The association of thyroid dysfunction with chronic plaque psoriasis: A hospital-based retrospective descriptive observational study

Rana, Ashwani; Mahajan, Vikram K.; Chauhan, Pushpinder S; Mehta, Karaninder S; Sharma, Satya Bhushan; Sharma, Abha; Sharma, Reena

doi:10.4103/idoj.idoj_432_19

Cited by 4 publications

(2 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Wu et al [ 6 ] found an extremely low prevalence of 0.01% in a large sample size. The other studies demonstrated results of thyroid profile in psoriasis, which were at variance with our results [ 7 - 13 ].…”

Section: Discussioncontrasting

confidence: 61%

“…Some studies also found a significant prevalence and association of AITD in psoriatic patients. Thyroid dysregulation and autoimmunity were responsible factors in psoriasis [ 7 , 12 ]. Biochemical markers of thyroid autoimmunity, i.e., anti-TG or anti-TPO Ab positivity or thyroiditis diagnosed by ultrasonography, were significantly higher and more frequent in patients with psoriatic arthropathy [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Autoimmune Thyroid Disease in Psoriasis Patients: A Case-Control Study

Prashant,

Garg,

Kataria

et al. 2023

Cureus

View full text Add to dashboard Cite

Introduction: Psoriasis is a common immunologically mediated inflammatory disease characterized by skin inflammation, epidermal hyperplasia, an increased risk of painful and destructive arthritis, cardiovascular morbidity, and psychosocial challenges. Some autoimmune diseases are mediated by stimulating or blocking auto-antibodies. Auto-antibodies may act as antagonists and bind to hormone receptors, blocking receptor function. It may result in impaired secretion of mediators and gradual dysfunction of the affected organ, e.g., Graves disease and myasthenia gravis. Objective: This study was planned to evaluate the association between anti-thyroid peroxidase antibody (anti-TPO Ab) and anti-thyroglobulin antibody (anti-TG Ab) as biochemical markers in 30 clinically diagnosed psoriasis patients. Materials and methods: This hospital-based, epidemiological case-control study was conducted in the Department of Biochemistry in collaboration with the Department of Dermatology, Venereology, and Leprology at Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India. Thirty subjects diagnosed clinically with psoriasis and an equal number of age-matched controls with no known autoimmune disease from the outpatient department were also enrolled. The following hormonal tests, i.e., thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), and antibodies, anti-TPO Ab and anti-TG Ab, were performed. The study period was one year. The data thus obtained was analyzed using SPSS Statistics version 26.0 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp). The significance level (p-value) was taken as <0.05. Results: The mean age of psoriasis subjects was 37.83±12.89 years compared to 36.91±12.32 years in the control group and was found to be non-significant (p=0.432), reflecting a similar age distribution. A male preponderance was observed in the present study, where the psoriasis group consisted of 80% males and 20% females, while the control group had 60% males and 40% females. All six psoriasis patients diagnosed with autoimmune thyroid disease (AITD) were euthyroid at the time of enrollment, compared to only one control subject in a subclinical hypothyroid state. The mean values of anti-TPO Ab were 30.93±41.26 IU/mL in psoriasis patients and 11.39±28.42 IU/mL in the control group (p=0.001), while the mean values of anti-TG Ab were 11.21±27.69 IU/mL in psoriatic subjects and 2.49±9.05 IU/mL in the control group (p=0.004). No significant correlation between AITD and psoriasis was found when both parameters were analyzed statistically for correlation; even when one marker was considered, no significant correlation was found. The odds ratio was calculated to find an association between the disease and thyroid autoimmunity. The odds ratio was estimated to be 2.25 for psoriasis and the control group, with a confidence interval of 95% (0.77-6.59) and a p-value of 0.139, which was not statis...

show abstract

Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Autoimmune Thyroid Disease in Psoriasis Patients: A Case-Control Study

Prashant,

Garg,

Kataria

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

Cardiomyopathy and echocardiographic abnormalities in Indian patients with psoriasis: Results of a pilot study

et al. 2020

View full text Add to dashboard Cite

Background The relationship between psoriasis and cardiomyopathy is understudied in Indian patients. Objective We evaluated psoriasis patients for cardiomyopathy and other echocardiographic abnormalities. Methods About 98 (M:F = 67:31) patients with mild to moderate psoriasis aged 18‐75 years (mean ± SD = 42.12 ± 12.79 years) having no pre‐existing metabolic syndrome and cardiovascular disorders were studied. X‐ray chest, electrocardiogram and echocardiography were performed and interpreted by cardiologist for size of the left and right ventricles, left ventricle ejection fraction, diastolic function, pulmonary artery pressure and valve abnormality/regurgitation and their severity as per current guidelines/recommendations. The cardiomyopathies were defined according to standard diagnostic guidelines. Results Echocardiographic abnormalities were noted in 13 (13.3%) patients aged 19‐75 years (mean ± SD = 43.30 ± 15.71 years). The left ventricular diastolic dysfunction (grade 1) was observed in nine patients (moderate severe psoriasis in four patients) and one of them also had concentric left ventricular hypertrophy; a precursor of restrictive cardiomyopathy. Mild tricuspid valve regurgitation was present in other four patients. There was no statistically significant difference in age, gender, duration and the severity of psoriasis when compared with patients having normal echocardiography. The mitral or aortic valves, pulmonary artery pressure, mid‐right‐ventricular diameter and the left atrial volume showed no abnormality. Conclusions Psoriasis perhaps plays a role in left ventricular dysfunction and possibly cardiomyopathy even with moderately severe disease and in the absence of clinical symptoms. However, these observations need to be interpreted with caution in the absence of any statistically significant difference between age, gender, duration and severity of psoriasis in the patients having normal and abnormal echocardiography.

show abstract

Conundrum for Psoriasis and Thyroid Involvement

Cira

Cârșote

Nistor

et al. 2023

IJMS

View full text Add to dashboard Cite

Strategies concerning thyroid anomalies in patients confirmed with psoriasis, either on clinical level or molecular levels, and their genetic findings remain an open issue. Identification of the exact subgroup of individuals that are candidates to endocrine assessments is also controversial. Our purpose in this work was to overview clinical and pathogenic data concerning psoriasis and thyroid comorbidities from a dual perspective (dermatologic and endocrine). This was a narrative review of English literature between January 2016 and January 2023. We included clinically relevant, original articles with different levels of statistical evidence published on PubMed. We followed four clusters of conditions: thyroid dysfunction, autoimmunity, thyroid cancer, and subacute thyroiditis. A new piece of information in this field was the fact that psoriasis and autoimmune thyroid diseases (ATD) have been shown to be related to the immune-based side effects of modern anticancer drugs—namely, immune checkpoint inhibitors (ICP). Overall, we identified 16 confirmatory studies, but with heterogeneous data. Psoriatic arthritis had a higher risk of positive antithyroperoxidase antibodies (TPOAb) (25%) compared to cutaneous psoriasis or control. There was an increased risk of thyroid dysfunction versus control, and hypothyroidism was the most frequent type of dysfunction (subclinical rather than clinical), among thyroid anomalies correlated with >2-year disease duration, peripheral > axial and polyarticular involvement. With a few exceptions, there was a female predominance. Hormonal imbalance included, most frequently, low thyroxine (T4) and/or triiodothyronine (T3) with normal thyroid stimulating hormone (TSH), followed by high TSH (only one study had higher total T3). The highest ratio of thyroid involvement concerning dermatologic subtypes was 59% for erythrodermic psoriasis. Most studies found no correlation between thyroid anomalies and psoriasis severity. Statistically significant odds ratios were as follows: hypothyroidism: 1.34–1.38; hyperthyroidism: 1.17–1.32 (fewer studies than hypo); ATD: 1.42–2.05; Hashimoto’s thyroiditis (HT): 1.47–2.09; Graves’ disease: 1.26–1.38 (fewer studies than HT). A total of 8 studies had inconsistent or no correlations, while the lowest rate of thyroid involvement was 8% (uncontrolled studies). Other data included 3 studies on patients with ATD looking for psoriasis, as well as 1 study on psoriasis and thyroid cancer. ICP was shown to potentially exacerbate prior ATD and psoriasis or to induce them both de novo (5 studies). At the case report level, data showed subacute thyroiditis due to biological medication (ustekinumab, adalimumab, infliximab). Thyroid involvement in patients with psoriasis thus remained puzzling. We observed significant data that confirmed a higher risk of identifying positive antibodies and/or thyroid dysfunction, especially hypothyroidism, in these subjects. Awareness will be necessary to improve overall outcomes. The exact profile of individuals diagnosed with psoriasis who should be screened by the endocrinology team is still a matter of debate, in terms of dermatological subtype, disease duration, activity, and other synchronous (especially autoimmune) conditions.

show abstract

The association of thyroid dysfunction with chronic plaque psoriasis: A hospital-based retrospective descriptive observational study

Cited by 4 publications

References 42 publications

Autoimmune Thyroid Disease in Psoriasis Patients: A Case-Control Study

Autoimmune Thyroid Disease in Psoriasis Patients: A Case-Control Study

Cardiomyopathy and echocardiographic abnormalities in Indian patients with psoriasis: Results of a pilot study

Conundrum for Psoriasis and Thyroid Involvement

Contact Info

Product

Resources

About