Prevalence of thyroid diseases and antithyroid antibodies in women with rheumatoid arthritis

Abstract

INTROduCTION Thyroid abnormal function and and/or auto immune thyroid disease (ATD) are observed in 6% to 33.8% patients with rheumatoid arthritis (RA). ObjECTIvEs The aim of the study was to determine whether ATD is more prevalent in patients with RA compared to the control group involving age and sex-matched subjects without RA and whether these patients should be screened for thyroid disease. PATIENTs ANd mEThOds In 100 patients with RA and 55 patients without RA (control group) hormonal thyroid function and antithyroid antibodies were assessed. REsuLTs ATD was more prevalent (16%) in patients with RA than in the control group (9%). The difference was no statistically significant. The RA patients with concomitant ATD had lower RA activity than non-ATD RA patients. Antithyreoglobulin (anti-TG) and antithyroid peroxidase (anti-TPO) antibodies were present in similar percentage of patients with RA (12% and 15%, respectively) and in the control group (9% and 18%, respectively). The most common thyroid dysfunction observed in both groups was subclinical hypothyroidism. An association between thyroid dysfunction and clinical symptoms suggestive of thyroid disease in RA patients was not demonstrated. In patients with RA low free triiodothyronine concentrations were significantly more common. CONCLusIONs A higher prevalence of ATD in female RA patients compared with controls indicates the need for screening not only of thyroid function, but also of the presence of anti-TPO antibodies as the ATD marker in RA patients. Their presence does not correlate with the occurrence of thyroid disorders in RA patients. Monitoring of thyroid function is of particular importance since as already shown the course of thyroid disease in RA patients is often asymptomatic. KEy wORds auto immune thyroid disease (ATD), rheumatoid arthritis (RA), thyroid antibodies ACKNOwLEdGmENTs The authors would like to thank Doctor Krzysztof Chojnowski (Clinical Department of Endocrinology Medical University Warsaw) for consultations and helpful suggestions.

Relationship between rheumatoid arthritis activity and antithyroid antibodies

“…The authors suggested that this is possible when antithyroid antibodies are produced by synovial lymphocytes in the synovial membrane affected by inflammation, which may produce antithyroid antibodies more actively and promptly than peripheral lymphocytes. 18 In their study, Przygodzka et al 19 showed that patients with both RA and ATD were characterized by lower disease activity, but that study was focused on the cooccurrence of ATD and thyroid dysfunction. On the contrary, Atzeni et al 20 concluded that antithyroid antibodies do not seem to be associated with any particular RA phenotype.…”

Assessment of left atrial mechanical functions in thyroid dysfunction

“…These hormones play a critical role in cardiac homeostasis because they can affect cardiac contractility, heart rate, diastolic function, and systemic vascular resistance through genomic and nongenomic mechanisms in both physiological and pathological conditions. [1][2][3] A decrease in thyroid function has been associated with various heart diseases such as myocardial infarction, 4 coronary atherosclerosis, 5 and congestive heart failure. 6 Previous studies have shown that the restoration of normal thyroid function can reverse abnormal cardiovascular hemodynamics.…”

Autoimmune Diseases and Thyroid Dysfunction in Rheumatoid Arthritis

“…Частота АЗЩЖ при РА в разных странах колеблется от 0,5 до 27%, еще чаще у больных РА наблюдается продук-ция органоспецифических аутоантител: аТПО (5-38%), аТГ (6-31%) [28][29][30][31][32].…”

“…Некоторые авторы не нашли доказательств роста па-тологии ЩЖ при РА по сравнению с популяцией [31,35].…”

“…Przygodska и A. Filipowicz-Sosnowska [31] не обна-ружили статистически значимых различий в частоте АЗЩЖ у пациенток с РА (16%) и здоровых женщин (9%). Из всех дисфункций ЩЖ в обеих группах преобладал суб-клинический гипотиреоз (7 и 5% соответственно).…”