Does systemic sclerosis affect thyroid functions? A study upholding association

Authors

  • Tasleem Arif
  • Iffat Hassan
  • Parvaiz Anwar

Keywords:

Systemic sclerosis, thyroid disorders, thyroid function tests

Abstract

Objective To study the association of clinical and subclinical thyroid dysfunction in patients of systemic sclerosis and compare with age and sex matched controls without systemic sclerosis. Methods This hospital-based study involved 56 patients of systemic sclerosis and 300 age and sex matched controls without systemic sclerosis. Thyroid function tests, such as thyroid-stimulating hormone (TSH), free tri-iodothyronine (T3), free thyroxine (T4), were advised in all cases, and anti thyroid peroxidase (anti-TPO) antibody, thyroid gland ultrasonography and fine needle aspiration cytology in selected patients only. Results Abnormal thyroid functions were found in 37.5% cases compared to 18.7% in control group, and 26.78% of cases had hypothyroidism compared to 16.7% among the controls. 21.4% patients among cases had subclinical hypothyroidism (SCH) compared to 13.33% among controls. Conclusion Thyroid dysfunctions are common in systemic sclerosis and the same should be evaluated as routine clinical profiling of patients with systemic sclerosis. 

References

Medsger TA Jr. Systemic sclerosis (scleroderma): clinical aspects. In: WJ Koopman, editor. Arthritis and Allied Conditions. 14th ed. Philadelphia: Lippincott Williams & Wilkins; 2001. pp. 1590-1624.

Black CM, Denton CP. Scleroderma and related disorders in adults and children. In: Isenberg DA, Maddison PJ, Woo P, Glass D, Breedveld FC, editors. Oxford Textbook of Rheumatology. 3rd ed. Oxford: Oxford Writing Press; 2004. pp 872-95.

Antonelli A, Fallahi P, Ferrari SM, Mancusi C, Giuggioli D, Colaci M et al. Incidence of thyroid disorders in systemic sclerosis: results from a longitudinal follow-up. J Clin Endocrinol Metab. 2013;98:198-202.

Delamer JP, Scott DL, Felix-Davies DD. Thyroid dysfunction and rheumatic diseases. J R Soc Med. 1982;75:102-6.

Antonelli A, Rotondi M, Fallahi P, Romagnani P, Ferrari SM, Paolicchi A et al. Increase of interferon-gamma inducible alpha chemokine CXCL10 but not beta chemokine CCL2 serum levels in chronic autoimmune thyroiditis. Eur J Endocrinol. 2005;152:171-7.

Antonelli A, Rotondi M, Fallahi P, Romagnani P, Ferrari SM, Buonamano A et al. High levels of circulating CXC chemokine ligand 10 are associated with chronic autoimmune thyroiditis and hypothyroidism. J Clin Endocrinol Metab. 2004;89:5496-9.

Antonelli A, Rotondi M, Ferrari SM, Fallahi P, Romagnani P, Franceschini SS et al. Interferon-gamma inducible alpha-chemokine CXCL10 involvement in Graves’ ophthalmopathy: modulation by peroxisome proliferator-activated receptor-gamma agonists. J Clin Endocrinol Metab. 2006;91:614-20.

Valentini G, Baroni A, Esposito K, Naclerio C, Buommino E, Farzati A et al. Peripheral blood T lymphocytes from systemic sclerosis patients show both Th1 and Th2 activation. J Clin Immunol. 2001;21:210-17.

Fujii H, Shimada Y, Hasegawa M, Takehara K, Sato S. Serum levels of a Th1 chemoattractant IP-10 and Th2 chemoattractants, TARC and MDC, are elevated in patients with systemic sclerosis. J Dermatol Sci. 2004;35:43-51.

Romagnani S. The Th1/Th2 paradigm. Immunol Today. 1997;18:263-6.

Morita S, Arima T, Matsuda M. Prevalence of nonthyroid specific autoantibodies in autoimmune thyroid diseases. J Clin Endocrinol Metab. 1995;80:1203-6.

Chardes T, Chapal N, Bresson D, Bes C, Giudicelli V, Lefranc MP et al. The human antithyroid peroxidase autoantibody repertoire in Graves’ and Hashimoto’s autoimmune thyroid diseases. Immunogenetics. 2002;54:141-57.

Jasani B, Ternynck T, Lazarus JH, Phillips DI, Avrameas S, Park. Natural antibody status in patients with Hashimoto’s thyroiditis. J Clin Lab Immunol. 1999;51:9-20.

Saravanan P, Dayan CM. Thyroid autoantibodies. Endocrinol Metab Clin North Am. 2001;30:315-37.

Gordon MB, Klein I, Dekker A, Rodnan GP, Medsger TA Jr. Thyroid disease in progressive systemic sclerosis: increased frequency of glandular fibrosis and hypothyroidism. Ann Intern Med. 1981;95:431-5.

Serup J, Hangdrup H. Thyroid hormones in generalized scleroderma. A controlled study. Acta Dermatol Venereol. 1986;66:35-8.

Kahl LE, Medsger TA Jr, Klein I. Prospective evaluation of thyroid function in patients with systemic sclerosis (scleroderma). J Rheumatol. 1986;13:103-7.

De Keyser L, Narhi DC, Furst DE, Huberman AK, Ross R, Clements J et al. Thyroid dysfunction in a prospectively followed series of patients with progressive systemic sclerosis. J Endocrinol Invest. 1990;13:161-9.

Molnar I, Balazs C, Szabo E, Czirjak L. Anti-thyroid antibodies and hypothyroidism in systemic sclerosis. J Endocrinol Invest. 1992;15:311.

Innocencio RM, Romaldini JH, Ward LS. Thyroid autoantibodies in autoimmune diseases. Medicina (B Aires). 2004;64:227-30.

Kucharz EJ. Thyroid disorders in patients with progressive systemic sclerosis: a review. Clin Rheumatol. 1993;12:159-61.

Gordon MB, Klein I, Dekker A, Rodnan GP, Thomas A, Medsger TA Jr. Thyroid disease in progressive systemic sclerosis: Increased frequency of glandular fibrosis and hypothyroidism. Ann Intern Med. 1981;95:431-5.

Marasini B, Ferrari PA, Solaro N, Selmi C. Thyroid dysfunction in women with systemic sclerosis. Ann N Y Acad Sci. 2007;1108:305-11.

Zulian F. Scleroderma in children. Pediatr Clin N Am. 2005;52:521-45.

Davidson J, Cleary AG, Bruce C. Disorders of bone, joints and connective tissue. In: McIntosh N, Helms PJ, Smyth RL, editors. Forfar and Arneil's Textbook of Pediatrics. 6th ed. Edinburgh, New York: Churchill Livingstone; 2003. pp 1525-89.

Regina MI, João HR, Laura SW. Thyroid autoantibodies in autoimmune diseases. Medicina (Buenos Aires) 2004;64:227-30.

Molteni M, Barili M, Eisera N, Scrofani S, Mascagni B, Zulian C et al. Anti-thyroid antibodies in Italian scleroderma patients: association of anti-thyroid peroxidase (anti-TPO) antibodies with HLA-DR15. Clin Exp Rheumatol. 1997;15:529-34.

Mourier-Clavreul MC, Rousset H, Claudy A. Scleroderma and thyroid diseases. Ann Dermatol Venereol. 1989;116:701-6.

Downloads

Published

2017-06-13

How to Cite

1.
Arif T, Hassan I, Anwar P. Does systemic sclerosis affect thyroid functions? A study upholding association. J Pak Assoc Dermatol [Internet]. 2017Jun.13 [cited 2024May19];27(1):4-9. Available from: http://jpad.com.pk/index.php/jpad/article/view/1018

Issue

Section

Original Articles

Most read articles by the same author(s)

1 2 3 > >>