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Altered platelet plug formation in hyperthyroidism and hypothyroidism.

Monika Homoncik1, Alois Gessl, Arnulf Ferlitsch

  • 1Department of Internal Medicine IV, Medical University of Vienna, Austria.

The Journal of Clinical Endocrinology and Metabolism
|May 10, 2007
PubMed
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Thyroid disease alters blood clotting. Hyperthyroidism increases von Willebrand factor (vWF) and platelet plug formation, while hypothyroidism decreases them, impacting cardiovascular risk.

Area of Science:

  • Endocrinology
  • Hematology
  • Cardiovascular Medicine

Background:

  • Thyroid diseases are linked to blood coagulation abnormalities, including altered von Willebrand factor (vWF) levels.
  • vWF is crucial for primary hemostasis, influencing platelet plug formation.

Purpose of the Study:

  • To investigate the hypothesis that altered vWF levels in hyperthyroidism and hypothyroidism affect platelet plug formation.
  • To determine the relationship between vWF levels, platelet function, and thyroid status.

Main Methods:

  • A cohort of 120 patients with hyperthyroidism, hypothyroidism, and euthyroid controls was studied.
  • Measurements included von Willebrand factor (vWF) and collagen-epinephrine-induced closure time (CEPI-CT) for platelet plug formation at baseline and during therapy.

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Main Results:

  • Baseline vWF levels were elevated in hyperthyroidism and reduced in overt hypothyroidism compared to controls.
  • Increased vWF in hyperthyroidism correlated with enhanced platelet plug formation (shorter CEPI-CT).
  • Therapy normalized vWF and prolonged CEPI-CT in hyperthyroid patients; T(4) therapy increased vWF and shortened CEPI-CT in hypothyroid patients.

Conclusions:

  • Hyperthyroidism-associated vWF elevation enhances platelet function, potentially increasing cardiovascular disease risk.
  • Platelet plug formation is reduced during antithyroid therapy (thiamazole).
  • CEPI-CT is sensitive for detecting acquired von Willebrand disease in overt hypothyroidism.