International Journal of Endocrinology and Metabolism

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Hemostasis in Overt and Subclinical Hyperthyroidism

Arash Ordookhani 1 and Kenneth D. Burman 2 , *
Authors Information
1 Endocrine Section, Department of Internal Medicine, Providence Hospital, Washington, DC, 20017
2 Endocrine Section, MedStar Washington Hospital Center, Washington, DC, 20010
Article information
  • International Journal of Endocrinology and Metabolism: July 2017, 15 (3); e44157
  • Published Online: April 23, 2017
  • Article Type: Review Article
  • Received: November 21, 2016
  • Revised: February 24, 2017
  • Accepted: March 14, 2017
  • DOI: 10.5812/ijem.44157

To Cite: Ordookhani A, Burman K D. Hemostasis in Overt and Subclinical Hyperthyroidism, Int J Endocrinol Metab. 2017 ;15(3):e44157. doi: 10.5812/ijem.44157.

Abstract
Copyright: Copyright © 2017, International Journal of Endocrinology and Metabolism. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Context
2. Methods
3. Results
4. Conclusions
Acknowledgements
Footnote
References
  • 1. Furie B, Furie BC. Mechanisms of thrombus formation. N Engl J Med. 2008; 359(9): 938-49[DOI][PubMed]
  • 2. Furie B. Pathogenesis of thrombosis. Hematology Am Soc Hematol Educ Program. 2009; : 255-8[DOI][PubMed]
  • 3. Falati S, Gross P, Merrill-Skoloff G, Furie BC, Furie B. Real-time in vivo imaging of platelets, tissue factor and fibrin during arterial thrombus formation in the mouse. Nat Med. 2002; 8(10): 1175-81
  • 4. Arnout J, Hoylaerts MF, Lijnen HR. Haemostasis. Handb Exp Pharmacol. 2006; (176 Pt 2): 1-41[PubMed]
  • 5. Fressinaud E, Baruch D, Girma JP, Sakariassen KS, Baumgartner HR, Meyer D. von Willebrand factor-mediated platelet adhesion to collagen involves platelet membrane glycoprotein IIb-IIIa as well as glycoprotein Ib. J Lab Clin Med. 1988; 112(1): 58-67[PubMed]
  • 6. Foster PA, Fulcher CA, Marti T, Titani K, Zimmerman TS. A major factor VIII binding domain resides within the amino-terminal 272 amino acid residues of von Willebrand factor. J Biol Chem. 1987; 262(18): 8443-6[PubMed]
  • 7. Stump DC, Mann KG. Mechanisms of thrombus formation and lysis. Ann Emerg Med. 1988; 17(11): 1138-47[PubMed]
  • 8. Hulbert AJ. Thyroid hormones and their effects: a new perspective. Biol Rev Camb Philos Soc. 2000; 75(4): 519-631[PubMed]
  • 9. Vescovi PP, Favaloro EJ, Lippi G, Garofano M, Montagnana M, Manzato F, et al. The spectrum of coagulation abnormalities in thyroid disorders. Semin Thromb Hemost. 2011; 37(1): 7-10[DOI][PubMed]
  • 10. Erem C. Coagulation and fibrinolysis in thyroid dysfunction. Endocrine. 2009; 36(1): 110-8[DOI][PubMed]
  • 11. Shih CH, Chen SL, Yen CC, Huang YH, Chen CD, Lee YS, et al. Thyroid hormone receptor-dependent transcriptional regulation of fibrinogen and coagulation proteins. Endocrinology. 2004; 145(6): 2804-14[DOI][PubMed]
  • 12. Doyle JB. Obstruction of the longitudinal sinus. Arch Neurol Psychiat. 1927; 29: 374-82
  • 13. Squizzato A, Gerdes VE, Brandjes DP, Buller HR, Stam J. Thyroid diseases and cerebrovascular disease. Stroke. 2005; 36(10): 2302-10[DOI][PubMed]
  • 14. Kaliebe H. Autochthone sinusthrombose bei einem falle von morbus Basedow und tabes. Med Klinik. 1913; 9: 1929-32
  • 15. Marongiu F, Cauli C, Mariotti S. Thyroid, hemostasis and thrombosis. J Endocrinol Invest. 2004; 27(11): 1065-71[DOI][PubMed]
  • 16. Franchini M. Hemostasis and thyroid diseases revisited. J Endocrinol Invest. 2004; 27(9): 886-92[DOI][PubMed]
  • 17. Franchini M. Hemostatic changes in thyroid diseases: haemostasis and thrombosis. Hematology. 2006; 11(3): 203-8[DOI][PubMed]
  • 18. Erem C, Ersoz HO, Karti SS, Ukinc K, Hacihasanoglu A, Deger O, et al. Blood coagulation and fibrinolysis in patients with hyperthyroidism. J Endocrinol Invest. 2002; 25(4): 345-50[DOI][PubMed]
  • 19. Hofbauer LC, Heufelder AE. Coagulation disorders in thyroid diseases. Eur J Endocrinol. 1997; 136(1): 1-7[PubMed]
  • 20. Ozcan MA, Comlekci A, Demirkan F, Yuksel F, Sari I, Demir T, et al. Plasma levels of free tissue factor pathway inhibitor in patients with various thyroid disorders. Thromb Res. 2003; 110(4): 243-7[PubMed]
  • 21. Erem C, Kavgaci H, Ersoz HO, Hacihasanoglu A, Ukinc K, Karti SS, et al. Blood coagulation and fibrinolytic activity in hypothyroidism. Int J Clin Pract. 2003; 57(2): 78-81[PubMed]
  • 22. Marongiu F, Conti M, Mameli G, Murtas ML, Balzano S, Sorano G, et al. Fibrinogen and fibrinolytic activity in hyperthyroidism before and after antithyroid treatment. J Endocrinol Invest. 1988; 11(10): 723-5[DOI][PubMed]
  • 23. Marongiu F, Biondi G, Conti M, Murtas ML, Mameli G, Sorano GG, et al. Is a hypercoagulable state present in hypothyroidism? Thromb Haemost. 1992; 67(6): 729[PubMed]
  • 24. Chadarevian R, Bruckert E, Leenhardt L, Giral P, Ankri A, Turpin G. Components of the fibrinolytic system are differently altered in moderate and severe hypothyroidism. J Clin Endocrinol Metab. 2001; 86(2): 732-7[DOI][PubMed]
  • 25. Horne M3, Singh KK, Rosenfeld KG, Wesley R, Skarulis MC, Merryman PK, et al. Is thyroid hormone suppression therapy prothrombotic? J Clin Endocrinol Metab. 2004; 89(9): 4469-73[DOI][PubMed]
  • 26. Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002; 87(2): 489-99[DOI][PubMed]
  • 27. De Schryver EL, Hoogenraad TU, Banga JD, Kappelle LJ. Thyrotoxicosis, protein C deficiency and lupus anticoagulant in a case of cerebral sinus thrombosis. Neth J Med. 1999; 55(4): 201-2[PubMed]
  • 28. Molloy E, Cahill M, O'Hare JA. Cerebral venous sinus thrombosis precipitated by Graves' disease and Factor V Leiden mutation. Ir Med J. 2003; 96(2): 46-7[PubMed]
  • 29. Mouton S, Nighoghossian N, Berruyer M, Derex L, Philippeau F, Cakmak S, et al. Hyperthyroidism and cerebral venous thrombosis. Eur Neurol. 2005; 54(2): 78-80[DOI][PubMed]
  • 30. Pekdemir M, Yilmaz S, Ersel M, Sarisoy HT. A rare cause of headache: cerebral venous sinus thrombosis due to hyperthyroidism. Am J Emerg Med. 2008; 26(3): 383 e1-2[DOI][PubMed]
  • 31. Siegert CE, Smelt AH, de Bruin TW. Superior sagittal sinus thrombosis and thyrotoxicosis. Possible association in two cases. Stroke. 1995; 26(3): 496-7[PubMed]
  • 32. Squizzato A, Romualdi E, Buller HR, Gerdes VE. Clinical review: Thyroid dysfunction and effects on coagulation and fibrinolysis: a systematic review. J Clin Endocrinol Metab. 2007; 92(7): 2415-20[DOI][PubMed]
  • 33. Farid NR, Griffiths BL, Collins JR, Marshall WH, Ingram DW. Blood coagulation and fibrinolysis in thyroid disease. Thromb Haemost. 1976; 35(2): 415-22[PubMed]
  • 34. Stuijver DJ, van Zaane B, Romualdi E, Brandjes DP, Gerdes VE, Squizzato A. The effect of hyperthyroidism on procoagulant, anticoagulant and fibrinolytic factors: a systematic review and meta-analysis. Thromb Haemost. 2012; 108(6): 1077-88[DOI][PubMed]
  • 35. Parker JL, Lawson DH. Death from thyrotoxicosis. Lancet. 1973; 2(7834): 894-5[PubMed]
  • 36. Predictors of thromboembolism in atrial fibrillation: I. Clinical features of patients at risk. The Stroke Prevention in Atrial Fibrillation Investigators. Ann Intern Med. 1992; 116(1): 1-5[PubMed]
  • 37. Presti CF, Hart RG. Thyrotoxicosis, atrial fibrillation, and embolism, revisited. Am Heart J. 1989; 117(4): 976-7[PubMed]
  • 38. van Zaane B, Stuijver DJ, Squizzato A, Gerdes VE. Arterial and venous thrombosis in endocrine diseases. Semin Thromb Hemost. 2013; 39(5): 489-95[DOI][PubMed]
  • 39. van Zaane B, Squizzato A, Huijgen R, van Zanten AP, Fliers E, Cannegieter SC, et al. Increasing levels of free thyroxine as a risk factor for a first venous thrombosis: a case-control study. Blood. 2010; 115(22): 4344-9[DOI][PubMed]
  • 40. Elbers LP, van Zaane B, Gerdes VE, Coutinho JM, Bisschop PH, Fliers E. Venous thromboembolism in overt hyperthyroidism - a direct association with clinical implications? Neth J Med. 2014; 72(4): 242-4[PubMed]
  • 41. Squizzato A, Vitale J, Gerdes VEA, Romualdi E, Büller HR, Ageno W. Recurrent deep venous thrombosis during optimal anticoagulation and overt hyperthyroidism: a case report. Blood Coagulation Fibrinolysis. 2007; 18(8): 801-3[DOI]
  • 42. Verberne HJ, Fliers E, Prummel MF, Stam J, Brandjes DP, Wiersinga WM. Thyrotoxicosis as a predisposing factor for cerebral venous thrombosis. Thyroid. 2000; 10(7): 607-10[DOI][PubMed]
  • 43. Danescu LG, Badshah A, Danescu SC, Janjua M, Marandici AM, Matta F, et al. Venous thromboembolism in patients hospitalized with thyroid dysfunction. Clin Appl Thromb Hemost. 2009; 15(6): 676-80[DOI][PubMed]
  • 44. Debeij J, Dekkers OM, Asvold BO, Christiansen SC, Naess IA, Hammerstrom J, et al. Increased levels of free thyroxine and risk of venous thrombosis in a large population-based prospective study. J Thromb Haemost. 2012; 10(8): 1539-46[DOI][PubMed]
  • 45. Lin HC, Yang LY, Kang JH. Increased risk of pulmonary embolism among patients with hyperthyroidism: a 5-year follow-up study. J Thromb Haemost. 2010; 8(10): 2176-81[DOI][PubMed]
  • 46. Debeij J, van Zaane B, Dekkers OM, Doggen CJ, Smit JW, van Zanten AP, et al. High levels of procoagulant factors mediate the association between free thyroxine and the risk of venous thrombosis: the MEGA study. J Thromb Haemost. 2014; 12(6): 839-46[DOI][PubMed]
  • 47. Kootte RS, Stuijver DJ, Dekkers OM, van Zaane B, Fliers E, Cannegieter SC, et al. The incidence of venous thromboembolism in patients with overt hyperthyroidism: a retrospective multicentre cohort study. Thromb Haemost. 2012; 107(3): 417-22[DOI][PubMed]
  • 48. Ramagopalan SV, Wotton CJ, Handel AE, Yeates D, Goldacre MJ. Risk of venous thromboembolism in people admitted to hospital with selected immune-mediated diseases: record-linkage study. BMC Med. 2011; 9: 1[DOI][PubMed]
  • 49. Franchini M, Montagnana M, Manzato F, Vescovi PP. Thyroid dysfunction and hemostasis: an issue still unresolved. Semin Thromb Hemost. 2009; 35(3): 288-94[DOI][PubMed]
  • 50. Mohamed-Ali MS, Ahmed RO. Coagulation profiles in hypothyroid and hyperthyroid female patients in Sudan. Saudi Med J. 2008; 29(9): 1289-93[PubMed]
  • 51. Myrup B, Bregengard C, Faber J. Primary haemostasis in thyroid disease. J Intern Med. 1995; 238(1): 59-63[PubMed]
  • 52. Kurata Y, Nishioeda Y, Tsubakio T, Kitani T. Thrombocytopenia in Graves' disease: effect of T3 on platelet kinetics. Acta Haematol. 1980; 63(4): 185-90[PubMed]
  • 53. Panzer S, Haubenstock A, Minar E. Platelets in hyperthyroidism: studies on platelet counts, mean platelet volume, 111-indium-labeled platelet kinetics, and platelet-associated immunoglobulins G and M. J Clin Endocrinol Metab. 1990; 70(2): 491-6[DOI][PubMed]
  • 54. Dorr M, Robinson DM, Wallaschofski H, Schwahn C, John U, Felix SB, et al. Low serum thyrotropin is associated with high plasma fibrinogen. J Clin Endocrinol Metab. 2006; 91(2): 530-4[DOI][PubMed]
  • 55. Lippi G, Franchini M, Targher G, Montagnana M, Salvagno GL, Guidi GC, et al. Hyperthyroidism is associated with shortened APTT and increased fibrinogen values in a general population of unselected outpatients. J Thromb Thrombolysis. 2009; 28(3): 362-5[DOI][PubMed]
  • 56. Bennett NB, Ogston CM, McAndrew GM. The thyroid and fibrinolysis. Br Med J. 1967; 4(5572): 147-8[PubMed]
  • 57. Homoncik M, Gessl A, Ferlitsch A, Jilma B, Vierhapper H. Altered platelet plug formation in hyperthyroidism and hypothyroidism. J Clin Endocrinol Metab. 2007; 92(8): 3006-12[DOI][PubMed]
  • 58. Rogers J2, Shane SR, Jencks FS. Factor VIII activity and thyroid function. Ann Intern Med. 1982; 97(5): 713-6[PubMed]
  • 59. Burggraaf J, Lalezari S, Emeis JJ, Vischer UM, de Meyer PH, Pijl H, et al. Endothelial function in patients with hyperthyroidism before and after treatment with propranolol and thiamazol. Thyroid. 2001; 11(2): 153-60[DOI][PubMed]
  • 60. Van Zaane B, Squizzato A, Debeij J, Dekkers OM, Meijers JC, Van Zanten AP, et al. Alterations in coagulation and fibrinolysis after levothyroxine exposure in healthy volunteers: a controlled randomized crossover study. J Thromb Haemost. 2011; 9(9): 1816-24[DOI][PubMed]
  • 61. Arnaout MA, Awidi AS, el-Najdawi AM, Khateeb MS, Ajlouni KM. Arginine-vasopressin and endothelium-associated proteins in thyroid disease. Acta Endocrinol (Copenh). 1992; 126(5): 399-403[PubMed]
  • 62. Li Y, Chen H, Tan J, Wang X, Liang H, Sun X. Impaired release of tissue plasminogen activator from the endothelium in Graves' disease - indicator of endothelial dysfunction and reduced fibrinolytic capacity. Eur J Clin Invest. 1998; 28(12): 1050-4[PubMed]
  • 63. Horacek J, Maly J, Svilias I, Smolej L, Cepkova J, Vizda J, et al. Prothrombotic changes due to an increase in thyroid hormone levels. Eur J Endocrinol. 2015; 172(5): 537-42
  • 64. Poplawska-Kita A, Siewko K, Telejko B, Modzelewska A, Mysliwiec J, Milewski R, et al. The changes in the endothelial function and haemostatic and inflammatory parameters in subclinical and overt hyperthyroidism Int J Endocrinol 2013; : 981638
  • 65. Hooper JM, Stuijver DJ, Orme SM, van Zaane B, Hess K, Gerdes VE, et al. Thyroid dysfunction and fibrin network structure: a mechanism for increased thrombotic risk in hyperthyroid individuals. J Clin Endocrinol Metab. 2012; 97(5): 1463-73[DOI][PubMed]
  • 66. Klein I, Ojamaa K. Thyroid hormone and the cardiovascular system. N Engl J Med. 2001; 344(7): 501-9[DOI][PubMed]
  • 67. Wahrenberg H, Wennlund A, Hoffstedt J. Increased adipose tissue secretion of interleukin-6, but not of leptin, plasminogen activator inhibitor-1 or tumour necrosis factor alpha, in Graves' hyperthyroidism. Eur J Endocrinol. 2002; 146(5): 607-11[PubMed]
  • 68. Morishita E, Hashimoto T, Asakura H, Saito M, Yamazaki M, Aoshima K, et al. Increased plasma levels of free tissue factor pathway inhibitor in patients with Graves' disease. Thromb Haemost. 1998; 79(5): 919-23[PubMed]
  • 69. Morikawa Y, Morikawa A, Makino I. Relationship of thyroid states and serum thrombomodulin (TM) levels in patients with Graves' disease: TM, a possible new marker of the peripheral activity of thyroid hormones. J Clin Endocrinol Metab. 1993; 76(3): 609-14[DOI][PubMed]
  • 70. Stuijver DJ, van Zaane B, Squizzato A, Meijers JC, Otten HM. The effects of an extremely high dose of levothyroxine on coagulation and fibrinolysis. J Thromb Haemost. 2010; 8(6): 1427-8[DOI][PubMed]
  • 71. Akinci B, Comlekci A, Yener S, Demir T, Ozcan MA, Bayraktar F, et al. Thrombin activatable fibrinolysis inhibitor antigen levels are inversely correlated with plasminogen activator inhibitor-1 antigen levels in hyperthyroid patients. Endocr J. 2007; 54(4): 593-9[PubMed]
  • 72. Erem C, Ucuncu O, Yilmaz M, Kocak M, Nuhoglu I, Ersoz HO. Increased thrombin-activatable fibrinolysis inhibitor and decreased tissue factor pathway inhibitor in patients with hyperthyroidism. Endocrine. 2009; 36(3): 473-8[DOI][PubMed]
  • 73. Stuijver DJ, Romualdi E, van Zaane B, Bax L, Buller HR, Gerdes VE, et al. Under-reporting of venous and arterial thrombotic events in randomized clinical trials: a meta-analysis. Intern Emerg Med. 2015; 10(2): 219-46[DOI][PubMed]
  • 74. Maraveyas A, Johnson M. Does clinical method mask significant VTE-related mortality and morbidity in malignant disease? Br J Cancer. 2009; 100(12): 1837-41[DOI][PubMed]
  • 75. Sievert R, Goldstein ML, Surks MI. Graves' disease and autoimmune factor VIII deficiency. Thyroid. 1996; 6(3): 245-7[DOI][PubMed]
  • 76. Marongiu F, Cauli C, Mameli G, Usai B, Mariotti S. Apathetic Graves' disease and acquired hemophilia due to factor VIIIc antibody. J Endocrinol Invest. 2002; 25(3): 246-9[DOI][PubMed]
  • 77. Akinci B, Demir T, Comlekci A, Yener S, Ozcan MA, Karaoglu O, et al. Effect of levothyroxine suppression therapy on plasma thrombin activatable fibrinolysis inhibitor antigen levels in benign thyroid nodules. Med Princ Pract. 2011; 20(1): 23-8[DOI][PubMed]
  • 78. Loeliger EA, Van Der Esch B, Mattern MJ, Hemker HC. The Biological Disappearance Rate of Prothrombin, Factors Vii, Ix and X from Plasma in Hypothyroidism, Hyperthyroidism, and during Fever. Thromb Diath Haemorrh. 1964; 10: 267-77[PubMed]
  • 79. Kellett HA, Sawers JS, Boulton FE, Cholerton S, Park BK, Toft AD. Problems of anticoagulation with warfarin in hyperthyroidism. Q J Med. 1986; 58(225): 43-51[PubMed]
  • 80. Self T, Weisburst M, Wooten E, Straughn A, Oliver J. Warfarin-induced hypoprothrombinemia. Potentiation by hyperthyroidism. JAMA. 1975; 231(11): 1165-6[PubMed]
  • 81. Collen D, Lijnen HR. Basic and clinical aspects of fibrinolysis and thrombolysis. Blood. 1991; 78(12): 3114-24[PubMed]
  • 82. Rosc, D. , Zastawna, E. , Drewniak, W. , Michalski, A. , Kotschy, M. . Plasminogen activators (tissue type t-PA, urokinase type u-PA) and plasminogen activator inhibitor type 1 (PAI-1) in Graves disease. Med Sci Monit. 1998; 4(6): 975-8
  • 83. Maroney SA, Mast AE. New insights into the biology of tissue factor pathway inhibitor. J Thromb Haemost. 2015; 13 Suppl 1-7[DOI][PubMed]
  • 84. Simone JV, Abildgaard CF, Schulman I. Blood coagulation in thyroid dysfunction. N Engl J Med. 1965; 273(20): 1057-61[DOI][PubMed]
  • 85. Brona A, Bohdanowicz-Pawlak A, Jedrzejuk D, Milewicz A. Fibrinogen and D-dimers levels in patients with hyperthyroidism before and after radioiodine therapy. Endokrynol Pol. 2011; 62(5): 409-15[PubMed]
  • 86. Erem C. Blood coagulation, fibrinolytic activity and lipid profile in subclinical thyroid disease: subclinical hyperthyroidism increases plasma factor X activity. Clin Endocrinol (Oxf). 2006; 64(3): 323-9[DOI][PubMed]
  • 87. Gharib H, Tuttle RM, Baskin HJ, Fish LH, Singer PA, McDermott MT. Subclinical thyroid dysfunction: a joint statement on management from the American Association of Clinical Endocrinologists, the American Thyroid Association, and the Endocrine Society. J Clin Endocrinol Metab. 2005; 90(1): 581-5[DOI][PubMed]
  • 88. Biondi B, Palmieri EA, Fazio S, Cosco C, Nocera M, Sacca L, et al. Endogenous subclinical hyperthyroidism affects quality of life and cardiac morphology and function in young and middle-aged patients. J Clin Endocrinol Metab. 2000; 85(12): 4701-5[DOI][PubMed]
  • 89. Iervasi G, Molinaro S, Landi P, Taddei MC, Galli E, Mariani F, et al. Association between increased mortality and mild thyroid dysfunction in cardiac patients. Arch Intern Med. 2007; 167(14): 1526-32[DOI][PubMed]
  • 90. Singh S, Duggal J, Molnar J, Maldonado F, Barsano CP, Arora R. Impact of subclinical thyroid disorders on coronary heart disease, cardiovascular and all-cause mortality: a meta-analysis. Int J Cardiol. 2008; 125(1): 41-8[DOI][PubMed]
  • 91. Cappola AR, Fried LP, Arnold AM, Danese MD, Kuller LH, Burke GL, et al. Thyroid status, cardiovascular risk, and mortality in older adults. JAMA. 2006; 295(9): 1033-41[DOI][PubMed]
  • 92. Walsh JP, Bremner AP, Bulsara MK, O'Leary P, Leedman PJ, Feddema P, et al. Subclinical thyroid dysfunction as a risk factor for cardiovascular disease. Arch Intern Med. 2005; 165(21): 2467-72[DOI][PubMed]
  • 93. Gelfand RA, Hutchinson-Williams KA, Bonde AA, Castellino P, Sherwin RS. Catabolic effects of thyroid hormone excess: the contribution of adrenergic activity to hypermetabolism and protein breakdown. Metabolism. 1987; 36(6): 562-9[PubMed]
  • 94. Coban E, Aydemir M, Yazicioglu G, Ozdogan M. Endothelial dysfunction in subjects with subclinical hyperthyroidism. J Endocrinol Invest. 2006; 29(3): 197-200[DOI][PubMed]
  • 95. Gazdag A, Nagy EV, Burman KD, Paragh G, Jenei Z. Improved endothelial function and lipid profile compensate for impaired hemostatic and inflammatory status in iatrogenic chronic subclinical hyperthyroidism of thyroid cancer patients on L-t4 therapy. Exp Clin Endocrinol Diabetes. 2010; 118(6): 381-7[DOI][PubMed]
  • 96. Coban E, Aydemir M. Levels of plasma fibrinogen and D-dimer in subjects with subclinical hyperthyroidism. Med Sci Monit. 2008; 14(1)-6[PubMed]
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