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

Year 2019, Volume: 19 Issue: 3, 571 - 581, 30.09.2019

Funda Erbasan

https://doi.org/10.17098/amj.624524

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

Abstract

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.

Keywords

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

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