Association and Similarities between Undifferentiated Connective Tissue Diseases and Autoimmune Thyroid Diseases

Abstract

Objectives: Autoimmune thyroid diseases (ATDs) can be accompanied by systemic autoimmune diseases. The aim of this study was to determine the association, similarities, and differences between undifferentiated connective tissue diseases (UCTDs) and ATDs.
Materials and Methods: Fifty nine UCTD patients and 108 control subjects were retrospectively evaluated. Thyroid function tests, antithyroid antibodies, antinuclear antibody (ANA), anti-double stranded deoxyribonucleic acid and anti-extractable nuclear antigens peptide levels, and histopathological examination of the minor salivary gland were evaluated.
Results: The prevalence of ATD was 23.70% and 33.30% in the UCTD and control groups, respectively (p = 0.220). The prevalence of arthritis in isolated UCTD patients was 11.10%, which was significantly increased (35.70%) if UCTD was accompanied by a ATD (p = 0.047). Other clinical symptoms such as arthralgia, xerostomia, keratoconjunctivitis sicca, Raynaud’s phenomenon, oral aphthous ulcers, and photosensitivity observed in UCTD, ANA positivity rates, and the most common staining pattern (speckled) were similar between the ATD and non-ATD patients. Histopathological examination of the minor salivary gland in 9 ATD patients revealed no significant lymphocyte infiltration. In the comparison of UCTD and ATD patients, the findings were similar, except arthralgia and ANA positivity, which were higher in UCTD patients.
Conclusion: As a result, considering similar clinical symptoms and autoimmune profiles of UCTD and ATD, it is recommended to make a clear differential diagnosis of both diseases in patients presenting with complaints such as arthralgia, xerostomia, and Raynaud’s phenomenon.

Keywords

• Undifferentiated connective tissue disease,autoimmune thyroid disease,antithyroid antibodies,antinuclear antibody,,

Undifferansiye Bağ Doku Hastalıkları ve Otoimmün Tiroid Hastalıklarının Birlikteliği ve Benzerlikleri

Öz

Amaç: Otoimmün tiroid hastalıkları (OTH) sistemik otoimmün hastalıklara eşlik edebilmektedirler. Bu çalışmanın amacı Undifferansiye Bağ Doku Hastalıkları (UBDH) ve OTH hastalıkları arasındaki ilişkiyi, benzerlikleri ve farklılıkları saptamaktır.
Materyal ve Metot: Çalışmaya 59 UDBH hastası ve 108 kişilik kontrol grubu alındı. Tiroid fonksiyon testleri, antitiroid antikorları, antinükleer antikorlar (ANA), anti-dsDNA ve ekstrakte edilebilen nükleer antijenlere karşı gelişen antikorların seviyeleri ile minör tükürük bezinin histopatolojik incelemesi değerlendirildi.
Bulgular: OTH prevalansı UDBH grubunda %23,70, kontrol grubunda ise %33,30 olarak bulundu (p=0,220). İzole UDBH’da artrit görülme oranı %11,10 iken, OTH ile birlikteliği durumunda bu oranın %35,70 olarak anlamlı derecede artmış olduğu saptandı (p=0,047). UDBH da görülen artralji, xserostomi, keratokonjuktivitis sikka, raynaud, oral aft ve fotosensitivite gibi diğer klinik belirtiler, ANA pozitiflik oranları ve en sık görülen boyanma paterni benekli olmak üzere OTH olan ve olmayanlarda benzerdi. OTH bulunan 9 hastanın yapılan minör tükrük bezinin histopatolojik incelemesinde anlamlı bir lenfosit infiltrasyonu izlenmedi. Tek başına UDBH ile OTH olan hastalar karşılaştırıldığında, UDBH’da daha yüksek oranda görülen artralji ve ANA poziftiliği dışında diğer bulgular benzerdi.
Sonuç: Sonuç olarak, UDBH ile OTH klinik belirtileri ve otoimmün profilinin büyük oranda benzer olduğu göz önüne alınarak artralji, xserotomi, raynaud gibi yakınmalar ile gelen hastalarda her 2 hastalığın ayırıcı tanısının iyi yapılması ve ayrıca bu iki hastalığın birlikte bulunabileceğininde gözününde tutulması önerilir.

Anahtar Kelimeler

• Undiferansiye bağ doku hastalığı,otoimmün tiroid hastalığı,antitiroid antikor,antinükleer antikor

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