Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 13:18:11795514251349337.
doi: 10.1177/11795514251349337. eCollection 2025.

Platelet Indices and RDW to Assess Inflammatory Milieu in Subclinical Hashimoto's Thyroiditis

Aly Elkholy  1 , Alaa Efat  1 , Sabry Shoeib  1 , Ahmed Salah  2 , Marwa Tahoon  3 , Hytham Reda Badr  4
Affiliations

Platelet Indices and RDW to Assess Inflammatory Milieu in Subclinical Hashimoto's Thyroiditis

Aly Elkholy et al. Clin Med Insights Endocrinol Diabetes. .

Abstract

Background: Serum thyrotropin levels rise above normal while thyroid hormone levels remain within normal ranges, indicating subclinical hypothyroidism. PLT and MPV levels significantly increase in AITD patients; PLT levels are higher in hypothyroidism and Hashimoto's disease, whereas MPV levels are higher in hyperthyroidism and Graeve's disease. An increased MPV and other abnormal platelet values lead to a higher incidence of cardiovascular events. The aim was to evaluate RDW and platelet indices in Egyptian patients with subclinical Hashimo's thyroiditis using high-sensitivity CRP Hs-CRP as an indicator of inflammation.

Methods: Data for patients (60 patients) with subclinical Hashimoto's thyroiditis who visited the Menoufia University Hospital, Internal Medicine outpatient clinic included. We measured RDW, MPV, PDW, PC, LPCR, (FT3), (FT4), (TSH), lipid profile, Hs-CRP, and Antithyroid antibodies. According to Antithyroid antibodies positivity the 60 patients subdivided into 3 groups 1 (negative for Abs), 2 (positive to 1 Ab), and 3 (positive for both Abs).

Results: Among our patients 40 (66.7%) tested positive for anti-thyroglobulin Abs while 36 (60.0%) tested positive for antiperoxidase Abs. RDW, MPV, and LPCR demonstrated positive significant correlations with serum Hs-CRP levels. The study revealed negative significant correlations between TSH levels and PDW and between T4 levels and MPV.

Conclusion: Early diagnosis of Hashimoto's thyroiditis can be supported by platelet indices and RDW as diagnostic tools and these markers can also offer prognostic insights into disease severity and complications to help initiate timely treatment for hypothyroidism and prevent atherosclerotic cardiovascular disease.

Keywords: Hashimoto; RDW; autoimmune; indices; inflammation; thyroiditis.

Plain language summary

CBC indices and inflammatory milieu in Hashimoto’s thyroiditis A frequent autoimmune disease that affects the thyroid gland is called Hashimoto’s thyroiditis. Early on, it might not exhibit obvious symptoms; this is referred to as subclinical Hashimoto’s thyroiditis. Even in this early stage, though, the body may exhibit certain changes that point to inflammation, which is the body’s reaction to injury or stress. In this study, we examined a few basic blood test indicators that may indicate inflammation. Measurements of red blood cells and platelets, which are microscopic cells involved in clotting, are among them. In particular, we looked at platelet indices such mean platelet volume, as well as red cell distribution width RDW, a measure of variation in red blood cell size. An established indicator of inflammation, a blood plasma protein called hs-CRP, was also tested. Sixty patients with subclinical Hashimoto’s thyroiditis were studied. According to our findings, greater levels of the inflammatory plasma protein hs-CRP were substantially correlated with RBCs anisocytosis RDW, and platelet indices MPV, and LPCR. This implies that the body may already be experiencing low-grade inflammation even when thyroid hormone levels are only slightly off. These blood indicators have the potential to be helpful for early identification and monitoring because they are simple to measure and already included in standard blood tests. Our findings suggest that people with early thyroid problems might already be at risk for inflammation-related complications, and that these simple markers could help doctors assess that risk. However, the study had some limitations, such as the small number of participants and the lack of a healthy control group. More research on larger populations is needed to confirm our results. In summary, our study highlights the potential value of RDW and platelet indices as early indicators of inflammation in subclinical Hashimoto’s thyroiditis.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Similar articles

See all similar articles

References

    1. Vanderpump MP. The epidemiology of thyroid disease. Br Med Bull. 2011;99:39-51. - PubMed
    1. Hollowell JG, Staehling NW, Flanders WD, 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):489-499. - PubMed
    1. Diez JJ, Iglesias P. Spontaneous subclinical hypothyroidism remission: a prospective study. J Clin Endocrinol Metab. 2004;89(4):4890-4897. - PubMed
    1. Bremner AP, Feddema P, Leedman PJ, et al. Age-related changes in thyroid function: a longitudinal study of a community-based cohort. J Clin Endocrinol Metab. 2012;97(5):1554-1562. - PubMed
    1. Andersen S, Pedersen KM, Bruun NH, Laurberg P. Narrow individual variations in serum T4 and T3 in normal subjects: a clue to the understanding of subclinical thyroid disease. J Clin Endocrinol Metab. 2002;87(3):1068-1072. - PubMed

LinkOut - more resources