Hypothyroidism in patients with rheumatoid arthritis and its activity

• Published in: Egyptian Rheumatology and Rehabilitation Vol. 41; no. 2; pp. 58 - 65
• Main Authors: al-Attar, Inas A., Mubashir, Samih A., Taqwah, Yunus B.
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt The Egyptian Society for Rheumatology and Rehabilitation 2014
• Subjects: Autoimmune thyroiditis; Diagnosis; Hypothyroidism; Rheumatoid arthritis; التشخيص
• ISSN: 1110-161X; 2090-3235

-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.