Heba Sayed Assal1,
Ashraf Elsherbiny1, Ahmed
Alsayed1, Mohamed Abdel
Maaboud2, Hesham alShabrawi3, Enas Abdel Rasheed4
1Internal Medicine Department, National Research Center,
Cairo-Egypt;
2Internal Medicine Department,Faculty of Medicine,
Ain-shams University, Cairo-Egypt;
3Internal Medicine Department, Ahmed Maher Teaching
Hospital, Cairo-Egypt;
4Clinical and Chemical Pathology Department, National
Research Center, Cairo-Egypt
Background. Alterations in the circulating thyroid hormone
concentrations constituting the euthyroid sick syndrome (ESS) are frequently
associated with systemic non-thyroidal diseases such as systemic connective
tissue disease (SCTD).
Aim. to elucidate the pattern of thyroid dysfunction in patients with
SCTD.
Subjects and Methods. Thirty patients with systemic lupus
erythematosus (SLE) and thirty rheumatoid arthritis (RA) patients in
addition to 30 healthy age- and sex- matched controls were recruited from
the Internal Medicine Department of Ain- Shams University Hospital. Thyroid
stimulating hormone (TSH), thyroid hormones including T3 and T4,
antithyroglobulin antibodies (ATGAb), thyroid peroxidase antibodies (TPOAb),
ESR, RF, ANA, LE cells and CRP were determined.
Results. 46.6 percent of SLE patients showed thyroid dysfunction
compared to 16.6% of RA (P<0.05). In SLE group, 20% had euthyroid sick
syndrome, 16 % had hypothyroidism (10% subclinical and 6% overt), and 9% had
hyperthyroidism (3% subclinical and 6% overt). However in RA, 13% had
hypothyroidism (10% subclinical and 3% overt) and 3% had subclinical
hyperthyroidism. TPOAb was found in 16% of SLE and 6% in RA patients. Also
ATGAb was found in 6% of SLE and 30% in RA patients and 10% of controls, but
the titers were higher in the patients.
Conclusion. Thyroid dysfunction was common in patients with SCTD and
they were associated with antithyroid antibodies.
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