Prevalence of hypothyroidism in rheumatoid arthritis and its correlation with disease activity

Joshi, Prakash; Agarwal, Abhishek; Vyas, Sony; Kumar, Ravindra

doi:10.1177/0049475515627235

Cited by 28 publications

(21 citation statements)

References 20 publications

(30 reference statements)

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“…[ 10 ] Our results also confirmed that there was no association between presence of thyroid disorders in RA patients and age, and also IgM RF; however, we think that small difference between our results and Shiroky et al's results was caused by methodological or laboratory analysis differences. Our results were in line with a recent study by Joshi et al [ 24 ] and illustrated that there was a significant correlation between disease activity (at the time of diagnosis) and thyroid disorders among RA patients. A population-based, case-control study (1998 adult cases vs 2252 controls) by Bengtsson et al [ 25 ] revealed that patients treated with thyroxin (hypothyroidism) were at double risk of both anti-CCP negative (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.5–3.1) and anti-CCP positive (OR 1.9, 95% CI 1.4–2.6) RA.…”

Section: Discussionsupporting

confidence: 94%

Thyroid disorders in patients with newly diagnosed rheumatoid arthritis is associated with poor initial treatment response evaluated by disease activity score in 28 joints-C-reactive protein (DAS28-CRP)

Emamifar¹,

Hangaard

Hansen

2017

Medicine

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To determine the prevalence of thyroid disorders among newly diagnosed rheumatoid arthritis (RA) patients and evaluate the association between clinical characteristics of RA and thyroid disorders, and also initial treatment response in the RA patients with thyroid disorders.Newly diagnosed, adult RA patients who were diagnosed according to the new 2010 American College of Rheumatology/European League Against Rheumatism criteria since January 1, 2010, were included. Patients’ demographic data, serology results including immunoglobulin M rheumatoid factor (IgM RF), anticyclic citrullinated peptide antibody (anti-CCP), and antinuclear antibody (ANA), and also disease activity score in 28 joints-C-reactive protein at the time of diagnosis and after 4 months (±1–2 months) of treatment initiation were extracted from Danish Danbio Registry. Patients’ electronic hospital records for the past 10 years were reviewed to reveal if they had been diagnosed with thyroid disorders or they had abnormal thyroid test.In all, 439 patients were included, female 60.1%, mean age 64.6 ± 15.0 years and disease duration 2.6 ± 1.7 years. Prevalence of thyroid disorders was 69/439 (15.7%) and hypothyroidism was the most frequent disorder (30.4%). The presence of thyroid disorders among RA patients was significantly associated with female sex (P < .001), ANA positivity (P = .04), and anti-CCP ≥100 EU/mL (P = .05). Furthermore, RA patients with thyroid disorders had significantly poorer initial response to RA treatment compared with patients with isolated RA after 4 months of treatment (P = .02). There were no associations between thyroid disorders and age, disease duration, and also IgM RF positivity.Presence of thyroid disorders in RA patients is suggestive of a more aggressive disease and poor outcome, with direct effect on initial treatment response. To diagnose concurrent thyroid disorders at an earlier stage, routine measurement of serum thyroid-stimulating hormone is recommended in all RA patients at the time of diagnosis and with yearly interval thereafter.

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Section: Discussionsupporting

confidence: 94%

Thyroid disorders in patients with newly diagnosed rheumatoid arthritis is associated with poor initial treatment response evaluated by disease activity score in 28 joints-C-reactive protein (DAS28-CRP)

Emamifar¹,

Hangaard

Hansen

2017

Medicine

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“…16 we measured the disease activity using DAS-ESR score and VAS and we found significant correlation between serum levels of TSH and disease activity parameters (ESR and DAS-28), as did the study by Elattar et al 3 The comparison between two groups created in patients based on presence or absence of thyroid dysfunction showed disease activity parameters such as the visual analogue scale for pain, patients' global health assessment score, tender joint count, DAS-28 and ESR were significantly higher in patients of thyroid dysfunction group as compared to patients of normal thyroid functions. Swollen joint count was also higher in first group but this difference was not statistically significant the results where correlating with study done by Prakash Joshi et al 17…”

Section: Discussionsupporting

confidence: 83%

Effect of thyroid dysfunction on disease activity of patients with rheumatoid arthritis

et al. 2019

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Background: Rheumatoid arthritis (RA) is a chronic autoimmune systemic inflammatory multisystem disease of unknown cause that may affect many tissues and organs, but principally attacks synovial joints, primarily affecting the peripheral joints in a symmetrical pattern. The pathology of the disease process often leads to destruction of articular cartilage. It is the commonest inflammatory arthropathy worldwide with a gender predilection towards women. Prevalence of RA in the adult general population is approximately 1%. An association between RA and thyroid dysfunction with or without autoimmune origin has been reported in 6% to 34% of patients with RA. On the contrary, when presence of thyroid antibodies is considered, despite normal thyroid function, the prevalence can rise up to about 38%. These rates are significantly greater when compared with the general population.Methods: RA patients who were diagnosed according to the new 2010 EULAR/ACR criteria and thyroid function tests were done and patients with thyroid dysfunction were identified and then patients were divided into two groups based on presence of thyroid dysfunction with rheumatoid arthritis and disease activity was illustrated in both groups based on different scales.Results: In all, 250 patients 215 (86.8%) were females and 33 (13.2%) were males. ESR was elevated in 85 (34%) patients while as it was normal in 165(66%) patients. CRP was positive in 127 (52.7%) negative in 123 (47.3%) patients. Although subclinical hypothyroidism was the most frequent abnormality observed in 38.3% patients, only 30% had concomitant anti-TPO raised and 71.4% patients of overt hypothyroidism had raised anti-TPO antibody. Disease activity parameters were significantly higher in patients of RA with hypothyroidism as compared to other group. Although most of parameters of disease activity showed a higher frequency in the group having patients with thyroid disorder but the swollen joint count was comparable in both the groups and was not statistically significant.Conclusions: Presence of thyroid disorders in RA patients is suggestive of a more aggressive disease. To diagnose concurrent thyroid disorders at an earlier stage, routine measurement of serum thyroid- stimulating hormone is recommended in all RA patients at the time of diagnosis and with yearly interval thereafter.

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“…It has been estimated that onethird of the genetic risk for RA resides within this locus. Most, but probably not all, of this risk is associated with allelic variation in the HLA-DRB1 gene, which encodes the MHC II β-chain molecule [4] thus common genetic predisposition between AITD and RA could be one of the reason for there co existence in many patients.In this study prevalence of rheumatoid arthritis among 200 hypothyroid patient was found to be 24.5% including 18.5% of females and 6% males which is supported by study conducted by other authors too [5,6] Osteoarthritis (OA) isn't caused by immune system issues. Emerging evidence has identified genetic mutations that confer a high risk of OA, the best replicated is a polymorphism within the growth differentiation factor 5 gene.…”

Section: Introductionsupporting

confidence: 69%

Prevalence of Musculoskeletal Manifestations among Primary Hypothyroid Patient in North India

Singh¹

2018

jmscr

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Prevalence of hypothyroidism in rheumatoid arthritis and its correlation with disease activity

Abstract: Thyroid function test should be included in clinical evaluation of RA patients.

Cited by 28 publications

References 20 publications

Thyroid disorders in patients with newly diagnosed rheumatoid arthritis is associated with poor initial treatment response evaluated by disease activity score in 28 joints-C-reactive protein (DAS28-CRP)

Thyroid disorders in patients with newly diagnosed rheumatoid arthritis is associated with poor initial treatment response evaluated by disease activity score in 28 joints-C-reactive protein (DAS28-CRP)

Effect of thyroid dysfunction on disease activity of patients with rheumatoid arthritis

Prevalence of Musculoskeletal Manifestations among Primary Hypothyroid Patient in North India

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