ABSTRACT
The prevalence of thyroid function tests' abnormalities in 170 patients with various connective tissue diseases (CTD) was examined and compared to a group of 100 age- and sex-matched controls. The overall prevalence of diagnosed thyroid disease was 3.5%. Categorizing the patients into 5 "functional groups" by the concurrent thyroid function test/results showed normal thyroid function tests in 14%, isolated elevated TSH levels with normal T4 and T3 levels in 4% and findings consistent with the laboratory diagnosis of primary hypothyroidism in 3%. The "euthyroid sick syndrome" was evidenced in 54% and elevated T4 levels and/or increased or normal T3 values with normal TSH in 25%. Antimicrosomal antibodies were noted in 12 patients (7%), with the highest incidence in systemic lupus erythromatosus patients (10%). patients with mixed connective tissue disease had significantly (p < 0.0005) higher frequency of hypothyroidism, whereas patients with systemic vasculities had higher frequency of hyperthyroxinemia. In conclusion, CTD patients frequently have abnormal results of one or more of thyroid function tests. Hypothyroidism and hyperthyroidism should be considered when evaluating symptoms and signs in CTD and a significant subset of CTD patients appears to be predisposed to the development of hyperthyroidism.
Subject(s)
Connective Tissue Diseases/complications , Thyroid Diseases/complications , Thyroid Diseases/epidemiology , Adolescent , Adult , Aged , Antibodies/analysis , Child , Child, Preschool , Connective Tissue Diseases/classification , Connective Tissue Diseases/physiopathology , Female , Humans , Male , Microsomes/immunology , Middle Aged , Prevalence , Thyroid Diseases/diagnosis , Thyroid Function Tests , Thyroid Hormones/bloodABSTRACT
A 19-year old female with catatonia associated with multi-system involvement with systemic lupus erythematosus is described. There was no evidence of CNS involvement (negative CT scan, normal EEG, normal ice-caloric response, and normal CSF findings). The patient improved on large doses of steroids. It is suggested that cerebral lupus should be considered in the differential diagnosis of catatonia even in the absence of radiological and focal neurological signs when the active disease is present.
Subject(s)
Catatonia/drug therapy , Lupus Erythematosus, Systemic/complications , Adult , Azathioprine/therapeutic use , Catatonia/etiology , Catatonia/physiopathology , Electroencephalography , Female , Humans , Prednisolone/therapeutic useABSTRACT
HLA typing for B27 antigen is a helpful diagnostic aid in the classification of peripheral arthritis patients (especially young patients) who are rheumatoid factor negative. We studied 109 patients with seronegative peripheral arthritis belonging to various clinical categories; 23% proved to be B27 positive in comparison to 7% of normal controls. In spite of a paucity of spinal manifestations there was a high prevalence of sacroiliitis (83%) in the B27 positive peripheral arthritis patients as opposed to only 21% in those without B27 antigen. HLA-B27 typing and radiographs of the sacroiliac joints are important differential tests.
