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Thyroid dysfunction in patients with systemic lupus erythematosus (SLE): relation to disease activity

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Abstract

We examined the prevalence of thyroid dysfunction and the production of anti-thyroid antibodies (ATA) in patients with systemic lupus erythematosus (SLE) and assessed the association between ATA production and SLE disease activity status. Seventy-seven patients who met the American College of Rheumatology classification criteria for SLE participated in the study. Fifty-two individuals served as a control group. Demographic, clinical information and SLE disease activity (SLEDAI) status were collected from all patients. The sera of all participants were tested for free thyroxine (FT4), thyroid-stimulating hormone (TSH), anti-thyroglobulin (ATg) and anti-thyroid peroxidase (TPO). A SLEDAI score of ≥6 was considered clinically significant. The results of the thyroid function tests and ATA were compared between the study group and the control group. ATA levels were compared between the patients with a SLEDAI score of ≥6 to those with a SLEDAI score of <6. Hypothyroidism was detected in 11.6% of SLE patients compared to 1.9% in the control group. None of the patients or controls had evidence of hyperthyroidism. No statistically significant difference was observed in the levels of ATg or TPO between the study group and the control group. No correlation was found between ATA levels and the degree of the disease activity. Among the different variables tested in this study, hypothyroidism was the only significant abnormal finding in SLE patients. No association was found between the SLEDAI score and the prevalence of ATA production. Larger controlled, longitudinal studies are necessary to confirm these findings and elucidate the role played by ATA in the pathogenesis of thyroid dysfunction in SLE patients.

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References

  1. Lorber M, Gershwin ME, Shoenfeld Y (1994) The coexistence of systemic lupus erythematosus with other autoimmune diseases: the kaleidoscope of autoimmunity. Semin Arthritis Rheum 24:105–113

    Article  PubMed  CAS  Google Scholar 

  2. Tektonidou MG, Anapliotou M, Vlachayiannopoulos P, Moutsopoulos (2004) Presence of systemic autoimmune disorders in patients with autoimmune thyroid diseases. Ann Rheum Dis 63:1159–1161

    Article  PubMed  CAS  Google Scholar 

  3. Goh KL, Wang F (1986) Thyroid disorders in systemic lupus erythematosus. Ann Rheum Dis 45:579–583

    PubMed  CAS  Google Scholar 

  4. Byron MA, Mowat AG (1987) Thyroid disorders in systemic lupus erythematosus. Ann Rheum Dis 46:174–175

    Article  PubMed  CAS  Google Scholar 

  5. Konstadoulakis MM, Kroubouzos G, Toska A, Piperingos G, Marafelia P, Konstadoulakis M et al (1993) Thyroid autoantibodies in the subsets of lupus erythematosus: correlation with other autoantibodies and thyroid function. Thyrology 5:1–7

    CAS  Google Scholar 

  6. Miller WF, Moore GF, Weintraub BD, Steinberg AD (1987) Prevalence of thyroid disease and abnormal thyroid function test results in patients with systemic lupus erythematosus. Arthritis Rheum 30:1124–1131

    Article  PubMed  CAS  Google Scholar 

  7. Vianna JL, Haga HJ, Asherson RA, Swana G, Hughes GRV (1991) A prospective evaluation of antithyroid antibody prevalence in 100 patients with systemic lupus erythematosus. J Rheumatol 18:1193–1195

    PubMed  CAS  Google Scholar 

  8. Chan ATY, Al-Saffar Z, Bucknall RC (2001) Thyroid disease in systemic lupus erythematosus and rheumatoid arthritis. Rheumatology 40:353–354

    Article  PubMed  CAS  Google Scholar 

  9. Pyne D, Isenberg DA (2002) Autoimmune thyroid disease in systemic lupus erythematosus. Ann Rheum Dis 61:70–72

    Article  PubMed  CAS  Google Scholar 

  10. Kausman D, Isenberg DA (1995) Thyroid autoimmunity in systemic lupus erythematosus: the clinical significance of a fluctuating course. Br J Rheumatol 34:361–364

    Article  PubMed  CAS  Google Scholar 

  11. Chan ATY, Al-Saffar Z, Bucknall RC (2001) Thyroid disease in systemic lupus erythematosus and rheumatoid arthritis. Rheumatology 40:353–354

    Article  PubMed  CAS  Google Scholar 

  12. Weetman AP, Walport MJ (1987) The association of autoimmune thyroiditis with systemic lupus erythematosus. Br J Rheumatol 26:359–361

    Article  PubMed  CAS  Google Scholar 

  13. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, Scaller JG, Talal N, Winchester RJ (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271–1277

    Article  PubMed  CAS  Google Scholar 

  14. Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725

    Article  PubMed  CAS  Google Scholar 

  15. Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH (1992) Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum 35:630–640

    Article  PubMed  CAS  Google Scholar 

  16. Gladman DD, Urowitz MB, Kagal A, Hallett D (2000) Accurately describing changes in disease activity in systemic lupus erythematosus. J Rheumatol 27:377–379

    PubMed  CAS  Google Scholar 

  17. Biro’ E, Szekanecz Z, Czirja’k L, Danko’ K, Kiss E, Szabo’ NA et al (2006) Association of systemic and thyroid autoimmune diseases. Clin Rheumatol 25:240–245

    Article  Google Scholar 

  18. Blich M, Rozin A, Edoute Y (2004) Systemic lupus erythematosus and thyroid disease. Isr Med Assoc J 6:218–220

    PubMed  Google Scholar 

  19. Kaercher Kramer C, Freitas Tourinho T, Pedro de Castro W, da Costa Oliviera M (2005) Association between systemic lupus erythematosus, rheumatoid arthritis, hyperprolactinemia and thyroid autoantibodies. Arch Med Res 36:54–58

    Article  CAS  Google Scholar 

  20. Ronchezel MV, Len CA, Castro AS, Sacchetti S, Lourenzi VM, Ajzen S, Tufik S, Hilario MOE (2001) Thyroid function and serum prolactin levels in patients with juvenile systemic lupus erythematosus. J Pediatr Endocrinol Metab 14:165–169

    PubMed  CAS  Google Scholar 

  21. Park DJ, Cho CS, Lee SH, Park SH, Kim HY (1995) Thyroid disorders in Kprean patients with systemic lupus erythematosus. Scand J Rheumatol 24:13–17

    PubMed  CAS  Google Scholar 

  22. Yoshida H, Amino N, Yagawa K, Uemura K, Satoh M, Miyai K, Kumahara Y (1978) Association of serum antithyroid antibodies with lymphocytic infiltration of the thyroid gland: studies of seventy autopsied cases. J Clin Endocrinol Metab 46:562–569

    Article  Google Scholar 

  23. Groves GJ, Howells RD, Williams S, Darke C, Parkes AB (1990) Primary standardization for the ELISA of serum thyroperoxidase and thyroglobulin antibodies and their prevalence in normal Welsh population. J Clin Lab Imunol 32:147–151

    CAS  Google Scholar 

  24. Nordyke RA, Gilbert FI, Miyamoto LA, Fleury KA (1993) The superiority of antimicrosomal antibodies over antithyroglobulin antibodies for detecting Hashimoto thyroiditis. Arch Intern Med 153:862–865

    Article  PubMed  CAS  Google Scholar 

  25. Vanderpump MPJ, Tunbridge WMG, French JM, Appleton D, Bates D, Cklark F, Evans JG, Hasan DM, Rodgers H, Tunbridge F, Young ET (1995) The incidence of thyroid disorders in the community: a twenty-year follow-up of the whickham survey. Clin Endocrinol 43:55–68

    CAS  Google Scholar 

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Authors and Affiliations

  1. Rheumatic Disease Unit, Ha’emek Medical Center, Afula, 18101, Israel

    Reuven Mader, Samer Mishail & Muhammed Adawi

  2. Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel

    Idit Lavi

  3. Endocrine Institute, Ha’Emek Medical Center, Afula, Israel

    Rafael Luboshitzky

  4. The B. Rappaport Faculty of Medicine, The Technion, Haifa, Israel

    Reuven Mader & Rafael Luboshitzky

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  1. Reuven Mader
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  2. Samer Mishail
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  3. Muhammed Adawi
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  4. Idit Lavi
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  5. Rafael Luboshitzky
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Correspondence to Reuven Mader.

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Mader, R., Mishail, S., Adawi, M. et al. Thyroid dysfunction in patients with systemic lupus erythematosus (SLE): relation to disease activity. Clin Rheumatol 26, 1891–1894 (2007). https://doi.org/10.1007/s10067-007-0602-5

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  • DOI: https://doi.org/10.1007/s10067-007-0602-5

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