Background/Purpose:  Patients with Hashimoto´s thyroiditis (HT) are frequently seen by rheumatologists due to rheumatic complain that do not fit into diagnostic criteria for a definite arthropathy. The purpose of this study was to establish the prevalence and associated factors of undifferentiated inflammatory arthropathy (UIA) in a sample of Hispanic patients with Hashimoto’s thyroiditis (HT).

Methods:  Cross-sectional study in consecutive patients with HT from the outpatient clinic of the Endocrinology Division of the University Hospital. Diagnosis was based on the presence of anti-thyroid peroxidase antibodies (N=76) or typical ultrasonographic findings (N=25).

Results:  One hundred one patients were evaluated by two rheumatologists (EJGC, LMVH). Ninety six percent were female and the median age was 50.01 years. We excluded six patients from the study (five who met the American College of Rheumatology 1987 criteria for RA and one who met the Assessment of SpondyloArthritis international Society criteria for SpA). Overall, 73.27% referred arthralgias and 36.30% axial inflammatory pain. ANA were positive in 54.46%, RF in 12.87%, and ACPA in 2.97% of patients. Twenty five percent of patients met criteria for undifferentiated inflammatory arthropathy (UIA). The following features distinguished HT patients with UIA versus HT patients without UIA: peripheral arthralgias (100.00% vs. 58.60, p < 0.0001), xerostomy (64.00% vs. 34.30%, p = 0.0200), xerophtalmy (64.00% vs. 40.00%, p = 0.0330), myalgia (96.00% vs. 50.00%, p < 0.0001), Raynaud phenomenon (32.00% vs. 8.60%, p = 0.0100) and axial inflammatory manifestations (68.00% vs. 24,30%, p = 0,0001). The independent risk factors for UIA were the presence of myalgia (OR = 15.04; 95% CI: 1.83 – 123.41) and axial inflammatory manifestations (OR = 4.20; 95% CI: 1.37 – 12.87). RF and ACPA were positive in 3 and 1 patients with UIA; and in 7 and 1 patients without UIA, respectively (NS). There was no correlation between thyroid function levels and UIA, and no laboratory tests showed clinical utility as predictors of UIA in patients with HT.

Conclusion:   One out of four patients with HT of our sample had UIA. Risk factors for the development of UIA were the presence of myalgia and axial inflammatory manifestations. UIA is a common manifestation in patients with HT. Therefore, HT should be considered in the differential diagnosis of patients with inflammatory joint symptoms.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/inflammatory-arthropathy-and-hashimotos-thyroiditis-prevalence-and-associated-factors/