Arnaout M A, Nasrallah N S, el-Khateeb M S
Department of Medicine, School of Medicine, University of Jordan, Amman.
Scand J Rheumatol. 1994;23(3):128-32. doi: 10.3109/03009749409103044.
The prevalence of thyroid function tests' abnormalities in 170 patients with various connective tissue diseases (CTD) was examined and compared to a group of 100 age- and sex-matched controls. The overall prevalence of diagnosed thyroid disease was 3.5%. Categorizing the patients into 5 "functional groups" by the concurrent thyroid function test/results showed normal thyroid function tests in 14%, isolated elevated TSH levels with normal T4 and T3 levels in 4% and findings consistent with the laboratory diagnosis of primary hypothyroidism in 3%. The "euthyroid sick syndrome" was evidenced in 54% and elevated T4 levels and/or increased or normal T3 values with normal TSH in 25%. Antimicrosomal antibodies were noted in 12 patients (7%), with the highest incidence in systemic lupus erythromatosus patients (10%). patients with mixed connective tissue disease had significantly (p < 0.0005) higher frequency of hypothyroidism, whereas patients with systemic vasculities had higher frequency of hyperthyroxinemia. In conclusion, CTD patients frequently have abnormal results of one or more of thyroid function tests. Hypothyroidism and hyperthyroidism should be considered when evaluating symptoms and signs in CTD and a significant subset of CTD patients appears to be predisposed to the development of hyperthyroidism.
对170例患有各种结缔组织病（CTD）的患者进行甲状腺功能检查异常的患病率检查，并与100例年龄和性别匹配的对照组进行比较。确诊甲状腺疾病的总体患病率为3.5%。根据同时进行的甲状腺功能检查/结果将患者分为5个“功能组”，其中14%的患者甲状腺功能检查正常，4%的患者促甲状腺激素（TSH）水平单独升高而甲状腺素（T4）和三碘甲状腺原氨酸（T3）水平正常，3%的患者检查结果符合原发性甲状腺功能减退的实验室诊断。54%的患者表现为“甲状腺功能正常的病态综合征”，25%的患者T4水平升高和/或T3值升高或正常而TSH正常。12例患者（7%）检测到抗微粒体抗体，其中系统性红斑狼疮患者的发生率最高（10%）。混合性结缔组织病患者甲状腺功能减退的发生率显著更高（p < 0.0005），而系统性血管炎患者甲状腺素血症的发生率更高。总之，CTD患者经常出现一项或多项甲状腺功能检查结果异常。在评估CTD的症状和体征时应考虑甲状腺功能减退和甲状腺功能亢进，并且相当一部分CTD患者似乎易患甲状腺功能亢进。
