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Thyroid involvement in chronic inflammatory rheumatological disorders

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Summary

The association between rheumatological and thyroid disorders has long been known, the most common being the association of rheumatoid arthritis and autoimmune thyroiditis. Little is known as to possible thyroid involvement in other rheumatological disease of possible autoimmune aetiology, such as psoriatic arthritis and ankylosing spondylitis. We measured thyroid volume and function as well as the prevalence of anti-microsome and anti-thyroglobulin antibodies in 107 consecutive patients with rheumatoid arthritis, 42 patients with psoriatic arthritis, and 12 male patients with ankylosing spondylitis. Fifty-two normal subjects were used as controls. The average thyroid volume, measured at ultrasounds, was increased in all groups of patients, and the prevalence of thyroid enlargement (A-P diameter > 20 mm) was 2–3 fold higher in rheumatological disorders in comparison to controls. Both, patients with rheumatoid arthritis and psoriatic arthritis had higher-than-normal fT4 levels and an increased prevalence of anti-microsome antibodies. In the rheumatoid arthritis group alterations in thyroid volume and function were present irrespective of disease activity, whereas in psoriatic arthritis thyroid involvement was confined to patients with active disease. Our data are consistent with a significant thyroid involvement in rheumatological disorders, which is not limited to diseases with a definite autoimmune aetiology.

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References

  1. Guerin, V., Bene, M.C., Leclere, J., Faure, G. Syndrome sec et dysthyrodies autoimmunes. Press Med 1987, 16, 638.

    Google Scholar 

  2. Buchanan, W.W., Crooks, J., Alexander, W.D., Koutras, D.A., Wayne, E.J., Gray, K.G. Association of Hashimoto's thyroiditis and rheumatoid arthritis. Lancet 1961, i, 245–248.

    Google Scholar 

  3. Guerin, V., Bene, M.C., Barbe, F., Amiel, C., Faure, C. Stigmates autoimmunitaires thyrodiens au cours de la polyarthritic reumatoide. Rev Rhum 1987, 54, 438.

    Google Scholar 

  4. Kahl, L.E., Carpenter, A.B., Medsger, T.A., Eisenbeis, C.H. Prospective evaluation of thyroid function in patients with rheumatoid arthritis (RA). Arthritis Rheum 1986, 29, S38.

  5. Kabadi, U.M. Onset of type I diabetes mellitus, hypothyroidism and hypogonadism on withdrawal of glucocorticoid therapy and remission on its resumption in a patient with rheumatoid arthritis. Am J Med 1986, 80, 139–142.

    PubMed  Google Scholar 

  6. Irvine, W.J. Studies on the citotoxic factor in thyroid disease. Br Med J 1962, 1, 1444–1449.

    Google Scholar 

  7. Kite, J.H., Rose, N.R., Kano, K., Witesby, E. Citotoxicity of human thyroid autoantibodies. Ann N Y Acad Sci 1965, 124, 626–653.

    PubMed  Google Scholar 

  8. Khoury, E.L., Hammond, L., Bottazzo, G.F., Doniach, D. Presence of the organ-specific “microsomal” autoantigen in human thyroid cell in culture: its involvement in complement-mediated citotoxicity. Clin Exp Immunol 1981, 45, 316–328.

    PubMed  Google Scholar 

  9. Baker, H. Epidemiological aspects of psoriasis and arthritis. Br J Dermatol 1966, 78, 249–261.

    PubMed  Google Scholar 

  10. Leonard, D.G., O'Duffy, J.D., Rogers III, R.S. Prospective analysis of psoriatic arthritis in patients hospitalized for psoriasis. Mayo Clin Proc 1978, 53, 511–518.

    PubMed  Google Scholar 

  11. Wahba, A. Psoriasis and epidermal disease or a systemic condition. Int J Dermatol 1981, 20, 108–109.

    PubMed  Google Scholar 

  12. Zoli, M., Iervese, T., Abbati, S., Bianchi, G.P., Marchesini, G., Pisi, E. Portal blood velocity and flow in aging man. Gerontology 1989, 35, 61–65.

    PubMed  Google Scholar 

  13. Arnett, F.C., Edworthy, S.M., Bloch, D.A., et al. The American Rheumatism Association 1987 revised criteria for rheumatoid arthritis. Arthritis Rheum 1988, 31, 315–324.

    PubMed  Google Scholar 

  14. Silman, A.J. The 1987 American Rheumatism Association criteria for rheumatoid arthritis. Br J Rheumatol 1988, 27, 341–350.

    PubMed  Google Scholar 

  15. Pinals, R.S., Masi, A.T., Larsen, R.A. Preliminary criteria for clinical remission in rheumatoid arthritis. Arthritis Rheum 1981, 24, 1308–1315.

    PubMed  Google Scholar 

  16. Bennett, R.M. Psoriatic arthritis. In: Arthritis and Allied Conditions, 11th ed. Ed.: McCarthy, D.J. Jr., Philadelphia, Lea & Febiger, 1989, 954–971.

    Google Scholar 

  17. Bianchi, G.P., Zoli, M., Marchesini G., et al. Thyroid gland size and function in patients with cirrhosis of the liver. Liver 1991, 11, 71–77.

    PubMed  Google Scholar 

  18. Bruneton, J.N. Ultrasonography of the neck, Springer-Verlag, Berlin, 1987.

    Google Scholar 

  19. Duncan, D.B. Multiple range tests for correlated and heteroscedastic means. Biometrics 1957, 13, 164–204.

    Google Scholar 

  20. Brown, M.C., Spencer, R. Thyroid gland volume estimated by use of ultrasound in addition to scintigraphy. Acta Radiologica Oncology 1978, 17, 337–341.

    Google Scholar 

  21. Ueda, D. Normal volume of the thyroid gland in children. J Clin Ultrasound 1990, 18, 455–462.

    PubMed  Google Scholar 

  22. Silman, A.J., Ollier, W.E.R., Bubel, MA. Autoimmune thyroid disease and thyroid autoantibodies in rheumatoid arthritis patients and their families. Br J Rheumatol 1989, 28, 18–21.

    PubMed  Google Scholar 

  23. Deighton, C.M., Fay, A., Walker, D.J. Rheumatoid arthritis in thyroid disease positive and negative same-sexed sibships. Br J Rheumatol 1992, 31, 13–17.

    Google Scholar 

  24. Tunbridge, W.M.G., Evered, D.C., Hall R., et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf) 1977, 7, 481–490.

    Google Scholar 

  25. Bastenie, P.A., Bonnyns, M., Vanhaelst, L. Grades of subclinical hypothyroidism in asymptomatic autoimmune thyroiditis revealed by the thyrotropin-releasing hormone test. J Clin Endocrinol Metab 1979, 51, 163–166.

    Google Scholar 

  26. Baker, J.R. Jr., Saunders, N.B., Wartofsky, L., Tseng, Y-C.L., Burman, K.D. Seronegative Hashimoto thyroiditis with thyroid autoantibody production localized in the thyroid. Ann Intern Med 1988, 108, 26–30.

    PubMed  Google Scholar 

  27. Franklyn, J.A., Fitzgerald, M.G., Oates, G.D., Sheppard, M.C. Fine needle aspiration cytology in the management of euthyroid goitre. Quart J Med 1987, 65, 997–1003.

    PubMed  Google Scholar 

  28. Cusker, C.T., Reid, B., Green, D., et al. HLA-D region antigens in patients with rheumatoid arthritis. Arthritis Rheum 1991, 34, 192–197.

    PubMed  Google Scholar 

  29. Bottazzo, G.F., Pujol-Borrell, R., Hanafusa, T., Feldman, M. Role of aberrant HLA-DR expression and antigen presentation in induction of endocrine autoimmunity. Lancet 1983, ii, 1115–1119.

    Google Scholar 

  30. Gerber, L.H., Hall, P.R., Lawley, T.J. IgA immune complexes in patients with psoriatic arthritis. Arthritis Rheum 1982, 25, S73.

    Google Scholar 

  31. Espinoza, L.R., Gaylord, S.W., Boccanegra, T.S., et al. Circulating immune complexes in the seronegative spondylarthropathies. Clin Immunol Immunopathol 1982, 22, 384–393.

    PubMed  Google Scholar 

  32. Fyrand, O., Mellbye, O.J., Natvig, J.B. Immunofluorescence studies for immunoglobulins and complement C3 in synovial joint membranes in psoriatic arthritis. Clin Exp Immunol 1977, 29, 422–427.

    PubMed  Google Scholar 

  33. Trentham, D.E., Kammer, G.M., McCune, W.J. Autoimmunity to collagen: a shared feature of psoriatic and rheumatoid arthritis. Arth Rheum 1981, 24, 1363–1368.

    Google Scholar 

  34. Murray, C., Mann D.L., Gerber L.N., et al. Histocompatibility alloantigens in psoriasis and psoriatic arthritis. Evidence for the influence of multiple genes in the major histocompatibility complex. J Clin Invest 1980, 66, 670–675.

    PubMed  Google Scholar 

  35. Espinoza, L.R., Vasey, F.B., Gaylord, S.W., et al. Histocompatibility typing in the seronegative spondyloarthropathies: A survey. Semin Arth Rheum 1982, 11, 375–381.

    Google Scholar 

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Bianchi, G., Marchesini, G., Zoli, M. et al. Thyroid involvement in chronic inflammatory rheumatological disorders. Clin Rheumatol 12, 479–484 (1993). https://doi.org/10.1007/BF02231775

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