Predictive factors for docking site procedure in bone transport for large lower extremity segmental defects.

BACKGROUND: Segmental bone transport is a common technique for treating large segmental bone defects. However, a docking site procedure is often necessary in segmental bone transport. To date, no prognostic factors for the need of docking site procedure have been reported. Thus, the decision is often made at random, based on the surgeon's subjective judgment and experience. The aim of this study was to identify prognostic factors for the need of docking site operation. METHODS: Patients with segmental bone transport in lower extremity bone defects were included regardless of age, aetiology, and defect size. We excluded patients undergoing treatments that were not yet completed, and those who discontinued therapy by any reason. The need for docking site operation was modelled with logistical and linear regression as well as univariate analysis of variances (ANOVA). Receiver operating characteristics (ROC) curve analysis was also performed. RESULTS: Twenty-seven patients from age 12 to 74 years (mean age: 39.07 ± 18.20 years) were included. The mean defect size was 76.39 ± 41.10 mm. The duration of transport (days) showed a significant influence (p = 0.049, 95%CI: 1.00-1.02) on the need for docking site operation. No other significant influences were detected. CONCLUSION: A link between the duration of transport and the need for docking site operation was detected. Our data showed that if a threshold of about 188 days is exceeded, docking surgery should be considered.

Does mean platelet volume/lymphocyte count ratio associate with frailty in type 2 diabetes mellitus?

OBJECTIVES: Frailty is a common problem in patients with type 2 diabetes mellitus (T2DM). It is considered to be associated with inflammation. Novel markers derived from hemogram, such as neutrophil/lymphocyte ratio (NLR) and mean platelet volume/lymphocyte ratio (MPVLR), are proposed as inflammatory markers. In present study, we aimed to compare NLR and MPVLR levels of frail patients with T2DM to non­frail diabetic subjects. METHODS: Diabetic subjects were grouped in frail and non-frail groups according to the Edmonton Frail Scale. General characteristics and laboratory data of the frail and non-frail groups were compared. RESULTS: The MPVLR of the frail (3.9 [1.4-13.2] %) group was significantly higher than that of the non-frail (3.4 [1.5-6.9] %) group (p = 0.02). MPVLR was positively and significantly correlated with Edmonton Frail Scale score (r = 0.21, p = 0.03). A MPVLR level greater than 3.41 % has 71 % sensitivity and 51 % specifity in predicting frailty. CONCLUSION: We suggest that elevated MPVLR could be a finding that marks frailty in diabetic subjects. Inexpensive and easy­to­assess nature of the MPVLR may be useful in predicting frailty in type 2 diabetic population (Tab. 2, Fig. 1, Ref. 32).

Single anterior tooth replacement with direct fiber-reinforced composite bridges: A report of three cases.

In today's dentistry, with the development of adhesive techniques and the improvement of resin-based materials, invasive restorative treatments have been replaced by minimally invasive or noninvasive restorative procedures. Fiber-reinforced adhesive bridges are minimal-invasive or noninvasive restorations that can be applied for definitive restoration in single tooth loss or short spans, where teeth or implant-supported fixed partial prosthesis cannot be applied. This case series describes the rehabilitation of three patients with anterior single tooth loss using the direct fiber-reinforced adhesive bridge. In all patients, esthetic and functional deficiencies in the missing tooth regions were solved with this minimally invasive technique, which is both cost-effective and conservative of tooth structures. During the three-year follow-up of these cases, there was neither fracture nor decementation in the restorations. Also, no caries or sensitivity was noted in the support teeth.

THE ASSOCIATION BETWEEN VITAMIN D LEVELS AND HANDGRIP STRENGTH IN ELDERLY MEN.

CONTEXT: Vitamin D is a steroid hormone that acts by binding to the vitamin D receptor (VDR) found in many tissues. According to the long-term mechanism, vitamin D causes the proliferation and differentiation of muscle cells by gene transcription. OBJECTIVE: We aimed to evaluate the relationship between muscle strength and serum vitamin D levels in elderly men. DESIGN: Cross-sectional study. SUBJECTS AND METHODS: Male patients over age 50 were included in the study. Study population was divided into 2 groups with handgrip strength according to body mass index, either as subjects with weak or with normal handgrip strength test (HGST). Vitamin D levels and other variables compared between weak and normal groups. RESULTS: Vitamin D level of weak and normal groups were 7.5 (3-19.9) µg/L, and 11.6 (11.6-34.9) µg/L, which means significant reduced vitamin D levels in weakness group (p=0.01). Vitamin D levels were significantly correlated with HGST levels (r:0.362, p=0.001). Vitamin D levels were found to be an independent predictor of weakness according to HGST in logistic regression analysis (OR: 0.453, 95% Cl:0.138-0.769, p=0.05). CONCLUSIONS: Low vitamin D level is an independent risk factor for muscle weakness in men aged more than 50 years. Therefore, vitamin D levels should be screened and early replacement should be initiated for the sake of improvement of muscle strength in elderly subjects that vulnerable for frailty.

Clinical Survival of Indirect, Anterior Surface-Retained Fiber-Reinforced Composite Fixed Dental Prosthesis: Up to 3-Year Follow-up.

This study evaluated the performance of indirect, anterior, surface-retained, fiber-reinforced-composite restorations (ISFRCR). Between September-2011 and September-2012, 17 patients (13 females, 4 males, mean age: 40.5) received 17 indirect ISFRCRs (maxilla=4; mandible=13). All restorations were made on a plaster model using unidirectional E-glass fibers (Interlig, Angelus) in combination with a veneering resin composite (Gradia, GC) and cemented adhesively (Choice 2, Bisco). No cavity preparations were made on the abutmentteeth. Before cementation, enamel surfaces were cleaned with pumice and etched with 38% H3PO4 for 30 s, rinsed 30 s. Then, adhesive resin was applied accordingly. Patients were followed every 3 months until May 2014. The evaluation protocol involved technical (chipping, debonding or fracture of tooth/restoration) and biological failures (caries). Survival (Kaplan Meier) and annual failure rates were calculated. Mean observation time was 34.6 months. Altogether, 5 failures were observed [survival rate: 70.5%] of which 3 were debondings and 2 delaminations of the veneering composite (chipping). All defective restorations were repaired or recemented, except one, which was remade.

Serum omentin levels predicts mesenteric ischemia.

BACKGROUND: Acute mesenteric ischemia (AMI) is an intestinal vascular disease with high mortality. Clinical diagnosis of acute mesenteric ischemia is difficult. Adipose tissue is an important mediator of metabolism and inflammation.Omentin is produced by visceral adipose tissue and decreased serum levels of omentin are associated with poor metabolic outcomes. We aimed to investigate whether serum omentin level predicts early diagnosis of AMI before development of transmural ischemia. METHODS: Twenty-four Sprague Dawley rats weighted about 200-250 gr grouped in 3 experimental groups as sham, transient ischemia and permanent ischemia. Each group consisted of 8 rats. Blood samples were evaluated to determine serum urea, creatinine, omentin and C-reactive protein (CRP) levels. A blinded histological examination performed with the same histologist for hemotoxileneosine painted ileal tissue samples. RESULTS: Mean serum omentin level in sham group (27.5±4.67) was significantly elevated compared to rats in Ischemia-reperfusion (IR) group (10.9±9.01).The difference reached the statistical significance (p=0.004). Serum omentin levels were not correlated to urea, creatinine or CRPlevels. CONCLUSION: Omentin levels may be a biochemical indicator to detect AMI. However, further human studies are needed (Tab. 3, Fig. 3, Ref. 34).

Effects of N-acetyl cysteine on lipid levels and on leukocyte and platelet count in rats after splenectomy.

INTRODUCTION: Many of studies have shown that increased lipid levels play a significant role in the pathogenesis of atherosclerosis after splenectomy. We investigated the effects of N-acetyl cysteine (NAC) on lipid parameters and leukocyte and platelet (PLT) levels following splenectomy. MATERIALS AND METHODS: 32 Sprague-Dawley rats weighing from 200 to 250 g were placed into four experimental groups. For 42 days post-operatively, all rats were fed standard rat food and water and the rats in the first group ( n = 8) received no intraperitoneal infusion. Rats in the second group ( n = 6) were given a 50 mg/kg saline solution (SF); those in the third group ( n = 8) received 50 mg/kg NAC and the rats in the fourth group ( n = 8) were administered a 100 mg/kg NAC infusion intraperitoneally. RESULTS: All parameters other than white blood cell count were significantly different between the four groups. There were no significant differences between the control and SF groups in terms of total cholesterol and PLT levels. Triglyceride (TG), very-low-density lipoprotein (VLDL) and high-density lipoprotein (HDL) levels were significantly elevated in the SF group compared with the control rats. There was no statistically significant difference between the SF and NAC 50/100 groups in terms of low-density lipoprotein levels. Total cholesterol, TG, HDL and VLDL levels were significantly reduced and the PLT level was significantly elevated in the NAC 50 and NAC 100 groups compared with the SF group. CONCLUSION: Serum VLDL and TG levels should be monitored in patients after splenectomy. For reduction in these lipid parameters, early NAC treatment should be initiated. More prospective larger studies are needed to confirm our results.

Evaluation of patients with nasal polyps about the possible association of desmosomal junctions, RORA and PDE4D gene.

OBJECTIVES: Nasal polyposis is chronic inflammatory disease of the nasal mucosa of the nose and sinuses, often associated with chronic non-allergic rhinitis, aspirin intolerance and non-allergic asthma. The etiology of nasal polyposis is unknown. Multiple factors contribute to the development of nasal polyps including genetic predisposition. PATIENTS AND METHODS: This study was conducted on patients applied due to nasal polyps. Blood samples were collected peripheral vein and stored at 4°C until analysis for DNA extraction. Genomic DNA was extracted from peripheral blood by a standard method, samples were studied in real time PCR. All patients were evaluated about the possible association of DSG1 (rs7236477-G, 96 rxn), DSG3 (rs1941184-C, 96 rxn), PDE4D (rs1588265) and RORA (rs11071559) gene. RESULTS: 32 patients (17 male, 15 female) with nasal polyposis were included to the study. The mean age was 34.9 ± 17.7 years, ranging between 18 and 55 years. Control group was consisted with 50 healthy volunteers without a history of nasal polyp. DSG1, DSG3 and RORA values of the study group were not statistically different from control group (p > 0.05). PDE4D values of the study group were significantly different from control group (p < 0.05). CONCLUSIONS: Multiple factors contribute to the pathogenesis of nasal polyps including genetic predisposition. The PDE4D family has gained interest in the complex pathogenesis of nasal polyposis. This is likely linked to the mucosal inflammatory response.

Platelet function in euthyroid patients undergoing thyroidectomy in women.

BACKGROUND: Several studies have reported several platelet abnormalities in patients with sub-clinical or overt thyroid dysfunctions. The primary mechanism that affects the hemostatic balance is excess or deficiency of thyroid hormones. The different ways of thyroid gland to the platelet function are not yet clearly understood. The relationship between in the thyroid gland and platelet activation without thyroid hormones has not been studied yet. AIM: The aim of our study is to determine the platelet function in euthyroid patients undergoing thyroidectomy in females. PATIENTS AND METHODS: The study group includes 52 female euthyroid patients undergoing thyroidectomy. The control group consisted with 21 healthy euthyroid female. Platelet count (PC), platelet mass (PM), mean platelet volume (MPV), and platelet distribution width (PDW) were measured. PM was calculated by multiplying MPV and PLT. RESULTS: MPV (8.4 ± 1.3 versus 7.9 ± 0.8) and PDW (17.8 ± 1 versus 17.6 ± 0.8) values were similar between the two groups. CONCLUSIONS: Thyroid gland does not directly affect platelet activation. Accordingly, platelet abnormalities of thyroid disease can be considered to be independent of the underlying thyroid tissue. This finding suggests that association between thyroid diseases and platelet function is dependent on the status of thyroid hormones.

Mean platelet volume in nasal polyps.

BACKGROUND: Many studies in literature point out that inflammation related to nasal polyp is mostly dependent on eosinophils and their inflammatory products. Beside eosinophils, platelets may have a role in nasal polyp development. Platelets are involved in haemostasis, tissue repairing and inflammation. However, to our knowledge, there are no reports in the literature that study the association between platelet parameters and nasal polyps. SUBJECTS AND METHODS: Forty-three patients with nasal polyps and forty-nine healthy controls were enrolled in the study, retrospectively. Laboratory data of patients with nasal polyp were obtained at the time of diagnosis. RESULTS: There were no statistically significant differences between the two groups in terms of white blood count, haemoglobin, haematocrit and platelet count. The mean platelet volume (MPV) value of the nasal polyp group was significantly lower than the control group (p = 0.025). Mean eosinophil count was significantly elevated in the nasal polyp group compared to the control group (p < 0.001). CONCLUSIONS: Reduction in MPV may be an indicator for nasal polyp formation. Further studies with a larger study population are needed to detect the possible correlation between eosinophil count and MPV values in patients with nasal polyps.

[Interdisciplinary extremity board in the treatment of complex injuries]. / Interdisziplinäres Extremitäten-Board in der Behandlung von Komplexverletzungen.

BACKGROUND: Interdisciplinary case conferences are well-established in the field of oncology in order to provide the best possible treatment for patients with complex disease patterns which overlap several disciplines. METHODS: After studying the available literature the aims, indications, frequency, patient enrolment and documentation modalities, disciplines necessary to create the reconstruction plan and evaluation parameters of the board, were agreed in an interdisciplinary discussion among colleagues. The utilization of the extremity board and demographic features of the cases presented in the extremity board within the first 6 months were subsequently descriptively analyzed. RESULTS: The agreed primary aim of an extremity board is the timely and transparent preparation of a high-quality holistic reconstruction plan for optimized treatment of a challenging patient collective with complex injuries of the extremities. Decisive interfaces of an extremity board are the participation of interdisciplinary disciplines, established enrolment and documentation modalities and a longitudinal analysis of parameters of the acute medical treatment, the long-term function and quality of life of those affected. The patient collective so far mostly includes men under 40 years old with traumatic soft tissue defects and combined injuries. On average, reconstruction plans for 1-2 patients were approved in an interdisciplinary team per session. CONCLUSION: The extremity board serves as a platform for coordinated planning of treatment for patients with complex injuries. The limited personnel and time resources represent the greatest challenge for the successful implementation. The extremity board enables a high degree of interdisciplinary networking. The digital registration and documentation modality within the internal hospital documentation system is of utmost relevance. The preparation of the reconstruction plan is of decisive importance for the qualitative success of treatment and the restoration of function. The longitudinal analysis of appropriate parameters is imperative to measure the quality of treatment.

Combined antihypertensive treatment is better than mono-therapy in hypertensive patients.

BACKGROUND: Hypertension (HT) is a chronic condition associated with serious complications. In the present cross-sectional study, we aimed to analyse factors that contribute to blood pressure control in subjects with HT. METHODS: Subjects with HT admitted to outpatient internal medicine clinics of the institution were enrolled in the study. According to the Joint National Committee (JNC) VIII criteria, subjects with a mean blood pressure above target levels were defined as poorly-controlled hypertensive patients and others were grouped as well-controlled hypertensive patients. Clinical and laboratory parameters were compared between study groups. RESULTS: Smokers were more prevalent in the poorly-controlled HT group compared to the well-controlled HT group (p = 0.001). The number of patients who adhered to dietary and exercise recommendations were greater in well-controlled HT group than poorly-controlled HT group (p < 0.001 for both). The rate of combined therapy was greater in well-controlled HT group compared to poorly-controlled HT group (p = 0.04). CONCLUSIONS: We suggest that, in addition to dietary and exercise recommendations and smoking cessation, treatment with combination therapy could be better in reaching blood pressure targets in patients with HT.

Bilateral symmetrical adrenal hypermetabolism on FDG PET/CT due to Cushing syndrome in well differentiated neuroendocrine carcinoma.

The (18)F-FDG PET/CT scan has been suggested for whole-body imaging to identify ectopic adrenocorticotrophic hormone secreting tumours, but there are some challenges involved. The case of a patient is presented, who was admitted with the pre-diagnosis of ectopic ACTH syndrome. On the CT, a nodular lesion was detected in the medial segment of the right lung. The FDG uptake of the lesion seemed to be increased visually, but was not pathological quantitatively (SUVmax: 1.8) on the PET/CT. There was also diffuse increased uptake (SUVmax: 14.2) in the enlarged adrenal glands. The lesion was reported as a possible malignant lesion with low FDG affinity, such as a low grade neuroendocrine tumour, while the diffuse enlarged adrenal glands with high uptake were interpreted as diffusely hyperplasic, due to Cushing's syndrome. The patient was treated with a surgical wedge resection. The histopathological diagnosis confirmed that the tumour was a grade 1 well-differentiated neuroendocrine carcinoma.

HpSA fecoprevalence in patients suspected to have Helicobacter pylori infection in Istanbul, Turkey.

OBJECTIVE: This study aims to investigate the Helicobacter pylori antigen in the stool samples of patients suspected to have H. pylori infection. It also aims to determine the fecoprevalence in different age groups and to look for the relationship between the clinical symptoms seen in patients and the existence of H. pylori. Current information in Turkey is insufficient. METHODS: The Helicobacter pylori antigen was investigated in the stool samples of 445 patients of whom 148 were in the 2-15 year age group, 96 in the 16-30 year age group, 85 in the 31-40 year age group and 116 in the 41-48 year age group. The main clinical complaints of the patients (stomach pain, heart burn, indigestion, gas, nausea, vomiting, diarrhea, abdominal pain) were recorded. RESULTS: The Helicobacter pylori antigen was found in 36.6% (163/445) of the patients and in the statistical evaluation made for different age groups, a significant linear relationship was found between age and infection (chi2=14.77, p=0.002). CONCLUSION: It was found that stomach pain was seen at a higher rate in patients with H. pylori antigen compared to those without it. The difference was highly statistically significant (chi2=117.70, p<0.001, OR=20.36, 95% CI=10.56-39.27).

Evaluation of the serodia Treponema pallidum particle agglutination, the Murex Syphilis ICE and the Enzywell TP tests for serodiagnosis of syphilis.

We evaluated the Treponema pallidum haemagglutination assay (TPHA), a treponemal test, with three other treponemal tests, the Serodia T. pallidum particle agglutination assay, the Murex Syphilis ICE IgG + IgM enzyme immunoassay (EIA) and the Enzywell TP IgG + M EIA (a new rapid EIA) for use in conjunction with the rapid plasma reagin test (RPR), a non-treponemal test, for serodiagnosis of syphilis. In all, 124 serum samples were found reactive with RPR and/or TPHA after testing by the routine laboratory protocol. Twenty-three (18.5%) of them were positive only by RPR test and were evaluated as biologically false-positive, 16 were positive only by the TPHA and 84 by both the RPR and TPHA tests; one sample was non-specific (heterophile reaction) in the TPHA. Agreements of the TPHA with the Serodia TPPA, the Murex Syphilis ICE and the Enzywell TP tests were 96.7%, 100% and 99.1%, respectively. We conclude that each one of the tests, the Serodia TPPA, the Murex Syphilis ICE and the Enzywell TP, is an appropriate substitute for screening for serodiagnosis of syphilis.

Enzywell recombinant enzyme immunoassay for the serological diagnosis of syphilis.

The aim of this study was to evaluate Enzywell TP, a new rapid enzyme immunoassay (EIA) that uses 2 recombinant Treponema pallidum antigens for the serological diagnosis of syphilis. Specificity was evaluated by screening 1055 unselected bloods requesting serological tests for syphilis in parallel with Enzywell TP and the Syphilis ICE EIA which is our standard screening test for syphilis. Sensitivity was evaluated using a panel of 159 known treponemal sera representing various stages of syphilis and 5 treponemal sera detected on screening. The specificity of Enzywell TP on initial and repeat testing (99.6% and 99.7% respectively) was similar to that of the Syphilis ICE test (99.8% and 99.9% respectively). The sensitivity of Enzywell TP (100%) was similar to that of Syphilis ICE (99.4%): both tests were significantly more sensitive (P=0.01) than the fluorescent antibody absorbed test (94.5%) but not the T. pallidum particle agglutination (TPPA) assay (99.4%). Both Enzywell TP and Syphilis ICE were positive with sera from 16 known HIV-infected patients who had been treated for syphilis many years previously (mean 9.4 years) confirming the value of these tests in excluding previous syphilis in HIV-infected individuals. We conclude that the Enzywell recombinant EIA is simple, rapid, highly sensitive and specific, and is a welcome addition to the range of currently available diagnostic tests for syphilis.

Serum omentin-1 levels in diabetic and nondiabetic patients with chronic kidney disease.

BACKGROUND: Omentin-1, a novel adipokine identified in visceral adipose tissue, is negatively correlated with different conditions such as diabetes, obesity and inflammation. However, changes in serum Omentin levels associated with the degree of the renal dysfunction and metabolic risk factors in CKD patients has not yet been revealed. In the present study, we aimed to investigate the level of Omentin-1 and related para-meters in diabetic and non-diabetic CKD patients. METHODS: 64 (30 diabetic, 34 non-diabetic) CKD patients and 27 healthy control subjects enrolled in this cross-sectional study. Anthropometric and laboratory assessment performed and malnutrition and inflammation components evaluated. Serum concentrations of Omentin-1 and insulin were measured by using ELISA. RESULTS: Serum Omentin-1 levels in CKD patients were significantly lower compared to the healthy controls. Further analyze revealed that decreased omentin in CKD patients was due to the reduced omentin levels in the diabetic subgroup. An increase in inflammation and malnutrition components was correlated with a decrease in the serum level of Omentin. Omentin levels were lower in stage 2 and 3 CKD but not stage 4 CKD patients compared to control. CONCLUSIONS: The results of the present study suggest that diabetes mellitus and inflammation should be associated with lower omentin levels in CKD population; however, this reduction resolves due to the failure of degradation and excretion of omentin when creatinine clearance falls below 30 ml/min (stage 4 CKD).

Effects of the inflammatory response on serum omentin levels in early acute and chronic pancreatitis.

BACKGROUND AND AIMS: Acute pancreatitis is an acute inflammation of the parenchyma of the pancreas. Several adipokines have been investigated in acute pancreatitis, and these cytokines contribute to inflammation in acute pancreatitis. However, not enough data exist regarding omentin in injuries of the pancreas. Because of a possible common pathogenesis, we aimed to study the association between pancreatic damage and serum omentin levels. MATERIALS AND METHODS: Twenty-four Sprague Dowley rats weighing 200-250 g were randomly placed into three groups: a sham group (n=8), an acute pancreatitis group (n=8), and a chronic pancreatitis group (n=8). Both rats in the sham group underwent laparotomy, and 0.1 cc of saline solution was injected through the pancreatic canal. On the seventh day, a blood sample was obtained by abdominal aorta puncture, and the pancreas was resected for histological examination. In the acute and chronic pancreatitis groups, 0.1 cc of 4.5% Sodium Taurocholote was injected through the pancreatic canal. Blood samples were obtained and pancreatic resection was performed after 24 hours for the acute pancreatitis group and after 7 days for the chronic pancreatitis group. RESULTS: Serum omentin levels of rats with chronic pancreatitis (49.37±2.82 ng/ml) were increased compared to both acute pancreatitis (37.79±1.24 ng/ml) (p<0.01) and sham rats (22.49±1.4 ng/ml) (p<0.01). In addition, the omentin level of rats with acute pancreatitis was significantly increased compared to the sham group (p<0.01). CONCLUSIONS: The elevation in omentin levels in rats in the early stage of pancreatitis was due to the anti-inflammatory effects of omentin; hence, elevated omentin levels improved insulin resistance and caused a significant reduction in glucose levels.

Treatment of iron deficiency anemia induces weight loss and improves metabolic parameters.

BACKGROUND: The treatment of iron deficiency anemia is oral iron replacement which has side effects mostly related with gastrointestinal system. A significant rate of the patients that discontinuing the treatment complained of weight gain during treatment in our clinical practise, despite, oral iron preparations are not known to have such a side effect in adults. Therefore, we planned to investigate this myth whether iron preparations cause an increase in weight, waist circumference, body mass index and laboratory metabolic parameters that may accompany to weight gain. MATERIALS AND METHODS: Twenty-one women admitted to our out-patient clinics with iron deficiency anemia were enrolled to the study. Waist circumference, body weight, body mass index, systolic and diastolic blood pressures, hemogram and other laboratory parameters assessed and recorded at the first visit and repeated 4 to 6 moths after initiation of treatment. RESULTS: Waist circumference, body weight and BMI significantly reduced in patients after treatment compared to pre-treatment period. Moreover, HDL was increased and triglyceride was decreased significantly in after treatment compared to pre-treatment period. CONCLUSIONS: We suggest that treatment of iron deficiency may improve not only haematological but also metabolic and anthropometric parameters. Due to the small study population of our cohort, larger prospective studies are needed to confirm our results.

Could red cell distribution width be a marker in Hashimoto's thyroiditis?

AIMS: Hashimoto's Thyroiditis (HT) is the most common autoimmune thyroiditis worldwide and characterized with lymphomonocytic inflammation of the thyroid gland. Red cell distribution width (RDW) reflects erythrocyte anisocytosis and besides it increases in iron deficiency anemia, recent studies reported that RDW was also associated with conditions characterized with overt or subclinical inflammation. We aimed to answer whether RDW increased in Hashimoto's thyroiditis. METHODS: Patients with HT admitted to outpatient clinic of our hospital were included to the study. Patients with anemia (especially iron deficiency), diabetes mellitus, chronic inflammatory disease and on medication that may affect hemogram results (e. g., aspirin) excluded from the study. Patient characteristics, thyroid stimulating hormone (TSH), Free T3 (FT3), Free T4 (FT4), Anti-thyroid peroxidase (Anti-TPO), Anti-Thyroglobulin (Anti-TG), leukocyte count (WBC), Hemoglobin (Hb), Hematocrit (Htc), mean corpuscular volume (MCV), RDW and platelet count (PLT) values of the study cohort were obtained from computerized database of our institution. RESULTS: There was no significant difference between study and control groups in terms of WBC, Hb, Htc, MCV, PLT, PDW and FT3 levels. However, FT4 level was significantly lower and TSH was significantly higher in study group compared to controls. RDW was significantly increased in study group compared to control group. CONCLUSION: We suggest that elevated RDW values in patients without iron deficiency anemia may require further evaluation for HT, especially in female population.