PATTERN OF THYROID DYSFUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS AND ITS ASSOCIATION WITH DISEASE ACTIVITY AND DURATION

Dihingia P; Debbarma M; Baruah SM; Das TK; Dutta A; Dutta C

Volume : VI, Issue : IV, April - 2017

PATTERN OF THYROID DYSFUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS AND ITS ASSOCIATION WITH DISEASE ACTIVITY AND DURATION

Dihingia P, Debbarma M, Baruah Sm, Das Tk, Dutta A, Dutta C

Abstract :

BACKGROUND/PURPOSE: Cardiovascular complications are one of the most common comorbid conditions in rheumatoid arthritis (RA). Hypothyroidism and RA are both relatively common autoimmune diseases associated with increased Cardiovascular Disease (CVD) morbidity and mortality, further research into the interaction between these two diseases is worthwhile. Thus the study was done to determine the pattern of thyroid dysfunctions in Rheumatoid Arthritis patients. Materials & Methods: A hospital based case-control study was done among patients who were admitted or attending various Out Patient Departments of Assam Medical College and Hospital, Diugarh, Rheumatology clinic in Assam Medical College & Hospital has been enrolled. 103 patients based on the Classification Criteria for Rheumatoid Arthritis (ACR/EULAR, 2010)were taken in the study and 103 healthy volunteers were taken in the control group.Patients age less than 13 and pregnant women were excluded. Results: This study showed that thyroid dysfunction was present in 22(21.35%) patients, 12 patients had subclinical hypothyroidism and 6 had hypothyroidism, 4 patients had subclinical hyperthyroidism whereas in the control group 5 (4.85%) had thyroid dysfunction. Majority of the thyroid dysfunction patients (25%) were in the low disease activity group and amongst the Anti-CCP–/RF+ group thyroid dysfunction were observed to be the highest (33.33%) Conclusion: The study shows that abnormal thyroid function tests, particularly subclinical hypothyroidism were seen more commonly in patients with Rheumatoid Arthritis compared to controls. The presence of non-specific suggestive symptoms in a RA patient inspite of a low disease activity may be a clinical pointer to the underlying thyroid disorder requiring laboratory evaluation. Thus Physicians should be aware of screening RA patients periodically for this comorbidity, especially those who are at high risk (female gender and positive thyroid autoantibody) and accordingly manage when patients become symptomatic or develops overt hypothyroidism.