Endocrine Abstracts

Introduction: In hypothyroidism bone turnover and osteoclastic resorption will be reduced which also aggravates Rheumatoid arthritis (RA) symptoms. In the literature shown data about relationship between RA and thyroid dysfunction. We aimed to discuss some possible causes and triggers that interplay in both conditions based on data from the literature.

Material and methods: Data analysis was done using the systematic search performed in PubMed, MEDLINE, Scopus, Web of Science database of the articles published during the past 5 years related to RA and thyroid disorders. Main factors to consider were age, gender, cortisol, TSH, T4, T3, anti-TPO.

Results: Combined data from 250 patients with RA were checked for thyroid dysfunction and anti-TPO positivity. Thyroid dysfunction were found in 84 (33.9%), in which 60 (24.2%) cases have prior history of thyroid diseases. Anti-TPO was positive in 77 (32.0%) cases. The frequency of AITD was 52 (21.5%) in cases. The autoimmune Hashimoto’s thyroiditis was 2.77 times more common in RA patients than in those without RA. It was reported that occurrence of thyroid pathology in Rheumatoid Arthritis patients is 34%, while specifically the range of Hashimoto’s Thyroiditis is 13, 5%. 75% of RA patients were women from 20-39 years and the incidence of hypothyroidism in this group were 3.6 times greater than men had. Tumor necrosis factor-α and interleukin-6, that involved in inflammatory process in RA can exacerbate the dyslipidemia in hypothyroidism. Inflammation leads to deteriorated lipid profiles and low HDL levels. Interestingly, antithyroglobulin antibodies were found in synovial fluid of 34 from 54 patients with Rheumatoid Arthritis. Steroid therapy can lead to hypothyroid state, increasing TSH and inhibiting T4 to T3 conversion. Endocrine changes in young women (puberty, pregnancy, childbirth, and abortion) considered as a risk factors.

Conclusion: Understanding the link between RA and thyroid dysfunction will be helpful in primary prevention, early detection, management, and diminishing further complications of these interconnected diseases in patients at risk. RA patients should be screened for thyroid diseases. Patients with thyroid diseases with increasing of thyroid autoantibody level, in particular Hashimoto’s thyroiditis should be screened for other autoimmune conditions, such as RA.