Korean J Ophthalmol.  2021 Jun;35(3):198-206. 10.3341/kjo.2021.0012.

Blood Count-derived Immunoinflammatory Markers in Thyroidassociated Ophthalmopathy

• Yeter V
• Koçak N
• Arslan MT
• Kan EK

• KMID: 2516665
• DOI: http://doi.org/10.3341/kjo.2021.0012

Abstract

Purpose
To investigate the diagnostic and prognostic significance of the blood-count derived systemic immunoinflammatory parameters in patients with thyroid-associated ophthalmopathy (TAO).
Methods
In this retrospective case-control study, the blood-count parameters and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio, and systemic immune-inflammatory index (SII), thyroid peroxidase antibody, and anti-thyroglobulin antibody were evaluated in 46 patients with TAO and 46 matched controls. The associations of the immunoinflammatory parameters with clinical outcomes were analyzed among TAO patients.
Results
Significant differences were found in NLR, PLR, SII, and lymphocyte count between the controls and the TAO group (p < 0.05 for all). In logistic regression analysis, these inflammatory parameters did not have any prognostic effect on the clinical outcomes of the TAO (p > 0.05 for all). The patients, who needed systemic treatment due to any ocular involvement of TAO during the follow-up period, had significantly lower platelet count (p = 0.001) and PLR (p = 0.02) at the time of initial diagnosis when compared to the no treatment-needed group of the TAO patients. The initial platelet count was significantly associated with the subsequent steroid need due to TAO during the follow-up period (β = -0.02, p = 0.03).
Conclusions
NLR, PLR, and SII may serve as potential inflammatory markers in the identification of the TAO, although they have no evident prognostic significance in TAO. However, the relatively lower platelet count at initial diagnosis may be associated with the need for systemic therapy during the follow-up in patients with TAO.

Keyword

Blood platelets; Graves ophthalmopathy; Lymphocytes; Neutrophils; Systemic immune-inflammatory index