Süleyman BÜYÜKBERBER, Murat TURGAY, Orhan ŞENCAN, Nuhmehmet BÜYÜKBERBER, Erbil BAŞEŞME

Abnormal thyroid function test results in systemic lupus erythematosus

Sistemik lupus eritematozuslu (SLE) 33 hasta (30 kadın, 3 erkek) ve kontrol grubu olarak 16 sağlıklı bireyin (15 kadın, 1 erkek) tiroid fonksiyon testleri ve anti-mikrozomal antikor (anti-M) düzeyleri çalışıldı. SLE'li 33 hastanın 3'ünde ve 16 kontrol bireyinin l'inde anti-M pozitifti ve iki grup arasında istatistiksel yönden fark yoktu. SLE'li hastaların 4'ünde hipotiroidi bulunurken, kontrol grubundakilerin tümü de ötiroiddi. SLE'li hastalardaki hipotiroidi oranı kontrol grubuna göre anlamlı şekilde daha yüksekti. SLE'li hastalardaki total ve serbest T3 ve total ve serbest T4 düzeyleri kontrol grubu ile karşılaştırıldığında anlamlı olarak daha düşük, TSH düzeyi ise daha yüksekti. Sonuç olarak, SLE'li hastalarda kontrol grubu ile karşılaştırıldığında, hipotiridi ve "ötiroid sick sendromu" (ESS) insidansı daha yüksekti. Hipotiroidili 4 hastanın 3 'ünde bulunan anti-M pozitifliği istatistiksel olarak anlamlı olmasa da, SLE 'li hastalarda otoimmün tiroid hastalığının sık görüldüğünü düşündürmektedir. [Turgut Özal Tıp Merkezi Dergisi 1996;3(2):80-84J

Sistemik lupus eritematozusda anormal tiroid fonksiyon testi sonuçları

Thyroid function tests and anti-microsomal antibody (anti-M) levels of 33 patients (30 female, 3 male) with systemic lupus erythematosus (SLE) and 16 healthy subjects (15 female, 1 male) were studied as control group. Anti-M was positive in 3 of 33 patients with SLE and in 1 of 16 control subjects, and there were no statistically significant differences between two groups. There were hypothyroidism in 4 of SLE patients and all of the control subjects were euthyroid. Hypothyroidism rate in SLE patient was significantly higher when compared to the control group. Total and free T3 levels and total and free T4 levels of SLE patients group were significantly lower and TSH levels were significantly higher when compared to the control group. In conclusion, hypothyroidism and "euthyroidsick syndrome" (ESS) incidence were high inpatients with SLE, when compared to the control group. Although there was no statistically significant difference for anti-M positivity in 3 of 4 patients with hypothyroidism suggests that autoimmune thyroid disease is a frequent finding in SLE patients. [Journal of Turgut Özal Medical Center 1996; 3 (2): 80-84]

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1. Kyle V, Hazleman BL. The thyroid. Clin Rheum Dis. 1981; 7:711-22.
2. Karsh C, Pavlidis N, Weintraub BD, Moutsopoulos HM. Thyroid disaese in Sjögren’s syndrome. Arthritis Rheum 1980; 23:1326-9.
3. Jonsson H, Nived O, Sturfelt G. Thyroid disorders in systemic lupus erythematosus are associated with secondary Sjögren’s syndrome (letter). Ann Rheum Dis 1987; 46:349.
4. Jonsson H, Nived O, Sturfelt G.Symptomatic secondary Sjögren’s syndrome in patients with systemic lupus erthematosus. Scand J Rheumatol (Suppl) 1986; 61:166-9.
5. Buchanan WW, Crooks J, Alexander WD, Koutras DA, Wayne EJ, Gray KG. Association of Hashimoto’s thyoiditis and rheumatoid arthritis. Lancet 1961; 1:245-8.
6. Thomas DJB, Young A, Gorsuch AN, Bottazzo GF, Cudworth AG. Evidence for an assocition between rheumatoid arthritis and autoimmune endocrine disease. Ann Rheum Dis 1983; 42:297-300.
7. Wahlberg P, Nyman D, Carlsson SA. 25 year follow-uo the Aland thyroid study of 1956. Thyroid status and incidence of rheumatoid arthritis. Acta Endocrinol (Kopenh) (suppl) 1983; 251:47-52.
8. Gordon MD, Klein I, Dekker A, Rodnan GP, Medsger KA. Thyroid disease in progressive systemic sclerosis: Increased frequency of glandular fibrosis an hypothyroidism. Ann Intern Med 1981;95:431-5.
9. Withrington RH, Seifert MH. Hypothyroidism associated with mixed connective tissue disease and its response to steroid therapy. Ann Rheum Dis 1981; 40:315-6.
10. Vierhapper H, Grubeck-Loebenstein B, Ferenci P, Lochs H, Bratusch-Marrain P, Waldhausl W. Alterations in thyroxine metabolism in Crohn’s diease. Hepatogastroenterology 1981; 28:31-3.
11. Gray RS, Borsey DQ, Seth J, Herd R, Brown NS, Clarke BF. Prevalance of subclinical thyroid failure in insulin-dependent diabetes. J Clin Endocrinol Metab 1980; 50:1034-7.
12. Carmel R, Spencer CA. Clinical and subclinical thyroid disorders associated with pernicious anemia. Arch Intern Med 1982; 142:1465-9.
13. LeRiche NGH, Bell DA. Hashimoto’s thyroiditis and polyarteritis. Ann Rheum Dis 1982; 43:594-8.
14. Miller FW, Moor GF, Weintraub BD, Steinberg AD. Prevalance of thyroid disease and abnormal thyroid function test results in patients with systemic lupus erythematosus. Arthritis Rheum 1987; 30:1124-31.
15. Weetman AP, Walport NJ. The association of autoimmune thyroiditis with systemic lupus erythematosus. Br Med Rheum 1987; 26:359-61.
16. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield N, Schaller JG, Tatal N, Winchester RJ. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982; 25:1271-7.
17. Goh KL, Wang F. Thyroid disorders in systemic lupus erythematosus. Ann Rheum Dis 1986; 45:579-83.
18. Mulhern LM, Masi AT, Schulman LE. Hashimoto’s disease: A search for associated disorders in 170 clinically detected cases. Lancet 1961; I:269-73.
19. Doniach D, Nilsson LR, Roitt IM. Autoimmune thyroiditis in children and adolescents. II. Immunological correlations and parents study. Acta Paediatr Scand 1965; 54:260-74.
20. Gordon T, Isenberg D. The endocrinologic associations of the autoimmune rheumatologic diseases. Semin Arthritis Rheum 1987; 17:58-70.
21. Kaplan MM; Reed LP. Symposium on thyroid disease. Med Clin North Am 1985; 69:871-6, 894-923, 1035-48.
22. Cavalieri RR. The effects of non-thyroid disease and drugs on thyroid function tests. Med Clin North Am 1991; 75:27-39.
23. Conemi JJ. The autoimmune diseases. JAMA 1987; 258:2920-30.
24. Walport MJ, Black CM, Richard BJ. The immunogenetics of SLE. Clin Rheum Dis 1982; 8:3-21.