الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hypothyroidism is the second most common endocrinological disease after DM. The commonest cause of hypothyroidism in iodine sufficient areas is HT. HT, along with GD comprise AITDs, however, HT is the commonest AITD. Multiple risk factors have been incriminated in the development of HT, mainly genetic, environmental, and nutritional factors.
The clinical picture of HT is insidious. Symptoms are mostly the result of transient hashitoxicosis or the eventual hypothyroidism. Diagnosis depends on the presence of anti TPO antibodies in sera of HT patients, the ultrasonographic features of HT and the histopathological characteristics of the HT thyroid tissue. Thyroid profiles give variable pictures: hyperthyroidism, euthyroidism, subclinical hypothyroidism and overt hypothyroidism.
PGRN is an anti-inflammatory marker that cleaves into proinflammatory granulins. PGRN is a neurotropic factor whose presence protects the central and peripheral nerves; it also has a role in lysosomal storage functions. Deficiency of PGRN as a result of GRN gene mutations has been proved to directly cause neurodegenerative diseases, mainly FTLD. Its deficiency has also been linked to the development of storage diseases, for example, Gaucher’s disease.
PGRN has been studied in various autoimmune diseases and the results were variable from high serum levels to low serum levels. Low PGRN levels in some autoimmune diseases were linked to the presence of high levels of neutralizing anti PGRN antibodies.
NLR and PLR have been studied as markers of inflammation. They are easily calculated, readily available and of low cost. They are also more accurate than absolute counts. Studies have shown that high levels of NLR and PLR were linked to the presence of inflammation.