scholarly journals A STUDY TO EVALUATE THE THYROID FUNCTION IN SERO POSITIVE RHEUMATOID ARTHRITIS

Author(s):  
Ashok Kumar Vedwal ◽  
Pankaj Mangal ◽  
P D Meena ◽  
C L Nawal

Background: The thyroid dysfunction in rheumatoid arthritis is well-known but unfortunately there are only few studies available in our country to assess the thyroid function in RA patients. Methods: It was a Hospital based observational, descriptive study . Upgraded department of General Medicine, SMS Medical College and AttachedHospitals, (Jaipur). Results: Maximum patients 208(80.00%) are euthyroid followed by 28(10.77%) are overt - hypothyroidism, 22(8.46%) subclinical hypothyroidism and 2 patients (0.77%) are subclinical hyperthyroidism patients Conclusion: Prevalence of thyroid dysfunctions in rheumatoid arthritis is high and associated with thyroid autoimmunity and suggested that allrheumatoid arthritis patients should go for thyroid functions. Hence, it is advisable to screen the patients of rheumatoid arthritis for thyroid dysfunction so that early identification and treatment can provide a healthier life ahead. Keywords: NAFLD, TSH, T3, T4.  

Med Phoenix ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 64-70
Author(s):  
Anup Shamsher Budhathoki ◽  
Suprita Gupta ◽  
Sanjay Kumar Sah ◽  
Navin Kumar Sah ◽  
Navin Kumar Sah ◽  
...  

Background: Thyroid dysfunction is one of the most common endocrinopathies after Diabetes Mellitus. Thyroid dysfunction is defined as the alteration in Thyroid Stimulating Hormone (TSH) with normal or abnormal thyroid hormones. Nepalese population have a high risk for thyroid dysfunction with a high prevalence of iodine deficiency. Objective: To study the prevalence of thyroid dysfunction among the patients visiting National Medical College, Birgunj, Nepal for checkup and suggested to assess thyroid function. Materials and Methods: The hospital-based study was conducted in Central Laboratory, National Medical College and Teaching Hospital (NMCTH), Birgunj in collaboration with the Department of Biochemistry. Total 7040 patients visiting Central Laboratory for thyroid function assessment were included in the study between July 2017 to December 2019. The venous blood sample was collected and serum-free triiodothyronine(fT3), free tetraiodothyronine(fT4) and thyroid stimulating hormone (TSH) was estimated by Chemiluminescence Immunoassay (CLIA) method using Access 2 Beckman Coulter analyser. (Beckman Coulter Inc., California, USA). Results: Among 7040 subjects under study, 2138(30%) were found to have thyroid dysfunction with 13% having subclinical hypothyroidism, about 8% of overt hypothyroidism, about 4% with subclinical hyperthyroidism and 5% with overt hyperthyroidism. Majority of the thyroid dysfunction study group belonged to the 16-30 years age group followed by 31-45 years. Mean±SE for TSH, fT4 and fT3 levels show statistically significant differences in different thyroid disorders. Conclusion: The study revealed a high prevalence of subclinical hypothyroidism followed by overt hypothyroidism among the patients visiting National Medical College and Teaching Hospital, Birgunj, Nepal. A higher percentage of females were found to have thyroid dysfunction compared to male.


2020 ◽  
Vol 7 (8) ◽  
pp. 1264
Author(s):  
Ayyanagouda A. Gangannavar ◽  
Raghu G. ◽  
Mahendra S. V. ◽  
Manoj Kumar B. K. ◽  
Umesh Rajoor

Background: Human immunodeficiency virus (HIV) infection is characterized by decrease in CD4 cell count and immunodeficiency, leading to opportunistic infections (OIs) and tumors.  Objective of this study was to find out any association between thyroid function abnormality and CD4 count, duration of disease and ART drugs.Methods: Among 300 HIV/AIDS Persons attending ART centre, M.Y. Hospital, or attending general OPD, or admitted as in patients Dept. of Medicine, MGM Medical College and M.Y. Hospital, Indore, India.Results: Amongst 300 HIV patients,62 (20.66%) had thyroid dysfunction, most common being subclinical hypothyroidism (24/300, 8.0%) followed by sick euthyroid (17/300, 5.6%) and subclinical hyperthyroidism (13/300, 4.3%). Overt hypothyroidism was present in 5 of 300 (1.66%) patients and overt hyperthyroidism was present in 3 of 300 (1.0%) patients.  25 of 152 (16.44%) and 37 of 148 (25%) male and female HIV patients had thyroid function abnormality. Thyroid dysfunction was significantly more observed in old HIV patients (42/150, 28.0%) than in newly diagnosed HIV patient’s group (20/150, 13.33%).Conclusions: This prevalence being fairly high, it can be suggested that all retro positive patients, recently diagnosed and on treatment also may be subjected for routine thyroid function testing.


Author(s):  
Mir Waseem ◽  
Tabinda Shah ◽  
Mir Nadeem ◽  
Jaspreet Singh ◽  
Saba Maqbool ◽  
...  

Background: Rheumatoid arthritis (RA) is a chronic autoimmune systemic inflammatory multisystem disease of unknown cause that may affect many tissues and organs, but principally attacks synovial joints, primarily affecting the peripheral joints in a symmetrical pattern. The pathology of the disease process often leads to destruction of articular cartilage. It is the commonest inflammatory arthropathy worldwide with a gender predilection towards women. Prevalence of RA in the adult general population is approximately 1%. An association between RA and thyroid dysfunction with or without autoimmune origin has been reported in 6% to 34% of patients with RA. On the contrary, when presence of thyroid antibodies is considered, despite normal thyroid function, the prevalence can rise up to about 38%. These rates are significantly greater when compared with the general population.Methods: RA patients who were diagnosed according to the new 2010 EULAR/ACR criteria and thyroid function tests were done and patients with thyroid dysfunction were identified and then patients were divided into two groups based on presence of thyroid dysfunction with rheumatoid arthritis and disease activity was illustrated in both groups based on different scales.Results: In all, 250 patients 215 (86.8%) were females and 33 (13.2%) were males. ESR was elevated in 85 (34%) patients while as it was normal in 165(66%) patients. CRP was positive in 127 (52.7%) negative in 123 (47.3%) patients. Although subclinical hypothyroidism was the most frequent abnormality observed in 38.3% patients, only 30% had concomitant anti-TPO raised and 71.4% patients of overt hypothyroidism had raised anti-TPO antibody. Disease activity parameters were significantly higher in patients of RA with hypothyroidism as compared to other group. Although most of parameters of disease activity showed a higher frequency in the group having patients with thyroid disorder but the swollen joint count was comparable in both the groups and was not statistically significant.Conclusions: Presence of thyroid disorders in RA patients is suggestive of a more aggressive disease. To diagnose concurrent thyroid disorders at an earlier stage, routine measurement of serum thyroid- stimulating hormone is recommended in all RA patients at the time of diagnosis and with yearly interval thereafter.


Author(s):  
Ankita Kumari ◽  
Reena Srivastav ◽  
Shaila Mitra

Background: The aim of the study is to determine the prevalence of thyroid dysfunction in pregnancy and its impact on obstetrical outcome in Eastern Uttar Pradesh.Methods: This was a prospective observational study undertaken at antenatal clinics and indoor of BRD Medical College, Gorakhpur. Total 720 antenatal women, ≤20 weeks of gestation were recruited for the study. In all patients’ routine obstetrical investigations and thyroid function tests were done. All patients were followed up to delivery. Maternal and perinatal outcome were ascertained.Results: Prevalence of thyroid dysfunction among pregnant was found to be 21.1% and subclinical hypothyroidism (15.9%) was the commonest thyroid disorder. Most common complication observed in subclinical and overt hypothyroidism was preeclampsia (9.56 % versus 20%) followed by preterm labour (7.82% versus 10%). Major fetal complications in hypothyroid mothers included intrauterine growth restriction, low birth weight and stillbirth.Conclusions: Prevalence of hypothyroidism was found to be high in our study and was associated with adverse pregnancy outcomes; hence, thyroid screening should be included in routine antenatal investigations.


2021 ◽  
Author(s):  
Ji Eun Park ◽  
Sook Min Hwang ◽  
Ji-Young Hwang ◽  
Jin Hee Moon ◽  
Ik Yang ◽  
...  

Abstract Purpose: To evaluate the association between thyroid echogenicity and heterogeneity seen on ultrasonography (US) and thyroid function in pediatric and adolescent populations with autoimmune diffuse thyroid diseases (AITD).Methods: From 2000 to 2020, we reviewed thyroid ultrasound (US) images and thyroid function statuses in 133 children and adolescent AITD patients. Our review of the images focused on decreased echogenicity and heterogeneity, which were classified into four grades.Results: Among patients with overt hypothyroidism or overt hyperthyroidism, 94.2% (65/69) showed a US grade of 3 or 4. In patients with subclinical hyper/hypothyroidism or euthyroidism, 45.3% (29/64) showed grades 1 or 2. There were no overt hyper/hypothyroidism patients with US grade 1. When we compared US grades according to thyroid status, more severe thyroid dysfunction was significantly associated with higher US grade (p=0.047). Thyroid stimulating hormone (TSH) level differed significantly according to US grades when we evaluated hyperthyroid (p=0.035) and hypothyroid (p=0.027) states independently. 11 patients showed both US grade and thyroid function status changes on follow-up US.Conclusions: In children and adolescent AITD patients, there was an association between decreased echogenicity and heterogeneity on US and thyroid dysfunction.


2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Donny L. F. Chang ◽  
Elizabeth N. Pearce

Observational studies have demonstrated that maternal thyroid dysfunction and thyroid autoimmunity in pregnancy may be associated with adverse obstetric and fetal outcomes. Treatment of overt maternal hyperthyroidism and overt hypothyroidism clearly improves outcomes. To date there is limited evidence that levothyroxine treatment of pregnant women with subclinical hypothyroidism, isolated hypothyroxinemia, or thyroid autoimmunity is beneficial. Therefore, there is ongoing debate regarding the need for universal screening for thyroid dysfunction during pregnancy. Current guidelines differ; some recommend an aggressive case-finding approach, whereas others advocate testing only symptomatic women or those with a personal history of thyroid disease or other associated medical conditions.


Author(s):  
Ramya M. R. ◽  
. Parvathavarthini ◽  
Darshan Savery ◽  
R. Sankareswari

Background: Present study was done to evaluate the thyroid function in patients presenting with varying menstrual patterns of reproductive age group from 15 to 45 years of age.Methods: This prospective study was carried out in obstetrics and gynecology Department of Sri Venkateshwaraa Medical College, Pondicherry, India on 155 women, clinically given the provisional diagnosis of dysfunctional uterine bleeding (DUB). All these patients were investigated for T3, T4, TSH (Thyroid stimulating hormone) levels and grouped according to that.Results: Among the 155 women (58.7%) were normal thyroid function, (41.3%) had hypothyroid and (1.3%) had subclinical hypothyroidism.Conclusions: There is a high prevalence of thyroid disorders in cases which are clinically diagnosed as DUB. Evaluating for thyroid and treating it medically which was most accurate and cost effective and unnecessary surgery was avoided. Hence the thyroid function evaluation should be mandatory in cases of DUB to detect thyroid dysfunction and these cases should be referred to physician for further medical treatment.


Author(s):  
Puja Banik ◽  
R. K. Praneshwari Devi ◽  
Aheibam Bidya ◽  
Akoijam Tamphasana ◽  
M. Agalya ◽  
...  

Background: Changes in thyroid function in normal pregnancy are well-documented but in complicated pregnancy like preeclampsia, very little is known. Studies have shown evidences of hypothyroidism in preeclampsia necessitating thyroid function tests to be done in preeclampsia. The study was done to analyze the fetomaternal outcome of preeclampsia with coexisting thyroid dysfunction.Methods: A cross-sectional analytical study was done over 18 months on 95 preeclamptic patients admitted at the antenatal ward and fetomaternal outcomes were analyzed according to thyroid status.Results: Out of 95 patients with preeclampsia, 42 (44.2%) had thyroid dysfunction. Among these 42 patients, 37 (38.9%) patients had subclinical hypothyroidism, 4 (4.2%) had overt hypothyroidism and 1 (1%) had hyperthyroidism. Severe preeclampsia was seen in 64.3% of the patients with thyroid dysfunction compared with 39.6% in euthyroid patients. The mean thyroid stimulating hormone (TSH) level was significantly higher and means free thyroxine (fT4) level was significantly lower in severe preeclampsia compared with non-severe preeclampsia. Complications like abruption, intrauterine fetal death (IUD), intrauterine growth restriction (IUGR), oligohydramnios, preterm deliveries, postpartum hemorrhage (PPH), low birth weight babies, birth asphyxia in babies and subsequent neonatal intensive care unit (NICU) admissions were significantly higher (p <0.05) in the preeclampsia patients with thyroid dysfunction in comparison with euthyroid ones.Conclusions: Hypothyroidism may be a modifiable risk factor for preeclampsia. Thyroid screening early in pregnancy may be helpful in predicting the occurrence of preeclampsia and timely thyroid hormone administration can reduce the maternal and perinatal morbidity and mortality associated with preeclampsia.


2018 ◽  
Vol 12 (2) ◽  
pp. 74-78
Author(s):  
Pramod Kattel

Aims: To evaluate and detect the thyroid dysfunction in patients with abnormal uterine bleeding (AUB) from puberty to menopause.Methods: This is an observational descriptive study of 90 patients of abnormal uterine bleeding at Paropakar Maternity and Women’s Hospital, Kathmandu from 17th January 2016 to 16th January 2017. Besides thyroid function test Pap smear, endometrial biopsy and histo-pathological examination of uterus following hysterectomy was done in selected cases.Results: The incidence of AUB was 6.2 % with mean age of 37 years. The most common presenting complaint was menorrhagia (36.7%) followed by metrorrhagia (23.3%). Thyroid dysfunction accounted for 20% of AUB with major share occupied by subclinical hypothyroidism (11%) and least by hyperthyroidism (1%). The most common association of thyroid dysfunction with AUB was overt hypothyroidism (27.3%) with menorrhagia. Non-structural cases of AUB accounted for 30.4% of thyroid dysfunction.Conclusions: This study shows that thyroid dysfunction plays significant role for AUB so it is wise enough to perform TFT on routine basis in order to avoid unnecessary hormonal treatment with Estrogen, Progesterone or their combination and even the hysterectomies.


2013 ◽  
Vol 10 (2) ◽  
pp. 54-58 ◽  
Author(s):  
S M Zakharova ◽  
L V Savelieva ◽  
M I Fadeeva

Obesity and hypothyroidism are common diseases, and consequently clinicians should be particularly alert to the possibility of thyroid dysfunction in obese patients. The relationship between thyroid function and obesity is likely to be bidirectional, with hypothyroidism affecting weight, but obesity also influencing thyroid function. Both serum thyroid-stimulating hormone and fT3 are typically increased in obese individuals, an effect likely mediated by leptin. Following L-T4 treatment for overt hypothyroidism, weight loss appears to be modest and mediated primarily by loss of water weight rather than fat. Selected thyroid analogs might be a means by which to improve weight loss by increasing energy expenditure in obese patients during continued caloric deprivation


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