Assessing the complete blood count in Graves’ ophthalmopathy patients treated with RAI-131 in Iraq

Zena A. Khalaf; Furqan Majid Khadhem; Marwah Sabah Altaiee; Iman I. AL-Sheakli

doi:10.51248/.v43i02.2681

Authors

Zena A. Khalaf
Furqan Majid Khadhem
Marwah Sabah Altaiee
Iman I. AL-Sheakli

DOI:

https://doi.org/10.51248/.v43i02.2681

Keywords:

Complete blood count, thyroid-stimulating hormone, Graves Ophthalmopathy disease, thyroid eye disease, radioactive iodine 131

Abstract

Introduction and Aim: Graves ophthalmopathy is one of the pandemic public health disorders in Iraq. The current investigation attempts to determine the variation in the complete total blood cells on the recovery of individuals with Graves' ophthalmopathy following low and high-dose Radioactive Iodine 131 (RI-131) exposures.

Materials and Methods: The complete blood CBC level in people with Graves' illness and healthy, normal controls were quantitatively identified using the CBC counter. Thyroid stimulating hormone was utilized to compare the recovery of ophthalmopathy patients in comparison to a control group.

Results: In comparison to healthy controls, patients with Graves' ophthalmopathy disease who received 10 mci of RAI-131 had elevated lymphocyte counts (P<0.01). After one year of therapy with antithyroid drugs, lymphocyte counts rose significantly (P<0.01). In contrast, patients treated with 10 mci of RAI-131 experienced a dramatic reduction in monocytes (P< 0.01) over the course of four months. Lymphocytes, monocytes, and platelets were significantly lower in patients with ophthalmopathy after one month of therapy with 20 mci of RAI-131 compared to controls. No significant difference in red blood cells and hemoglobin levels before and after treatment with low and high doses of RAI-131 was observed.

Conclusion: Assessment of lymphocytes, monocytes, granulocytes, and platelets levels in Graves' ophthalmopathy disease patients (GD ophthalmopathy) could be used as an effective diagnostic marker for determining the most effective dose for Graves' ophthalmopathy disease treatment.

Author Biographies

Zena A. Khalaf

Department of Optics Techniques, Al-Farabi University College, Al-Dora, Baghdad, Iraq

Furqan Majid Khadhem

Department of Optics Techniques, Al-Farabi University College, Al-Dora, Baghdad, Iraq

Marwah Sabah Altaiee

Department of Chemistry, College of Education for Pure Science (Ibn Al-Hatham), University of Baghdad, Iraq

Iman I. AL-Sheakli

Department of Orthodontics, College of Dentistry, University of AL-Farahidi, Baghdad, Iraq

References

Wani, M.M., Kumar, S., Tufail, S., Wani, J.S. and Ganie, M.A. Severe Grave's Ophthalmopathy–missed for many years. Indian Journal of Endocrinology and Metabolism.2010; 14(1):31-32.

Sonda, K., Mona, R., Sofien, A., Akid, F. H.K., Saloua, B.A., Amira, T. Ocular manifestations of Graves. In Endocrine Abstracts Bioscientifica.2022; (81): 12-19.

Bartley, G.B. The epidemiologic characteristics and clinical course of ophthalmopathy associated with autoimmune thyroid disease in Olmsted County, Minnesota. Transactions of the American Ophthalmological Society. 1994; 92: 477-481.

Bahn, R.S. Graves' ophthalmopathy. New England Journal of Medicine.2010; 362(8):726-738.

Dorgalaleh, A., Mahmoodi, M., Varmaghani, B., Kia, O.S., Alizadeh, S., Tabibian, S., et al., Effect of thyroid dysfunctions on blood cell count and red blood cell indices. Iranian Journal of Pediatric Hematology and Oncology. 2013; 3(2):73-82.

Mumtaz, M., Lin, L. S., Hui, K.C., Mohd-Khir, A.S. Radioiodine I-131 for the therapy of Graves ‘disease. Malays J Med Sci. 2009;16(1):25-33.

San Miguel, I., Arenas, M., Carmona, R., Rutllan, J., Medina-Rivero, F., Lara, P. Review of the treatment of Graves' ophthalmopathy: The role of the new radiation techniques. Saudi J Ophthalmol. 2018;32(2):139-145.

8 Aung, E.T., Zammitt, N.N., Dover, A.R., Strachan, M.W., Seckl, J.R., Gibb, F.W. Predicting outcomes and complications following radioiodine therapy in Graves’ thyrotoxicosis. Clinical Endocrinology. 2019; 90(1):192-199.

Yang, F.E., Vaida, F., Ignacio, L., Houghton, A., Nautiyal, J., Halpern, H. et al., Analysis of weekly complete blood counts in patients receiving standard fractionated partial body radiation therapy. International Journal of Radiation Oncology, Biology, Physics, 1995; 33(3), 607-617.

Jafarzadeh, A., Poorgholami, M., Izadi, N., Nemati, M., Rezayati, M. Immunological and hematological changes in patients with hyperthyroidism or hypothyroidism. Clinical and Investigative Medicine. 2010; 103 (89): E271-E279.

Park, I..J., Ahn, S., Kim, Y.I., Kang, S.J.,Cho, S.R. Performance evaluation of Samsung LABGEOHC10 hematology analyzer. Archives of Pathology and Laboratory Medicine. 2014; 138(8):1077-1082.

Imam, S. K. Hyperthyroidism. In Imam, S. K., Ahmad, S. I. (Eds.).Thyroid disorders: Basic science and clinical practice.2016:147-168. Cham: Springer International Publishing.

George-Gay, B., Parker, K. Understanding the complete blood count with differential. Journal of perianesthesia nursing: official journal of the American Society of PeriAnesthesia Nurses. 2013; 18(2): 96-117.

Yang, F.E., Vaida, F., Ignacio, L., Houghton, A., Nautiyal, J., Halpern, H. et al., Analysis of weekly complete blood counts in patients receiving standard fractionated partial body radiation therapy. International Journal of Radiation Oncology* Biology* Physics. 1995 33(3),.607-617.

Shahid, S., Mahmood, N., Chaudhry, M.N., Sheikh, S., Ahmad, N. Assessment of impacts of hematological parameters of chronic ionizing radiation exposed workers in hospitals. FUUAST Journal of Biology.2014; 4(2):135-146.

Venneri, L., Rossi, F., Botto, N., Andreassi, M.G., Salcone, N., Emad, A., et al., Cancer risk from professional exposure in staff working in cardiac catheterization laboratory: insights from the National Research Council's Biological Effects of Ionizing Radiation VII Report. American Heart Journal. 2009; 157(1):118-124.

Roguin, A., Goldstein, J., Bar, O. Brain tumours among interventional cardiologists: a cause for alarm. Report of four new cases from two cities and review of the literature. Euro Intervention. 2012; 7(9):1081-1086.

Goh, B.K., Chok, A.Y., Allen Jr, J.C., Quek, R., Teo, M.C., Chow, P.K. et al., Blood neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are independent prognostic factors for surgically resected gastrointestinal stromal tumors. Surgery. 2016; 159(4):1146-1156.

Green, D.E., Rubin, C.T. Consequences of irradiation on bone and marrow phenotypes, and its relation to disruption of hematopoietic precursors. Bone. 2014; 63:87-94.

Yoshihara, A., Noh, J.Y., Inoue, K., Taguchi, J., Hata, K., Aizawa, T. et al., Prediction model of Graves’ disease in general clinical practice based on complete blood count and biochemistry profile. Endocrine Journal. 2022; 23(1): EJ21-0741.

Zahedi, M., Mirkamali, F., Hezarkhani, S., Motiee, A., Shahmirzadi, A.R., Molseghi, M.H., et al., Hematologic changes in patients with Graves? disease in Gorgan during 2014-2015. Internal Medicine and Medical Investigation Journal. 2017; 2(3): 106-108.