Adapa Saimounika, Bhatt Varsha R, Shiddapur Govind, Jagdale Nilesh, Reddy Vutukuru Kalyan Kumar, Kondapalli Mohith Prakash, Agarwal Sonali, Sabharwal Diksha, Jha Advait
Department of General Medicine, Dr. D. Y. Patil College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND.
Department of Clinical Immunology and Rheumatology, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Pune, IND.
Cureus. 2024 Aug 1;16(8):e65950. doi: 10.7759/cureus.65950. eCollection 2024 Aug.
Autoimmune connective tissue disorders (CTDs) are characterized by inflammation of the connective tissue structures and immune system aberrations, such as autoantibody production. This study investigates the prevalence and clinical significance of thyroid abnormalities in patients with anti-nuclear antibody (ANA)-positive autoimmune CTDs.
This prospective cross-sectional observational study was conducted at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, from September 2022 to June 2024. Eighty patients diagnosed with ANA-positive CTDs were included. Comprehensive histories were collected from them and clinical examinations and routine investigations were performed. Blood samples were collected for thyroid function tests and autoantibody tests. Thyroid ultrasound investigations were also performed. Ethical approval and informed consent were obtained.
The study revealed a significant prevalence of thyroid dysfunction among participants, with 39 (48.75%) exhibiting some form of thyroid abnormality. Subclinical hypothyroidism was the most common condition in 18 (22.50%) participants, predominantly affecting females. Thyroid autoantibodies were present in 32 (40%) participants, with thyroid peroxidase antibodies (anti-TPO Ab) being the most common seen in 17 (21.25%) participants. Systemic lupus erythematosus (SLE) was the most prevalent CTD among participants, seen in 44 (55%) participants, followed by Sjogren's syndrome (SS) seen in 19 (23.75%) participants.
The study underscores the necessity of routine thyroid function screening in patients with ANA-positive CTDs to facilitate early detection and management of thyroid abnormalities, thereby preventing progression to overt hypothyroidism or hyperthyroidism. The findings highlight the significant association between thyroid dysfunction and autoimmune CTDs, advocating for a holistic approach to patient care.
自身免疫性结缔组织病（CTD）的特征是结缔组织结构炎症和免疫系统异常，如自身抗体产生。本研究调查抗核抗体（ANA）阳性自身免疫性CTD患者甲状腺异常的患病率及其临床意义。
本前瞻性横断面观察性研究于2022年9月至2024年6月在浦那的D.Y.帕蒂尔医学院、医院和研究中心（D.Y.帕蒂尔被视为大学）进行。纳入80例诊断为ANA阳性CTD的患者。收集了他们的全面病史，并进行了临床检查和常规检查。采集血样进行甲状腺功能测试和自身抗体检测。还进行了甲状腺超声检查。获得了伦理批准和知情同意。
研究显示参与者中甲状腺功能障碍的患病率很高，39例（48.75%）表现出某种形式的甲状腺异常。亚临床甲状腺功能减退是最常见的情况，18例（22.50%）参与者受影响，主要为女性。32例（40%）参与者存在甲状腺自身抗体，其中甲状腺过氧化物酶抗体（抗TPO Ab）最常见，17例（21.25%）参与者出现。系统性红斑狼疮（SLE）是参与者中最常见的CTD，44例（55%）参与者出现，其次是干燥综合征（SS），19例（23.75%）参与者出现。
该研究强调了对ANA阳性CTD患者进行常规甲状腺功能筛查的必要性，以便早期发现和管理甲状腺异常，从而防止发展为显性甲状腺功能减退或甲状腺功能亢进。研究结果突出了甲状腺功能障碍与自身免疫性CTD之间的显著关联，提倡采用整体方法进行患者护理。
