Neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, and platelet-tolymphocyte ratio in different etiological causes of thyrotoxicosis

Abstract

Background/aim: The most common causes of thyrotoxicosis include Graves’ disease (GD), toxic multinodular goiter (TMNG), toxicadenoma (TA), and subacute granulomatous thyroiditis (SAT). In our study, we aimed to see whether neutrophil‐to‐lymphocyte ratio(NLR), monocyte-to-lymphocyte ratio (MLR), platelet‐to‐lymphocyte ratio (PLR), and mean platelet volume (MPV) may be helpful inthe differential diagnosis of these diseases.Materials and methods: We retrospectively analyzed the hospital records of the Endocrinology Clinic of our hospital between 2016 and2019. We included data from 66 GD, 37 TA, and 35 SAT patients. We compared the data with those of 35 healthy subjects as controls.Results: NLR, MLR, and PLR were found to be higher in the SAT group when compared to other groups. The post hoc analysis ofcomparison of NLR, MLR, and PLR in each group showed that NLR and PLR were significantly different in the SAT group whencompared to the GD, TA, and controls groups (P < 0.001, P = 0.003, and P < 0.001 for NLR respectively and P < 0.001 for PLR inall groups). MPV levels were different between groups (P = 0.007). However, the intergroup analysis (Tukey’s test) failed to show astatistically significant difference for any of the groups. In patients with SAT, PLR and NLR were significantly higher than in the GD,TA, and control groups. MLR was also higher in SAT when compared to other groups, but the difference was not statistically significant.Conclusion: High PLR and NLR may be helpful to differentiate SAT from GD and TA, the other common causes of thyrotoxicosis.