BAĞ DOKUSU HASTALIKLARINDA TİROİD FONKSİYONLARI VE TİROİD OTOANTİKORLARI

Öz

Otoimmun hastalıklar sık olarak birarada bulunabilir. Biz bu çalışmada romatoid artrit RA , sistemik lupus eritematosus SLE , Skleroderma, Polimiyozit ve Sjögren Sendromu gibi bağ doku hastalıklarında tiroid fonksiyonları ve tiroid otoantikorlarını araştırdık. 57’si RA, 10’u SLE, 8’i belirlenemeyen bağ dokusu hastalığı, 3’ü Sjögren Sendromu, 2’si Skleroderma tanısı almış 80 olgu çalışmaya alındı. 3 olguda %4 hipotiroidi, 2 olguda %2 hipertiroidi saptadık. Tiroid sintigrafisinde; 44 olguda %55 diffuz hiper- plazi, 18’inde %22 multinodüler guatr saptadık. 26 %32 olguda anti-T ve anti-M pozitif olarak saptadık

THYROID FUNCTION TESTS AND AUTOANTİBODIES IN PATIENTS WITH CONNECTIVE TISSUE DISEASES

Abstract

Autoİmmun diseases can be diagnosed along together frequenty. In this study, we assesed the thyroid functions and the thyroid autoantibodies in the patients who have connective tissue diseases. n this study 80 patients 57 RA, 10 SLE, 8 unidentified connective tissue disease, 3 Sjogren Syndrome and 2 Scleroderma were evaluated through the thyroid functions, thyroid autoantibodies and thyroid scan parameters. 3 %4 hypothyroids, 2 %2 hyperthyroids, 44 %55 hyperplasia and, 18 %22 multinodular goiter diagnosed as result of the thyroid scan. Anti-T, Anti-M parameters were positive in 26 %32 patients

References

1. Hale LP, Haynes BF. Pathology of Rheumatoid Arthritis and Associated Disorders, Ed Kopman WJ, Mc Carty DJ. Arthritis and Allied conditions 13th ed. Vol1, Williams-Wilkins Comp. 52: 993-1017, 1997
2. Anaya JM, Talal N. Sjögren’ syndrome and connective tissue diseases associated with other immunological disorders. Kopman WS (ed); Arhritis and Allied Conditions. 13th edition, Williams and Wilkins, Baltimore,1997; 1561-80
3. Norman Lavin, Manuel of endocrinology and Metabolism Ed. 2 baskı.1994, 157-65
4. Younoi P, Mangold W, Jouguan J. et al. Organ spesific autoantibodies in nonorgan -spesific auto-immune disease cutth special reference to Rheumatoid arthritis. Rheumatol Int. 1987, 753; 125-6.
5. Mariotti S, Sansoni P, Barbesino G, et al. Thyroid and other organ spesific autoantibodies in healthy centenarians. Lancet 1992; : 1506-8
6. Ruggeri RM, Gallati M, Mandolfino MG et al. . Thyroid hormone autoantibodies in primary sjögren syndrome and rheumatoid arthritis are more prevalant than in auto- immune throid disease, becoming progressively more frequent in these disease. J. Endocrinol Invest 2002; 25 (5); 447-54
7. Molvalılar S. Tiroid hastalıkları. Büyük Öztürk (ed); İç hastalıkları. Bayda, İstanbul, 1992, s. 242-265
8. Parle JV, Franklyn JA, Cross KW et al. Prevalance and the United Kıngdom. Clin Endocrinol (Oxf) 1991; 34: 77-83

9. Lazarus JH , Burr ML, McGregor AM et al. The prevalance and progression of autoimmun thyroide disease in elderly.Acta- Endocrinol 1984; 106: 199 – 202
10. Amino N, Hagen SR, Yamada N, Retetof S , Measurement of circulating thyroid microsomaL antibodies by the tanned red cell hemaglutination technique : its useful- ness in the diagnosis of autoimmun thyroid disease. Clin Endocrinol 1976; 5: 115-25
11. Rieu M, Richard A, Rosilio M, et al. Effects of thyroid status on thyroid autoim- munity expression in euthyroid and hypothyroid pations with Hashimoto’s thyroiditis. Clin Endocrinol 1994; 40: 529-35
12. Tunbridge WMG, Evered Dc, Hall R et al.The spectrum of thyroid disease in a community: the Whickham survey.Clin Endocrinol (Oxf) 1977;7: 481-93
13. Barbato MP, Thyroid autoantibodies in an Australian community. Med J Aust 1978; 2: 511-2
14. Albani S, Carson DA: Etiology and Pathogenesis of Rheumatoid Arthritis. Arthritis an Allied Conditions. Ed. Kopman WJ, McCarty DJ.13th ed, Vol 1.Williams – Wilkins Comp, 55; 1071-1089, 1997
15. Harris E C .Rheumatoid arthritis; pathophysiolgy and implication for therapy.N Eng J Med 1990; 322: 1277.
16. Brook A, Corbett M;Radyographic changes in early rheumatoid arthritis.Ann Rheum Dise.1997; 36: 71-73
17. Walker DJ, Griffiths ID.Occurence of autoimmune disease and autoantibodies in multicase rheumatoid arthritis families.Ann Rheum Dise 1986 April; 45 (4):, 323-6
18. W.Watson Buchanan, J.Crooks, W. D. Alexander et al.Association of Hashimoto‘ s thyroiditis and rheumatoid arthritis.The Lancet 1961; 4: 245-48.
19. Magnus JH. A prospective evaluatin antithyroid antibodys prevalans in 100 patients with rheumatoid arthritis. Scand J Rheumatol.1995; 24 (3): 180-2.
20. Andonopoulos AP, Siambi V, Marky M et al.Thyroid function and immune profile in rheumatoid arthritis. A controlled study Clin Rheumatol.1996 Nov; 15 (6): 599-603
21. Magnus JH, Birkatvedt T, Haga HJ. A prosvective evalotion of antithyroid antibody prevalance in 100 patients with rheumatoid arthritis.Scand J Rheumatol. 1995; 24 (3): 180-2
22. Vanderpump MPJ, Tunbridge WMG, French JM, et al.The incidence of thyroid disorders in the community: a twenty – year follow – up of the Whickham Survey. Clin Endocrinol (Oxf) 1995; 43: 55-68
23. Alpigiani MG Carboni M, Bertini I et al. Endocrine autoimmunity in young patients with juvenile chronic arthritis.Clin. Exp Rheumatol.2002; 20 (4): 565-8
24. Mihaliova D, Grigonova R, Vassilova V et al.Autoimmune thyroid disorders in juvenile chronic arthritis and systemic lupus ertyhematosus.Adv.Exp Med.Bial.1999; 455: 55-60
25. Boey ML, Fong PH, Lee JS, Ng WY, Thai.Autoimmune thyroid disorders in SLE in Singapore.Lupus, 1993; 2 (1): 51-4
26. A. T. Y. Chan, Z. Al-Saffer and R. C. Bucknall.Thyroid disease in systemic lupus ertyhematosus and rheumatoid arthritis.Rheumatology 2001; 40: 353-354.
27. Nordyke RA, Gilbert Fl Jr, Miyamoto LA, Fleury KA.The superiorrity of antimicrosomal over antithyroglobulin antibodies for detecting Hashimoto‘ s thyroiditis.Arch Intern Med 1993; 153: 862-5.
28. Pyne D, Isenberg DA.Autoimmune thyroid disease in systemic lupus erythematosus. Ann.Rheum.Dis 2002; 61 (1): 70-2.
29. Wallace DJ, Metzger AL, Systemic Lupus Erythematosus: Clinical aspects and treatment.Arthritis and Allied Conditions (Ed: Koopman WJ). 13th ed.Williams and Wilkins Comp, Baltimore. 1997 P: 1319-45
30. Black C M, Denton CP ;Scleroderma and Releated disorders in Adult and Children.Oxford textbook of Rheumatology (Eds;Maddison PJ, Isenberg DA, Woo P, Glass DN) Claman HN, Giomo RC, Seibold JR:Endothelial and fibroblastic activation in scleroderma : The myth of the “ uninvolved skin”. Atrhritis Rheum 1991; 34: 1495-1501