ROMATOİD ARTRİTLİ HASTALARDA TİROİD OTOANTİKOR PREVALANSI

Year 2005, Volume: 6 Issue: 2, 15 - 18, 01.08.2005

Taşkın Şentürk İrfan Yavaşoğlu Adil Coşkun Zahit Bolaman

Abstract

Giriş:Romatoid artrit (RA) toplumun yaklaşık %1'ini etkileyen inflamatuar karakterde sistemik otoimmün birhastalıktır ve genellikle sistemik otoimmün hastalıklarla organa özgü otoimmün hastalıkların bir arada görülmesıklığının az olduğu kabul edilir. Biz çalışmamızda RA'li hastalarda, organa özgü otoimmün hastalıkların en sıkgörülenlerinden biri olan otoimmün tiroid hastalığı varlığını ve tiroid otoantikor sıklığını belirlemeyi amaçladık.Materyal ve Metod:Çalışmaya 1987 ARA sınıflama kriterlerine göre RA tanısı konulan ve yaş ortalaması 484olan, 82 aktif hasta (67 kadın ve 15 erkek) kabul edildi. Kontrol grubu olarak 31 kadın ve 16 erkek olmak üzere 47sağlıklı birey çalışmaya dahil edildi. Hasta ve kontrol grubunda serbest tiroksin (sT4), serbest triiodotironin(sT3), tirotropin(TSH), anti-tiroglobulin antikoru (Anti-T) ve anti-peroksidaz antikor (anti-TPO) bakıldı ve ikigrup arasında sonuçlar karşılaştırıldı.Sonuçlar:Serum tiroid otoantikor seviyeleri RA'li hasta grubunda anti-TPO:85.69±106.83 IU/ml ve antiTG:58.2±83.9 IU/ml olarak bulunurken, kontrol grubunda anti-TPO:43.16± 132.23 IU/ml ve antiTG:24.19±36.74 IU/ml olarak bulundu. İki grup arasında tiroid otoantikorlarının serum seviyeleri arasındaistatiksel olarak anlamlı fark saptandı (sırasıyla p=0.008 ve p=0.0004). Tiroid hormon seviyeleri (sT3, sT4 veTSH) açısından 2 grup arasında istatistiksel fark yoktu (p>0.05).Tartışma:Burada elde edilen bulgulara göre RA'li hastalarda otoimmün tiroid hastalığının sıklığı normalpopulasyona göre daha sıktır. Bu da sistemik veya organa özgü olduğuna bakmaksızın, otoimmün hastalıklardaimmün yanıtın tümden etkilendiğini düşündürmektedir. RA'li hastalarda başta otoimmün tiroid hastalığı olmaküzere diğer organa özgü otoimmün hastalıkların gelişimi açısından da dikkatli olunmalıdır

Keywords

Romatoid artrit, tiroid otoantikorları

The Prevalance of Thyroid Autoantibodies in Patients with Rheumatoid Arthritis

Abstract

Background: Rheumatoid  arthritis  (RA)  is  a  chronic  inflammatory  autoimmune  disorder  that  affectsapproximately 0.5-1% of the population and according to general opinion the frequency of systemic autoimmune disorders to be seen together with organ specific autoimmune disorders is not very common. The aim of this study was to evaluate the thyroid functions and thyroid autoantibodies in patients with RA and to determine the frequency of autoimmune thyroid disorders in these patients. Materyal and Method: 82 active patients (67 females and 15 males) witha diagnosis of RA according to 1987 ARA classification criteria were included in the study. 47 healthy individuals (31 females and 16 males) were included in the study as the control group. In all participants free thyroxine (fT4), free triiodothyronine (fT3), thyrotropin (TSH), thyroglobulin antibody (anti-Tg) and anti-peroxidase (anti-TPO) antibody titres were measured. Results of the RApatients were compared with the controls. Results: In the RAgroup thyroid autoantibody values were as follows: anti-TPO 85.69±106.83 IU/ml and anti-Tg 58.2±83.9 IU/ml. These values were: anti-TPO 43.16±132.23 IU/ml and anti-Tg 24.19±36.74 IU/ml in the control group. There was a statistically significant difference between two groups with regards to thyroid autoantibodies (p=0.008, p=0.0004, respectively). There was not any statistically significant difference between two groups with regards to fT3, fT4 and TSH values (p > 0.05). Conclusion: As there was not an apperent finding specific for a thyroid disorder in patients with RA in our study, the thyroid antibody positivity identified here might be due to a pathologic autoimmune response rather than demonstrating a thyroid disease.Thyroid function and TPO Ab tests should be performed as part of the biochemical and immunological profile in RApatients.

Keywords

Rheumatoid arthritis, thyroid autoantibodies

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