ABSTRACT
Background: The relationship between thyroid abnormalities and rheumatoid arthritis is a debatable subject. Studies show a higher prevalence of thyroid abnormalities in patients with RA. It is widely observed that disorders with an autoimmune pathogenesis occur with increased frequency in patients with a history of another disease. RA is a systemic disorder that can affect any organ in the body, it could be speculated that abnormal thyroid functions are due to thyroid activity of the autoantibodies produced in this disease. Objectives:-Present study was doneto study the prevalence and correlation between Rheumatoid Arthritis and thyroid dysfunction; hypo as well as hyperthyroidism and to find whether thyroid disorders are found with increased frequency in Rheumatoid Arthritis patients as compared to general population. Methods: A cross sectional observational study was conducted on 50 patients of RA (diagnosed according to 2010 ACR/EULAR criteria) attending outdoor or admitted in wards at Rajindra hospital Patiala. Age and sex matched 50 persons from general population were taken as control group. These patients were evaluated for thyroid abnormalities using thyroid function test T3, T4, TSH. Results: Thyroid abnormalities were found among 28% cases of RA as compared to 8% among controls. Percentage of clinical hypothyroidism, subclinical hypothyroidism, and clinical hyperthyroidism in cases was 10%, 16%, 2% respectively. In controls percentage of clinical and subclinical hypothyroidism observed was 2% and 6% respectively. Females with RA had two fold enhances prevalence of thyroid abnormalities as compared to males with RA (31.6% females and 16.7% males with RA had thyroid abnormalities). Conclusion: The asymptomatic or mildly symptomatic clinical course of thyroid diseases in RA patients may be masked by underlying disease, posing hazards of late diagnosis and treatment. So higher prevalence of thyroid abnormalities in RA patients in comparison to controls indicate the need for screening by thyroid function tests.
ABSTRACT
PURPOSE: To understand the various clinical and radiological features of ectopic thyroid. MATERIALS AND METHODS: This study involved nine ectopic thyroid cases (M:F=2:7; age range, 2-57 years) confirmed by RI thyroidscan between 1993 and 1997. We analyzed one neck ultrasonogram, five CT scans, three MR images, nine Tc-99mthyroid scans, and classified the ectopic thyroid by the basis of these findings. Hormonal abnormalities andsymptoms were evaluated on the basis of medical records. RESULTS: The status of nine patients was found to beeuthyroid (n=6), hypothyroid (n=2) or hyperthyroid (n=1). Among the nine, the ectopic thyroid was lingual (n=6),sublingual (n=3) or thyroglossal (n=1); one patient had both the lingual and sublingual types. Ectopic thyroid wasseen as a well-defined round mass, homogeneously enhanced on CT scan, homogeneously hyperechogenic onultrasonogram and of intermediate signal intense on MRI. All cases showed ectopic radioactivity uptake on Tc-99mthyroid scan. In eight patients, ectopic thyroid was the only hormone-producing thyroid tissue; one had bothnormal thyroid and ectopic thyroid tissue in a thyroglossal duct cyst. Among the six cases of euthyroidism,ectopic thyroid patients with the lingual type complained of throat discomfort. Those with the sublingual typecomplained of palpable neck mass, and preoperative evaluation of thyroglossal duct cyst showed that this wasectopic thyroid. CONCLUSION: Understanding the various clinical and radiologic features of ectopic thyroid canhelp accurate diagnosis and prevent unnecessary surgery or other procedure.