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Thyroid dysfunction in primary Sjogren's syndrome: a long-term followup study.
D'Arbonneau F, Ansart S, Le Berre R, Dueymes M, Youinou P, Pennec YL.
Arthritis Rheum. 2003 Dec 15;49(6):804-9.
"OBJECTIVE: To evaluate the prevalence of thyroid dysfunction and related autoantibodies in patients with primary Sjogren's
syndrome (pSS), and to determine whether these abnormalities develop over time. METHODS: pSS patients (n = 137) and
controls (n = 120) were investigated for thyroid dysfunction and for the presence of anti-thyroid peroxidase antibody (anti-TPO)
and antithyroglobulin antibody (ATG). Followup time for patients was 1-16 years, and 72 of the 120 controls were reevaluated 3
years after initial evaluation. RESULTS: Thyroid disease was more frequent in the pSS patients than in the controls (30% versus
4%; P < 10(-4)), as were anti-TPO and ATG (11% versus 3%; P < 0.02, and 3% versus 1%, not significant). Ten of 107 euthyroid
pSS patients dropped out of the study, and thyroid dysfunction became apparent at followup in 12 of the remaining 97. Most of
the patients with thyroid-related autoantibodies at entry developed autoimmune thyroid disease thereafter. CONCLUSION:
Thyroid dysfunction is frequent in pSS patients, and those prone to develop thyroid disorders are identified by thyroid-related
autoantibodies, or by rheumatoid factor and anti-Ro/SSA activity."
Thyroid disese in primary Sjogren syndrome. Study in a series of 160 patients.
Ramos-Casals M, Garcia-Carrasco M, Cervera R, Gaya J, Halperin I, Ubieto I, Aymami A, Morla RM, Font J, Ingelmo M.
Medicine (Baltimore). 2000 Mar;79(2):103-8.
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"We studied 160 consecutive patients (147 female and 13 male) with primary Sjogren syndrome (SS) to determine the
prevalence and clinical significance of thyroid disease in a large series of patients with primary SS from our unit and to
compare the prevalence and significance with those in 75 individuals without SS from a primary care center. Serum levels of
thyroid hormones (free thyroxine, triiodothyronine, and thyroid-stimulating hormone) and autoantibodies against thyroglobulin
(TgAb) and thyroid peroxidase (TPOAb) were measured in all SS patients and in 75 control patients. Fifty-eight (36%) of the 160
patients with primary SS had evidence of thyroid disease. Autoimmune thyroid disease (ATD) was diagnosed in 32 (20%)
patients and nonautoimmune thyroid disease (NATD) in 26 (16%). No significant differences were found when these prevalences
were compared with those in control patients. On the other hand, comparing those patients with altered hormonal profiles,
patients with NATD showed mainly hyperthyroidism (10/17, 59% versus 2/20, 10% in patients with ATD, p = 0.001). Finally, when
clinical and immunologic manifestations of SS were analyzed in patients with and without thyroid disease, respectively, we
found that patients with thyroid disease had a higher prevalence of female gender (98% versus 88%, p = 0.03), antiparietal cell
autoantibodies (33% versus 12%, p = 0.002), TgAb (30% versus 5%, p < 0.001), and TPOAb (40% versus 5%, p < 0.001). In
conclusion, thyroid disease occurred in more than one-third of patients with primary SS; the main cause was ATD, which was
present in 20% of the patients studied. We note that no significant differences were observed when the prevalence of thyroid
disease (either ATD or NATD) was compared with that in a control group of similar age and gender. Our results indicate that
middle-aged women (with or without SS) should be screened periodically for thyroid function."
Autoimmune thyroid disease in primary Sjogren's syndrome.
Perez B, Kraus A, Lopez G, Cifuentes M, Alarcon-Segovia D.
Am J Med. 1995 Nov;99(5):480-4.
Sjogren's syndrome. PATIENTS AND METHODS: Thyroid function of 33 patients with primary Sjogren's syndrome was clinically
and biochemically evaluated. Thyroid hormones and autoantibodies against thyroid peroxidase, thyroglobulin, and thyroid
hormones were measured. RESULTS: Autoimmune thyroid disease and thyroid dysfunction were found in 15 cases (45%):
autoimmune thyroiditis in 8 (24%); autoimmune hyperthyroidism in 2 (6%); and reversible iodine-induced hypothyroidism in the
remaining 5 (15%). One or more of the evaluated autoantibodies were detected in 8 euthyroid patients (24%). Overall, the
prevalence of autoantibodies against thyroid peroxidase, thyroglobulin, thyroxine, and triiodothyronine was 45%, 18%, 42%, and
36%, respectively. CONCLUSIONS: The high prevalence of autoimmune thyroid disease and thyroid dysfunction found in
primary Sjogren's syndrome, using sensitive immunologic and thyroid function tests, suggest that both diseases are more
frequently associated than it was previously thought, and should be sought clinically and by laboratory tests in all patients with
primary Sjogren's syndrome."