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Increased thrombin-activatable fibrinolysis inhibitor and decreased tissue factor pathway inhibitor and thrombomodulin levels in children with hypothyroidism.
J Clin Res Pediatr Endocrinol. 2012 Sep; 4(3):146-50.JC

Abstract

OBJECTIVE

We determined the profile of coagulation/fibrinolytic and vascular endothelial cell function parameters including plasminogen activator inhibitor (PAI) and thrombin-activatable fibrinolysis inhibitor (TAFI), tissue factor pathway inhibitor (TFPI), thrombomodulin (TM), and tissue plasminogen activator (tPA) levels in children with hypothyroidism.

METHODS

Forty children with hypothyroidism aged 0-16 months who presented for the first time to our hospital and 29 age-and sex-matched healthy controls were enrolled in the study. All coagulation tests were performed with ELISA method. One year after Na-L-thyroxine treatment, the study parameters were re-evaluated in 25 euthyroid children out of the 40 patients diagnosed with hypothyroidism.

RESULTS

Although no significant effect was detected regarding PAI antigen (Ag) and tPA Ag, the levels of TAFI, TM, and TFPI were consistent with subclinical hypercoagulability and hypofibrinolysis. There was a significant increase in TAFI Ag levels and a significant decrease in TFPI Ag and TM Ag levels in hypothyroid patients compared to healthy controls. As a result of correlation tests, the largest impact of hypothyroidism on coagulation system was on TFPI. In accordance with these findings, TAFI Ag levels decreased and TFPI Ag and TM Ag levels increased with hormonal replacement therapy.

CONCLUSIONS

Increased TAFI and decreased TFPI and TM in patients with hypothyroidism may indicate a potential hypercoagulable and hypofibrinolytic state as well as possible endothelial dysfunction, which may increase the risk of atherosclerotic and atherothrombotic complications. Thyroid hormone levels should also be checked in patients with a predisposition to coagulation, and thyroid replacement therapy should be initiated.

Authors+Show Affiliations

The Ministry of Health of Turkey, Ankara Training and Research Hospital, Department of Pediatric Hematology, Director of the Hematology Laboratories, Ankara, Turkey. alioglub@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22985614

Citation

Alioğlu, Bülent, et al. "Increased Thrombin-activatable Fibrinolysis Inhibitor and Decreased Tissue Factor Pathway Inhibitor and Thrombomodulin Levels in Children With Hypothyroidism." Journal of Clinical Research in Pediatric Endocrinology, vol. 4, no. 3, 2012, pp. 146-50.
Alioğlu B, Kılıç N, Şimşek E, et al. Increased thrombin-activatable fibrinolysis inhibitor and decreased tissue factor pathway inhibitor and thrombomodulin levels in children with hypothyroidism. J Clin Res Pediatr Endocrinol. 2012;4(3):146-50.
Alioğlu, B., Kılıç, N., Şimşek, E., & Dallar, Y. (2012). Increased thrombin-activatable fibrinolysis inhibitor and decreased tissue factor pathway inhibitor and thrombomodulin levels in children with hypothyroidism. Journal of Clinical Research in Pediatric Endocrinology, 4(3), 146-50. https://doi.org/10.4274/Jcrpe.652
Alioğlu B, et al. Increased Thrombin-activatable Fibrinolysis Inhibitor and Decreased Tissue Factor Pathway Inhibitor and Thrombomodulin Levels in Children With Hypothyroidism. J Clin Res Pediatr Endocrinol. 2012;4(3):146-50. PubMed PMID: 22985614.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased thrombin-activatable fibrinolysis inhibitor and decreased tissue factor pathway inhibitor and thrombomodulin levels in children with hypothyroidism. AU - Alioğlu,Bülent, AU - Kılıç,Nevin, AU - Şimşek,Enver, AU - Dallar,Yıldız, PY - 2012/9/19/entrez PY - 2012/9/19/pubmed PY - 2013/2/13/medline SP - 146 EP - 50 JF - Journal of clinical research in pediatric endocrinology JO - J Clin Res Pediatr Endocrinol VL - 4 IS - 3 N2 - OBJECTIVE: We determined the profile of coagulation/fibrinolytic and vascular endothelial cell function parameters including plasminogen activator inhibitor (PAI) and thrombin-activatable fibrinolysis inhibitor (TAFI), tissue factor pathway inhibitor (TFPI), thrombomodulin (TM), and tissue plasminogen activator (tPA) levels in children with hypothyroidism. METHODS: Forty children with hypothyroidism aged 0-16 months who presented for the first time to our hospital and 29 age-and sex-matched healthy controls were enrolled in the study. All coagulation tests were performed with ELISA method. One year after Na-L-thyroxine treatment, the study parameters were re-evaluated in 25 euthyroid children out of the 40 patients diagnosed with hypothyroidism. RESULTS: Although no significant effect was detected regarding PAI antigen (Ag) and tPA Ag, the levels of TAFI, TM, and TFPI were consistent with subclinical hypercoagulability and hypofibrinolysis. There was a significant increase in TAFI Ag levels and a significant decrease in TFPI Ag and TM Ag levels in hypothyroid patients compared to healthy controls. As a result of correlation tests, the largest impact of hypothyroidism on coagulation system was on TFPI. In accordance with these findings, TAFI Ag levels decreased and TFPI Ag and TM Ag levels increased with hormonal replacement therapy. CONCLUSIONS: Increased TAFI and decreased TFPI and TM in patients with hypothyroidism may indicate a potential hypercoagulable and hypofibrinolytic state as well as possible endothelial dysfunction, which may increase the risk of atherosclerotic and atherothrombotic complications. Thyroid hormone levels should also be checked in patients with a predisposition to coagulation, and thyroid replacement therapy should be initiated. SN - 1308-5735 UR - https://www.unboundmedicine.com/medline/citation/22985614/Increased_thrombin_activatable_fibrinolysis_inhibitor_and_decreased_tissue_factor_pathway_inhibitor_and_thrombomodulin_levels_in_children_with_hypothyroidism_ L2 - https://doi.org/10.4274/Jcrpe.652 DB - PRIME DP - Unbound Medicine ER -