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Year : 2014  |  Volume : 41  |  Issue : 2  |  Page : 58-65

Hypothyroidism in patients with rheumatoid arthritis and its relation to disease activity

1 Department of Physical Medicine, Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt
2 Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Enas A. Elattar
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Postal code: Cairo Elshorok city 11957
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-161X.132458

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Background and objective The relationship between thyroid disease and rheumatic disorders has been the subject of considerable debate. Thyroid abnormal function and/or autoimmune thyroid disease were observed in patients with rheumatoid arthritis (RA), which could be attributed to the natural feature of autoimmune diseases and their tendency to overlap. Consideration of the fact that autoimmunity plays a role in the pathogenesis of both RA and hypothyroidism has raised the need to study the frequency of hypothyroidism and thyroid antibodies in RA patients and their relation to disease activity. Patients and methods One hundred and fifty RA patients and 50 control participants were included in this study. RA patients were subjected to a full assessment of medical and rheumatological history, and examination as well as routine lab tests. Patients and controls underwent thyroid function testing including thyroid antibodies. Patients' disease activity was determined using the Modified Disease Activity Score and their functional status was assessed using the Modified Health Assessment Questionnaire. Results The most common thyroid dysfunction was hypothyroidism, which was found in 36 (24%) RA patients, followed by subclinical hypothyroidism in six (4%) patients, whereas subclinical hyperthyroidism was present in two (1.3%) patients. Autoimmune thyroid disease was present in 10 (6.6%) patients and absent in the controls. There was a significant positive correlation between thyroid stimulating hormone levels and RA disease activity parameters. Conclusion Hypothyroidism was the most common thyroid disorder associated with RA, present in 24%, with a significant association with RA disease activity parameters.

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