Endocrine Abstracts

Introduction: The association of thyroid nodules and connective tissue diseases (CTD) is not uncommon. The purpose of our work was to describe the clinical, biological and ultrasound characteristics of thyroid nodules during CTD.

Materials and methods: It was a retrospective study (2015–2019) including records of patients with CTD and thyroid nodule in an internal medicine department at Ben Arous regional hospital. Informations regarding thyroid function tests and imaging were recorded.

Results: We included eight female patients among patients presenting connective tissue disease (4% of connective tissue disease which are Sjôgren’ Syndrom (n = 127), Rheumatoid arthritis (n = 35), Scleroderma (n = 17), systemic lupus erythematosus (n = 22) and inflammatory myositis (n = 4)). The thyroid nodule was diagnosed at a mid age of 54 years old. The diagnosis of CTD and thyroid pathology was done concomitantly in four cases. Seven patients had Sjogren syndrome and one had rheumatoid arthritis. The circumstance of nodule discovery was accidental (n = 4), in front of clinical thyroid dysfunction (n = 2), biological thyroid dysfunction (n = 1) and in another case the nodule was palpable. Four cases were associated with hypothyroidia while the rest patients were in a clinical and biological euthyroid state. Immunologic testing was performed in these four patients and thyroperoxidase antibodies were positive in one case. The diagnostic means was in all cases thyroid ultrasound. The number of nodules was an average of two. The size was less than one centimeter in half of the cases and exceeded one centimeter in the rest with a maximum size of 2.4 cm. The nodules were bilateral in one case, isthmic in another, lower site in the rest of patients. Two thirds of the cases were classified as Eutirads 3, one third as Eutirads 2. All nodules were monitored with a good evolution after 1.9 years follow-up.

Conclusion: Thyroid nodules are a common pathology. Their presence during CTD can be a manifestation of the disease or a simple association. Physiopathology is not yet clear. That’ why it is necessary to search them in front of CTD so that we won’t miss a nodule which can hide a carcinoma.