University of Central Florida College of Medicine, Graduate Medical Education, Orlando, Florida.
Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, Florida.
Endocr Pract. 2022 Jul;28(7):654-659. doi: 10.1016/j.eprac.2022.03.017. Epub 2022 Apr 1.
We aimed to determine the prevalence and clinical characteristics of self-reported hyperthyroidism in patients with sarcoidosis.
A national registry-based study investigating 3836 respondents to the Sarcoidosis Advanced Registry for Cures questionnaire in the period between June 2014 and August 2019 was conducted. This registry is generated from a web-based questionnaire that is self-reported by patients with sarcoidosis. We compared patients with sarcoidosis who had hyperthyroidism with those who did not. We used multivariate logistic regression analysis to study the association between hyperthyroidism and different cardiac manifestations in patients with sarcoidosis.
Three percent of the study respondents self-reported having hyperthyroidism and were generally middle-aged Caucasian women. Compared with patients without hyperthyroidism, patients with hyperthyroidism had more sarcoidosis-related comorbidities (59% vs 43%, P = .001) and more steroid-related comorbidities (56% vs 44%, P = .01), but there was no difference in the sarcoidosis-specific treatments they received, which included corticosteroids. Patients with hyperthyroidism reported sarcoidosis involvement of the heart (26.6% vs 14.9%, P = .005), kidneys (14.9% vs 8%, P = .033) and sinuses (17.7% vs 10.2%, P = .030) more frequently. Cardiac manifestations that were more frequently reported in patients with hyperthyroidism included atrial arrhythmias (11.3% vs 6.3%, P = .046), ventricular arrhythmias (17.2% vs 7.5%, P < .001), congestive heart failure (10.4% vs 5%, P = .017), and heart block (9.4% vs 4.7%, P = .036).
Hyperthyroidism is infrequent in patients with sarcoidosis but is potentially associated with different cardiac manifestations. We suggest considering routine screening for hyperthyroidism in patients with sarcoidosis, especially in those with cardiac involvement. Further studies are needed to investigate the impact of identifying and treating hyperthyroidism in patients with sarcoidosis.
我们旨在确定报告的甲状腺功能亢进症在结节病患者中的患病率和临床特征。
进行了一项基于全国登记的研究，调查了 2014 年 6 月至 2019 年 8 月期间参加结节病高级注册治疗问卷的 3836 名应答者。该登记册是由结节病患者通过基于网络的问卷自我报告生成的。我们比较了患有甲状腺功能亢进症和未患有甲状腺功能亢进症的结节病患者。我们使用多变量逻辑回归分析研究甲状腺功能亢进症与结节病患者不同心脏表现之间的关联。
研究受访者中有 3%报告患有甲状腺功能亢进症，他们通常是中年白种女性。与没有甲状腺功能亢进症的患者相比，患有甲状腺功能亢进症的患者有更多的结节病相关合并症（59%对 43%，P=.001）和更多的类固醇相关合并症（56%对 44%，P=.01），但他们接受的结节病特异性治疗没有差异，包括皮质类固醇。患有甲状腺功能亢进症的患者报告结节病累及心脏（26.6%对 14.9%，P=.005）、肾脏（14.9%对 8%，P=.033）和鼻窦（17.7%对 10.2%，P=.030）更频繁。甲状腺功能亢进症患者更频繁报告的心脏表现包括房性心律失常（11.3%对 6.3%，P=.046）、室性心律失常（17.2%对 7.5%，P<0.001）、充血性心力衰竭（10.4%对 5%，P=.017）和心脏传导阻滞（9.4%对 4.7%，P=.036）。
甲状腺功能亢进症在结节病患者中并不常见，但可能与不同的心脏表现有关。我们建议考虑对结节病患者进行常规筛查甲状腺功能亢进症，特别是对有心脏受累的患者。需要进一步研究来调查识别和治疗结节病患者甲状腺功能亢进症的影响。
