Hemostatic defects in response to aspirin challenge in hypothyroidism

A patient with hypothyroidism had ingested aspirin and bled profusely following dental extraction. The only abnormalities noted on coagulation survey were a prolonged aspirin bleeding time and reduced retention of platelets on glass beads. Based on this index case, an additional 12 hypothyroid patie...

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Bibliographic Details
Published inAmerican journal of hematology Vol. 23; no. 4; p. 391
Main Authors Zeigler, Z R, Hasiba, U, Lewis, J H, Vagnucci, A H, West, V A, Bezek, E A
Format Journal Article
LanguageEnglish
Published United States 01.12.1986
Subjects
Aspirin
Bleeding Time
Blood Coagulation Disorders - etiology
Blood Platelets - metabolism
Hemostasis
Humans
Hypothyroidism - blood
Hypothyroidism - complications
Hypothyroidism - physiopathology
Platelet Aggregation
Serotonin - metabolism
Thrombin - physiology
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Summary:A patient with hypothyroidism had ingested aspirin and bled profusely following dental extraction. The only abnormalities noted on coagulation survey were a prolonged aspirin bleeding time and reduced retention of platelets on glass beads. Based on this index case, an additional 12 hypothyroid patients, on no medications, were evaluated for a mild bleeding disorder, including studies with aspirin challenge. The results indicate that thrombin-induced platelet serotonin release, following aspirin ingestion, was subnormal in most hypothyroid patients. However, only hypothyroid individuals with TSH levels of greater than 60 microU/ml have an increased hemostatic sensitivity to aspirin, as measured by the bleeding time test. These findings did not appear to result from decreased synthesis of the factor VIII-von Willebrand factor complex. As this drug is commonly ingested, the effects of aspirin on bleeding may explain the easy bruising and menorrhagia that occur in hypothyroid individuals.
ISSN:0361-8609
DOI:10.1002/ajh.2830230411