Rheumatic Manifestations of Autoimmune Thyroid Disease: The Other Autoimmune Disease

Abstract

Autoimmune thyroid disease (AITD) is an inflammatory thyroiditis that in some cases is characterized by lymphocytic infiltration of the thyroid gland, also referred to as chronic lymphocytic thyroiditis or Hashimoto thyroiditis. Hashimoto thyroiditis is one of the commonest causes of hypothyroidism. Hypothyroidism has been associated with osteoarthritis (OA) and inflammatory forms of arthritis and with several well defined connective tissue diseases, which in turn can cause arthritis. The presence of arthritis in patients with AITD with normal thyroid function is now being increasingly recognized. There is also considerable evidence to suggest that AITD is highly associated with fibromyalgia syndrome. We review the current literature on the rheumatologic manifestations of AITD and describe the features in its presentation that set it apart from other forms of autoimmune arthritis.

Fibromyalgia has a high prevalence and impact in cardiac failure patients

“…FM occurs in higher rates in patients with chronic disease, including rheumatological illnesses such as rheumatoid arthritis and systemic lupus erythematosus (11). It is also found in higher prevalence coexisting with other chronic disorders including hepatitis B and hepatitis C, thyroid disease, and diabetes (12)(13)(14)(15).…”

A 50-year Revisit of the Initiation and Associations of Hashimoto’s Disease: Might Findings Conform to a Concept of Multifactorial Physiopathologic Transitions?

“…One of our early reports 18 was the first reference in a detailed review of disease associations in AITD 33 , used to cite their text statement, "The many potential problems that beset studies of disease associations were clearly described over 30 years ago 1 : ...." Space limitations do not permit a review of the numerous potential design faults in association studies 13,16,17,18 , particularly Berkson's bias 34 , which could apply to the large number of putative associations with HD 1,10,33,35 . Our early detailed clinical and pathological study of 74 autopsied cases of HD (including diffuse chronic thyroiditis) failed to show a higher overall association with additional autoimmune disorders than a carefully matched set of postmortem patients 17 .…”

“…Tagoe, et al have comprehensively reviewed rheumatic disorders associated with autoimmune thyroid disease (AITD) in The Journal 1 . The spectrum of AITD was defined as including Graves' disease and chronic (nonfocal) lymphocytic thyroiditis, which incorporates Hashimoto's disease (HD) 2 .…”

“…This commentary attempts to modernize perspectives from clinical-epidemiological investigations conducted 5 decades ago, which had remained dormant, until reawakened by the recent review 1 . New research offers support for a multifactorial physiopathogenic concept of HD.…”

“…New research offers support for a multifactorial physiopathogenic concept of HD. Such a broadened framework includes the basis for documented ameliorating effects of thyroxine therapy, and enables questions that promise to increase understanding of host predisposing factors and associated medical disorders 1 .…”