Hematological Abnormalities and Associated Factors Among Patients with Hypothyroidism at the University of Gondar Comprehensive Specialized Hospital

Abstract

Objective

Abnormalities in blood cells are frequently associated with thyroid hormone disorders as a result of their involvement in the proliferation and production of blood cells. This study aimed to determine the magnitude and associated factors of hematological abnormalities in patients with hypothyroidism.

Methods

A cross-sectional study was conducted from January 1 to June 30, 2023, at the University of Gondar Comprehensive Specialized Hospital. The present study included a total of 300 patients with hypothyroidism prospectively using the systematic random sampling technique. The hematological parameter data were collected using data extraction sheets, whereas the associated factor data were collected using both structured questionnaires and data extraction sheets. For complete blood cell counts, 4 mL of anticoagulated venous blood was collected and analyzed. The data were entered into Epi-data version 3.1 and analyzed with Stata version 14. Both bivariate and multivariate logistic regressions were performed to identify factors associated with hematological abnormalities. A P value < 0.05 was considered to indicate statistical significance.

Results

The median value of red blood cell, hemoglobin, mean cell volume, white blood cell, and platelet were 4.63 x10¹²/µL, 14 g/dL, 84.3fl, 5.3 x10³/µL, and 228, respectively. The overall incidences of anemia, leucopoenia, and thrombocytopenia in patients with hypothyroidism were 26.3% (95% confidence interval (CI): 21–32), 15.7% (95% CI: 14.2–17.2), and 9% (95% CI: 7.5–10.5), respectively. Lymphopenia was detected in 9% (95% CI: 8.6–10.1) of the patients, and neutropenia was detected in 6% (95% CI: 4.4–7.6) of the patients. Only three factors, female sex (adjusted odds ratio (AOR) =2.1, 95% CI=1.3–3.1), alcohol consumption (AOR= 3.8, CI=1.7–8.9), and febrile illness (AOR=2.7, 95% CI=1.3–5.4), were found to be significantly associated factors for anemia.

Conclusion

The present study revealed heterogeneous hematological abnormalities in patients with hypothyroidism. Thus, early diagnosis and monitoring strategies are required to minimize complications in patients.

Keywords:

• hematological abnormalities
• anemia
• leucopenia
• thrombocytopenia
• thyroid dysfunction

Abbreviations

CBC, Completed Blood Count; Hb, Hemoglobin; Hct, Hematocrit; MCH, Mean corpuscular hemoglobin; MCHC, Mean corpuscular hemoglobin concentration; MCV, Mean corpuscular volume; MPV, Mean platelet volume; PDW, Platelet distribution width; RBCs, Red blood cells; RDW, Red cell distribution width; SOP, Standard Operational Procedure; T3, Triiodothyronine; T4, Thyroxine; TSH, Thyroid stimulating hormone; WBC, White blood cells; WHO, World Health Organization.

Data Sharing Statement

All the data supporting these findings are contained within the manuscript.

Consent to Participate and Ethical Approval

We confirm that all the procedures were performed in accordance with the Helsinki Declaration’s principles. Ethical approval was obtained from the Ethical Review Committee of the School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, the University of Gondar (SBLS/194/2015). The objective and purpose of the study were explained to the medical directors, and permission was obtained to collect the data. Written informed consent was obtained from each adult study participant to collect the data. Besides, written informed consent was obtained from the child’s parent or legal guardian and oral assent was obtained from children under 18 years of age after explaining the risks and benefits of the study. No unauthorized person had access to the collected data. The findings of this study are linked to the responsible bodies.

Acknowledgments

Special thanks to all the study participants for their willingness to participate and for providing the necessary information during the data collection. Finally, we thank University of Gondar for financial support.

Author Contributions

All authors made a significant contribution to the study reported whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation or all the areas: took part in drafting, revising, critically reviewing the article: gave final approval of the version to be published: have agreed on the journal to which the article to which the article has been submitted and agreed to accountable for all aspects of the work.

Disclosure

The authors declare that there are no conflicts of interest regarding the publication of this manuscript.

Additional information

Funding

The authors declare that the University of Gondar provided financial support for this work with funding number of 10124. Funder has no other role in this study.