Thyroid Dysfunction in Patients with Antineutrophil Cytoplasmic Antibody–associated Vasculitis: A Monocentric Retrospective Study

Kim, Jae Yeon; Park, Yong Bum; Lee, Sang Won

doi:10.3899/jrheum.181270

Cited by 3 publications

(5 citation statements)

References 10 publications

(13 reference statements)

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“…Patients with TD prior to the diagnosis of AAV were more likely to be female and MPO-ANCA+, as reported in previous studies. [15][16][17][18] Our findings also reflect common clinical and laboratory findings of lower inflammation and fewer general symptoms in patients with MPO-ANCA. 40 Data of individuals with established AAV who are later diagnosed with TD are scarce.…”

Section: Discussionsupporting

confidence: 74%

“…In agreement with Kermani et al, 18 we found no significant differences in renal involvement with respect to presence of TD, although differences have been reported. [15][16][17] We observed significantly better renal survival and a tendency towards greater overall survival in patients with TD at AAV diagnosis. Even after adjustment for covariates such as MPO-ANCA and age at diagnosis, TD remained associated with better outcome.…”

Section: Discussionmentioning

confidence: 61%

“…This is comparable to what has been reported in previous studies. [15][16][17] There are previous reports of elevated TSH and lower T3 concentrations in chronic kidney disease, 49 the focus of this study has been on the clinical diagnosis of TD. Paradoxically, the individuals with prior TD have less risk of ESKD in our study.…”

Section: Discussionmentioning

confidence: 99%

“…12 Studies have revealed increased presence of TD in AAV, both prior to 13 14 and following the AAV diagnosis. [15][16][17][18][19] While antithyroid drugs such as propylthiouracil (PTU) or methimazole (MMI) can trigger myeloperoxidase (MPO)-AAV, several reports have directly linked TD to AAV. [20][21][22][23][24] We aimed to investigate aspects of TD in patients diagnosed with AAV using cohorts from Sweden 25 26 and the UK.…”

Section: What This Study Addsmentioning

confidence: 99%

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Thyroid disease in ANCA-associated vasculitis: a clinical and epidemiological study

Wilding,

Smith,

Jayne

et al. 2024

RMD Open

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ObjectivesTo describe clinical and laboratory characteristics and outcomes in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and thyroid disease (TD). We also aimed to calculate incidence and identify predictors of TD in two large cohorts of patients with AAV.MethodsThe study comprised 644 patients with AAV in a population-based cohort from southern Sweden (n=325) and a cohort from a specialised vasculitis centre in Cambridge, UK (n=319). Diagnosis and classification of AAV and TD were confirmed by medical record review. Person-years (PY) of follow-up were calculated from AAV diagnosis to the earliest of TD, death or the end of study. Cox-regression analysis was employed to study predictors of TD.ResultsAt AAV diagnosis, 100 individuals (15.5%, 77 females) had TD, 59 had myeloperoxidase (MPO)-ANCA+ and 34 had proteinase-3 (PR3)-ANCA+. Patients with TD tended to have lower C reactive protein, lower haemoglobin and fewer constitutional symptoms. Survival and renal survival was greater in those patients with AAV with pre-existing TD. During 4522 PY of follow-up, a further 29 subjects developed TD, yielding an incidence rate of 641/100 000 PY. No analysed factor predicted de novo TD in AAV. The prevalence of TD among patients with AAV in southern Sweden was 18%.ConclusionTD is a common comorbidity in AAV, affecting nearly one in five. While TD diagnosis is more common in females and MPO-ANCA+, these factors do not predict de novo TD after initiation of AAV treatment, necessitating monitoring of all patients with AAV with respect to this comorbidity.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: What This Study Addsmentioning

confidence: 99%

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Thyroid disease in ANCA-associated vasculitis: a clinical and epidemiological study

Wilding,

Smith,

Jayne

et al. 2024

RMD Open

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“…In the current study, the prevalence of hypothyroidism in AAV patients was 31.6%. Prior studies reported an incidence of hypothyroidism ranging from 4% to 20% in AAV patients, and it was strongly associated with positive MPO-ANCA [15][16][17]19]. In the present study, 68.39% of the included patients were MPO-ANCA-positive, and this might contribute to the higher prevalence of thyroid dysfunction in the patients of the present study than that of patients in previous reports.…”

Section: Discussionsupporting

confidence: 45%

Analysis of Thyroid Function in ANCA-Associated Vasculitis Patients with Renal Injury

Yu,

Wang,

et al. 2024

JPM

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Background: Previous studies indicated common thyroid dysfunction in various kidney diseases. This study aimed to investigate the thyroid function in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) with renal injury. Methods: Briefly, 174 patients diagnosed as having AAV with renal injury and without previous thyroid disease history were included in the retrospective and prospective study. The clinical parameters were collected and compared between different groups. Results: Of the patients included, 24 exhibited normal thyroid function, while 150 had thyroid dysfunction, including 55 (36.67%) with hypothyroidism. Those AAV patients with thyroid dysfunction showed different clinical parameters from those with normal thyroid function. The patients were followed up for a median of 68.6 (64.3; 72.8) months. Those with thyroid dysfunction were more prone to progressing to dialysis dependence compared to the group with normal thyroid function. Logistic regression analysis showed advanced age and decreased albumin as independent risk factors for thyroid dysfunction in patients with AAV. Survival analysis and multivariate Cox regression analysis showed that thyroid dysfunction was a risk factor for AAV patients with renal injury to progress to the endpoint of dialysis dependence. Conclusion: Thyroid dysfunction, predominantly hypothyroidism, was commonly complicated in AAV patients with renal injury. AAV patients with thyroid dysfunction were presented with different clinical parameters and more prone to progressing to dialysis dependence compared to those with normal thyroid function.

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Hypothyroidism in vasculitis

et al. 2021

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Objective To study the prevalence, risk and clinical associations of hypothyroidism among several forms of vasculitis. Methods Patients with GCA, Takayasu’s arteritis (TAK), PAN and the three forms of ANCA-associated vasculitis [AAV; granulomatosis with polyangiitis (GPA), microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (EGPA)] enrolled in a prospective, multicentre, longitudinal study were included. Results The study included data on 2085 patients [63% female, 90% White] with a mean age of 54.6 years (S.d. 17.2). Diagnoses were GCA (20%), TAK (11%), PAN (5%), GPA (42%), microscopic polyangiitis (8%) and EGPA (14%). Hypothyroidism was present in 217 patients (10%) (83% female), with a mean age 59.8 years (S.d. 14.5). Age- and sex-adjusted risk of hypothyroidism was GCA, odds ratio (OR) 0.61 (95% CI 0.41, 0.90); TAK, OR 0.57 (95% CI 0.31, 1.03); PAN, OR 0.59 (95% CI 0.25, 1.38); GPA, OR 1.51 (95% CI 1.12, 2.05); microscopic polyangiitis, OR 1.81 (95% CI 1.18, 2.80) and EGPA, OR 0.82 (95% CI 0.52, 1.30). Among patients with AAV, age- and sex-adjusted risk of hypothyroidism was higher with positive MPO-ANCA [OR 1.89 (95% CI 1.39, 2.76)]. The clinical manifestations of vasculitis were similar in patients with and without hypothyroidism, except transient ischaemic attacks, which were more frequently observed in patients with GCA and hypothyroidism (12% vs 2%; P = 0.001). Conclusions Differences in the risk of hypothyroidism among vasculitides may be due to genetic susceptibilities or immune responses. This study confirms an association of hypothyroidism with MPO-ANCA.

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Thyroid Dysfunction in Patients with Antineutrophil Cytoplasmic Antibody–associated Vasculitis: A Monocentric Retrospective Study

Cited by 3 publications

References 10 publications

Thyroid disease in ANCA-associated vasculitis: a clinical and epidemiological study

Thyroid disease in ANCA-associated vasculitis: a clinical and epidemiological study

Analysis of Thyroid Function in ANCA-Associated Vasculitis Patients with Renal Injury

Hypothyroidism in vasculitis

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