Psöriatik artrit hastalarında otoimmun tiroid hastaliği sıklığı ve anti TNF-a tedavisinin etkisi

Year 2020, Volume: 45 Issue: 2, 461 - 467, 30.06.2020

Ümit Karaoğullarından , Emine Tarhan , Güzide Gonca Örük

https://doi.org/10.17826/cumj.669775

Abstract

Amaç: Bu çalışmada psöriatik artrit (PsA) hastalarında tiroid hastalığı sıklığı ve anti-TNF tedavinin otoimmun tiroid hastalığına olan etkisi araştırılmıştır..
Gereç ve Yöntem: Romatoloji polikliniğinde PsA tanısıyla takip edilen 95 hastanın tiroid stimülan hormonu (TSH), triiyodotironin (sT3), tiroksin (sT4), antitiroglobulin (Tg) ve anti-tiroid peroksidaz (TPO) retrospektif olarak incelendi. Çalışmaya, verileri eksiksiz olan ve tiroid hastalığına yol olan sekonder nedeni olmayan 66 adet PsA (F / M: 43/23) ve 35 sağlıklı kontrol (F / M: 25/10) alındı. Tüm olgulara endokrinoloji uzmanı tarafından tiroid ultrasonografisi yapıldı.
Bulgular: PsA hastalarından 38 tanesi hastalık modifiye edici antiromatizmal ajan (DMARD) tedavisi (Grup 1; ortalama yaş: 43.94 ± 9.81) ve 28 hasta anti-TNF-α tedavisi (Grup 2; ortalama yaş: 42.25 ± 11.48) alıyordu. Grup 3 sağlıklı kontrollerden oluşuyordu (yaş ortalaması: 40,52 ± 8,34). Tüm grupların ortalama anti-TPO değerleri ve anti-Tg değerleri arasında anlamlı farklılıklar gözlendi.
Sonuç: PsA hastalarında otoimmün tiroid bozuklukları kontrol grubundan daha sık gözlendi. DMARD alan PsA hastalarında anti-TNF-α tedavisi alan hastalardan daha sık otoimmün tiroid bozuklukları görüldü. Bu durum tiroid bozukluklarının patogenezinde TNF-α nın rolü olabileceğini gösterdi.  

Keywords

psoriatic arthritis, anti-TNF

Frequency of autoimmune thyroid disorders in patients with psoriatic arthritis and effect of anti-TNF alpha treatment

Abstract

Purpose: In this study, the frequency of thyroid disorders in psöriatic arthritis (PsA) patients and the effect of anti TNF-α treatment on autoimmune thyroid disease were investigated.
Materials and Methods: Thyroid stimulating hormone, triiodothyronine, thyroxine, antithyroglobulin(Tg) and anti-thyroid peroxidase (TPO) of 95 patients followed at the rheumatology outpatient clinic were retrospectively evaluated. Sixty-six patients with PsA (F/M: 43/23) whose data were complete, and 35 healthy controls (F/M: 25/10) were included in the study. Thyroid ultrasonography was applied to all cases by an endocrinology specialist.
Results :38 of the PsA patients received disease modifying antirheumatic drugs (DMARDs) (Group 1; mean age: 43.94±9.81), and 28 anti TNF-α treatment (Group 2; mean age:42.25±11.48). Group 3 was comprised of healthy controls (mean age: 40.52±8.34). Significant differences were observed between the mean anti-TPO values and anti-Tg values of all groups.
Conclusion:: Autoimmune thyroid disorders were observed more frequently in patients with PsA than in the control group. The PsA patients who are receiving DMARDs appeared to have autoimmune thyroid disorders more frequently than those receiving anti TNF-α treatment. This condition may be resulting from TNF-α on the pathogenesis of thyroid disorders. 

Keywords

Psoriatic arthritis, anti-TNF, thyroid dysfunction

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