Prevalence of hypothyroidism and Graves disease in sarcoidosis
Prevalence of hypothyroidism and Graves disease in sarcoidosis
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DOI：
10.1378/chest.130.2.526
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发表时间：
2006-08-01
期刊：
影响因子：
9.6
通讯作者：
Ferrannini, Ele
中科院分区：
文献类型：
--
作者：
Antonelli, Alessandro;Fazzi, Piera;Ferrannini, Ele
背景：结节病(S)和甲状腺自身免疫的关联已经在广泛的变异性研究中被报道。本研究的目的是评估S患者与性别匹配和年龄匹配的对照组中临床和亚临床甲状腺疾病的患病率。方法：对连续转诊至比萨大学呼吸病理生理科的111例S患者进行甲状腺激素和抗甲状腺抗体检测、甲状腺超声检查和细针抽吸检测，并与来自同一地理区域的333名性别匹配和年龄匹配的对照组进行比较。结果：女性S型患者与对照组亚临床甲状腺功能减退的比值比为2.7(95%可信区间[CI]， 1.3 ~ 5.9)；抗甲状腺过氧化物酶抗体滴度（AbTPO）阳性，2.2 (95% CI, 1.2 ~ 3.9)；甲状腺自身免疫为1.9 （95% CI, 1.1 - 3.2）。女性S组促甲状腺激素和AbTPO均值高于对照组（p < 0.01）。女性S患者的临床甲状腺功能减退症（4例）和Graves病（3例）的患病率明显高于对照组（p = 0.005和0.0026）。5例患者中检出2例甲状腺乳头状癌。S组患者游离三碘甲状腺原氨酸和甲状腺素、抗甲状腺球蛋白自身抗体、甲状腺体积和结节性、亚临床甲状腺功能亢进等指标与对照组无显著差异。结论：甲状腺功能、AbTPO抗体和超声检查应作为女性S患者临床资料的一部分。高危人群（女性、AbTPOs阳性、低回声、甲状腺小）应及时进行甲状腺功能随访和适当治疗。
Background: The association of sarcoidosis (S) and thyroid autoimmunity has been reported by several studies in a wide range of variability. The aim of our study was to evaluate the prevalence of clinical and subclinical thyroid disorders in patients with S vs gender-matched and age-matched control subjects.Methods: Thyroid hormones and antithyroid antibodies, thyroid ultrasonography and fine-needle aspiration were performed in 111 patients with S who had been consecutively referred to the Respiratory Pathophysiology Section of the University of Pisa, and the results were compared to 333 gender-matched and age-matched control subjects from the same geographic area.Results: The odds ratio for subclinical hypothyroidism for female patients with S vs control subjects was 2.7 (95% confidence interval [CI], 1.3 to 5.9); for anti-thyroid peroxidase antibody titer (AbTPO) positivity, 2.2 (95% CI, 1.2 to 3.9); and for thyroid autoimmunity, 1.9 (95% CI, 1.1 to 3.2). The mean values of thyroid-stimulating hormone and AbTPO were higher in female S patients than in control subjects (p < 0.01). A significantly higher prevalence of clinical hypothyroidism (four patients) and Graves disease (three patients) was observed in female S patients than in control subjects (none; p = 0.005 and 0.0026, respectively). Two cases of papillary thyroid cancer were detected in S patients. No significant difference between S patients and control subjects was detected for free triiodothyronine and thyroxine, antithyroglobulin autoantibodies, thyroid volume and nodularity, and subclinical hyperthyroidism.Conclusions: Thyroid function, AbTPO antibodies, and ultrasonography should be tested as part of the clinical profile in female S patients. Subjects who are at high risk (female subjects, those with positive AbTPOs, and those with hypoechoic and small thyroid) should have thyroid function follow-up and appropriate treatment in due course.