Rheumatic manifestations of euthyroid, anti-thyroid antibody-positive patients

Abstract

The aim of this study is to define the rheumatic manifestations of euthyroid patients with chronic lymphocytic thyroiditis (CLT) but without a well-defined connective tissue disease. Forty-six consecutive patients with anti-thyroid peroxidase (αTPO) and/or anti-thyroglobulin antibodies (αTG), and normal thyroid function in the absence of a well-defined connective tissue disease were included in a case-cohort study. Arthralgias were a presenting complaint in 98 % of patients. Fibromyalgia syndrome was found in 59 % of patients. Raynaud's phenomenon occurred in 28 % and sicca symptoms in 26 % of patients. Two patients had seronegative arthritis resembling rheumatoid arthritis. Arthritis was radiographically present in 88 %, affecting the spine in 45 % of patients. Thyroid-stimulating hormone (TSH) levels positively correlated with levels of αTPO, but not with erythrocyte sedimentation rate (ESR) or αTG levels. A positive ANA was found in 24 % of patients. One patient developed subclinical hypothyroidism during the study. Rheumatic manifestations frequently occur in patients with CLT in the absence of overt thyroid dysfunction and mimic the presentation of the well-defined connective tissue diseases.

Prevalence of thyroid autoantibodies in patients with systematic autoimmune rheumatic diseases. Cross-sectional study

“…2 Arthralgia and even arthritis of small joints such as the wrist and hand are found in patients with thyroid autoimmunity without concomitant connective tissue disease. 7,35 Punzi et al 47 observed antimicrosomal antibodies in the synovial fluid of patients one year prior to antibody detection in serum, and one year prior to the diagnosis of hypothyroidism.…”

“…3 Nearly all Hashimoto thyroiditis patients have high serum concentrations of antibodies against one or more thyroid antigens that are produced by lymphocytic infiltrate in the thyroid gland or, to a small extent, by regional lymph nodes or bone marrow. 4 Hypothyroidism and rheumatic diseases share common clinical findings such as arthralgias, arthritis, myalgias, myopathy and fatigue, [6][7][8] which need to be correctly diagnosed to be properly treated. Knowing the degree of association between rheumatic and thyroid diseases may help the clinician to make the correct decision.…”

Association of antithyroid peroxidase antibody with fibromyalgia in rheumatoid arthritis

“…Similarly, ATD has been linked independently with fibromyalgia and chronic widespread pain (CWP) [16,17]. This expands the argument that autoimmune thyroiditis itself may exert immunological sequelae beyond the confines of the thyroid gland [15].…”

Autoimmune Diseases and Thyroid Dysfunction in Rheumatoid Arthritis

“…Tagoe и соавт. [19] у 98% пациентов с антителами к гормонам ЩЖ и нормальным уровнем ТТГ встречались полиартралгии, а у 26% -синовит суставов кистей и/или лучезапястных суставов. При этом достовер-ные диагнозы каких-либо определенных РЗ были отверг-нуты ревматологами у всех больных.…”

“…Однако нередко в крови больных АЗЩЖ обнаруживаются и дру-гие антитела, в том числе РФ, антинуклеарный фактор, антитела к Ro [18][19][20]. При ДТЗ аутоантитела способны стимулировать тиреоциты, что приводит к развитию ги-пертиреоза.…”