Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Methods: We retrospectively reviewed the medical charts of 223 consecutive patients (1996-2016) with the diagnosis of pSS according to the AECG criteria. We registered demographics, glandular and extraglandular features, Schirmer-I test, non-stimulated whole salivary flow (NSWSF), ocular staining, serology (anti-Ro/SSA, anti-La/SSA, rheumatoid factor (RF), low C3 ever, low C4 ever, and hyperglobulinemia ever); as well as thyroid function tests (TFT), thyroid disease diagnosis, anti-thyroglobulin and anti-thyroid peroxidase antibodies and thyroid image studies. We scored the cumulative activity with the ESSDAI and damage accrual with the SSDDI at the end of follow-up.
Results: 149 patients (66.8%) had at least a set of TFT, these patients were older and had a longer disease duration than patients without a TFT assessment. Their mean age was 59.7±14.9 years, 95.2% female and median disease duration 10.4 years. Sixty-four of them (42.9%) had thyroid disease, being the main cause ATD in 24 patients (37.5%, CI 95% 27-50; 16 hypothyroidism and 8 hyperthyroidism). Other causes were non-autoimmune hypothyroidism (n=8, 12.5%), multinodular goiter (n=6, 9.3%), coloid goiter (n=4, 6%) and single thyroid nodule (one patient, 1%). We excluded for further analysis a group of 21 patients with hypothyroidism who lacked of anti-thyroid antibodies determination. When we compared patients with ATD (n=24) vs. without ATD (n=104) we did not find differences regarding the age, gender, disease duration, Schirmer-I test, impaired NSWSF, ocular staining, use of immunosuppressors, RF, low complement and hyperglobulinemia; as well as in the glandular and extraglandular features and cumulative ESSDAI (9.04±7.6 vs 11.4±8.9, p=0.19). However ATD patients had a lower prevalence of anti-Ro/SSA (58.3% vs. 88.3%, p=0.001) and anti-La/SSB antibodies (25% vs. 60.6%, p=0.002) than patients without ATD; as well as a lower SSDDI score (2.17±1.2 vs 2.77±2, p=0.05). At the logistic regression analysis, only anti-Ro/SSA and anti-La/SSB remained significant, conferring protection to ATD (OR 0.29, 95% CI 0.10-0.88, p=0.002 and OR 0.31, 95% CI 0.10-0.92, p=0.03, respectively).
Conclusion: Around one third of pSS patients were not evaluated for thyroid disease, and among those evaluated, 37.5% had ATD. These patients had a similar clinical prognosis than those without ATD, but were characterized by a lower prevalence of anti-Ro/SSA and anti-La/SSB antibodies.
To cite this abstract in AMA style:Giron-Pillado M, Atisha-Fregoso Y, Cruz-Bautista I, Astudillo-Angel M, Hernandez-Molina G. Evaluation of Thyroid Autoimmune Disease in Primary SjöGren’s Syndrome and Its Association with Disease Phenotype [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/evaluation-of-thyroid-autoimmune-disease-in-primary-sjogrens-syndrome-and-its-association-with-disease-phenotype/. Accessed September 28, 2020.
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