Mercado U, Mercado H

Language: Spanish
References: 10
Page: 703-707
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ABSTRACT

Background: Systemic autoimmune diseases including rheumatoid arthritis can coexist with organ-specific autoimmune diseases.
Objective: To report a case series of rheumatoid arthritis patients who developed autoimmune thyroid disease (Hashimoto’s thyroiditis, Graves’ disease).
Material and Method: A retrospective study was done from January to December 2017 including patients with rheumatoid arthritis and autoimmune thyroid disease. Rheumatoid arthritis was assessed according to the diagnostic criteria of 2010 (ACR/ EULAR).
Results:There were identified 26 cases with rheumatoid arthritis and an autoimmune thyroid disease. In 14 cases rheumatoid arthritis was the initial manifestation and in 12 the initial manifestation was hypothyroidism or Graves’ disease (GD). All the patients (females, median age: 46) had symmetrical polyarthritis of hands, wrists and knees. In total, serology was positive for rheumatoid factor (21), anti-cyclic citrullinated peptide antibody (11), anti-thyroid peroxidase antibody (21) and elevated levels of TSH in 15 cases. In 5 cases, hyperthyroidism was the initial feature. Palpable abnormality of the thyroid gland was present in 5 cases. The treatment consisted on synthetic thyroid hormones, radioactive iodine therapy, thyroid surgery and disease modifying drugs.
Conclusion: In this case series, the most common cause of hypothyroidism was Hashimoto’s thyroiditis preceding or following rheumatoid arthritis.

REFERENCES

1. Aletha D, Neogi T, Silman AJ, Funovitis J, Felson DT, Bingham CO, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum 2010;62:2569-81. doi: 10.1002/art.27584.

2. Tomer Y, Huber A. The etiology of autoimmune thyroid disease: A story of genes and environment. J Autoimmun 2009; 32:231-239. doi: 10.1016/j.jaut.2009.02.007.

3. Roitt IM, Doniach D, Campbell PN, Hudson RV. Autoantibodies in Hashimoto’s disease (lymphadenoid goitre); preliminary communication. Lancet 1956;2:820-821. DOI: 10.1016/s0140-6736(56)92249-8.

4. Rapoport B, McLachlan SM. Thyroid autoimmunity. J Clin Invest 2001;108:1253-1259. doi: 10.1172/JCI14321.

5. Chistiakov DA. Immunogenetics of Hashimoto’s thyroiditis. J Autoimmun Dis 2005;2:1. doi: 10.1186/1740-2557-2-1.

6. Antonelly A, Ferrari SM, Corrado A, Di Domenicantonio A, Fallahi P. Autoimmune thyroid disorders. Autoimmun Rev 2015;14:174-80. doi: 10.1016/j.autrev.2014.10.016.

7. Frohlich E, Wahl R. Thyroid autoimmunity: role of anti-thyroid antibodies in thyroid and extra-thyroidal diseases. Frontiers Immunol 2017;8:1-14. doi: 10.3389/ fimmu.2017.00521.

8. Caturegli P, De Remiges A, Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmun Rev 2014;13:391-7. doi: 10.1016/j.autrev.2014.01.007.

9. Molina EA, Molina MJ. Desórdenes tiroideos autoinmunes en artritis reumatoidea. ¿Factores etiopatogénicos interrelacionados? Rev Arg Reumatol 2011;22:30-39.

10. Latif S, Jamal A, Memon I, Yasmee S, Tressa V, Shaikh S, et al. Multiple autoimmune syndromes: Hashimoto’s thyroiditis. coeliac disease and systemic lupus erythematosus (SLE). J Pak Med Ass 2010;60:863-865.