Gezira (NCI-UG), Wad Medani, Sudan from January to October 2020. A total of 100 (50 patients with hypothyroidism as cases (38.50 ± 10.46 years) matched with 50 normal healthy individuals as controls (35.52 ± 11.64 years) participated in this study. Two ml of venous blood sample was collected in a trisodium citrate container. Coagulation profiles (PT, INR, and PTT) were measured using a Coatron M4 coagulometer. SPSS computer program (v 21.0) was used for data analysis.

Results: The prolonged PTT account for 74%. The average PTT of cases (42.29 ± 7.22 sec) was higher than controls (32.67 ± 5.90 sec) giving highly statistically significant differences (P value = 0.000) between them. There were significant differences in PTT between mild and severe hypothyroidism (P value = 0.0470). PTT had significant positive correlation within TSH (P value = 0.048; r = 0.070) and significant negative correlation within T3 (P value = 0.000; r = - 0.490) and T4 (P value = 0.020; r = - 520; P value = 000).

Conclusion: The study concluded that PTT was significantly higher in a patient with hypothyroidism when compared to the control. PTT results showed there was a significant negative correlation between T3 and T4 levels and a significant positive correlation with TSH levels. So, PTT should be included as a follow-up routine test for patients with hypothyroidism.