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MR Vol.12 No.4 indexに戻る
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MODERN RHEUMATOLOGY
Vol.12 No.4 |
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Thyroid hormones and thyroid-stimulating hormone
in Egyptian patients with systemic lupus erythematosus: correlation
between secondary hypothyroidism and neuropsychiatric systemic lupus
erythematosus syndromes |
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| A. A. Shahin1, H. Mostafa2, S. Mahmoud3 |
(1)Department of Rheumatology and Rehabilitation,
Faculty of Medicine, Cairo University, Kasr Eleini Street, Cairo,
Egypt
(2)Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo,
Egypt
(3)Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo,
Egypt |
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| Abstract |
| Abstract The purpose of this study was to
determine the serum levels of thyroid hormones and thyroid-stimulating
hormone (TSH), in addition to antithyroglobulin and antimicrosomal
antibodies and to investigate the correlation between these hormones
and various disease manifestations among Egyptian patients with
systemic lupus erythematosus (SLE). A group of 45 patients with
SLE (43 women and 2 men with a mean age of 27.57 - 9.89 years)
underment assessment of their thyroid hormones. Antithyroglobulin
and antimicrosomal antibodies were assessed in 27 patients. Various
disease manifestations were evaluated. A group of 20 normal female
volunteers were involved as controls. The mean serum free triiodothyronine
(FT3) levels in all patients were significantly lower than in controls
(1.89 - 1.14 vs. 3.15 - 0.93 pg/ml; P < 0.05). Patients with
a history of intravenous pulsed cyclophosphamide therapy showed
significantly decreased levels of FT3 compared to those in other
patients (1.17 - 0.5 vs. 2.05 - 0.95 pg/ml; P = 0.04). The mean
serum free thyroxine (FT4) levels in all patients were significantly
less than in the control group (1.24 - 1.22 vs. 1.4 - 0.3 mg/dl;
P < 0.001). Of the 45 patients, 2 (4.4%) were considered to
have primary hypothyroidism. Five of six patients (83.3%) with
decreased FT4 levels developed fibromyalgia compared to 7 of 39
(17.9%) patients with normal T4 (P = 0.003). The mean serum TSH
levels in all patients were significantly higher than in the controls
(4.82 - 22.2 vs. 2.65 - 1.18 7IU/ml; P < 0.001). Six patients
with decreased TSH levels were considered to have secondary hypothyroidism
(13.3%); one of them showed decreased T3 and T4, two had decreased
T4 only, and the other three were euthyroid. Comparing patients
with and without secondary hypothyroidism, showed acute confusion
in four (66.7%) in the former group versus four (10.3%) in the
latter group (P = 0.006), anxiety in four (66.7%) in the former
group versus six (15.4%) in the latter group (P = 0.016), and cognitive
disorders in five (83.3%) in the former group versus nine (23.1%)
in the latter group (P = 0.008). This study demonstrated evidence of secondary as well as primary
hypothyroidism in SLE patients and revealed a close association
between thyroid hormones or TSH and some organ involvement in SLE.
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| Key words |
| Key words Fibromyalgia ・ Jaccoud's
arthropathy ・ Neuropsychiatric systemic lupus erythematosus (SLE)
syndromes ・ Systemic lupus erythematosus
(SLE) ・ Thyroid hormones ・ Thyroid-stimulating hormone (TSH) |
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