Title:Autoimmune Thyroid Disease in Primary Sjögren’s Syndrome: Real-life
Screening Practice and Clinical Outcomes
Volume: 18
Issue: 3
Author(s): Mario Girón-Pïllado, Ivette Cruz-Bautista, Vanessa Saavedra-González, Yemil Atisha-Fregoso, Gustavo Barraza, Carlos A. Aguilar-Salinas and Gabriela Hernández-Molina*
Affiliation:
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán,
Mexico City, Mexico
Keywords:
Autoimmune thyroid disease, sjögren’s syndrome, thyroid function test, thyroid disease, thyroid screening, thyroid.
Abstract:
Background: Notwithstanding the frequent coexistence of autoimmune thyroid disease
(ATD) and primary Sjögren’s Syndrome (SS), it is still unknown how often this association is
studied along with its clinical impact.
Objective: This study aimed to describe real-world screening practices for ATD in patients with SS
and evaluate clinical outcomes of patients with both diagnoses using validated activity and chronicity
indexes.
Methods: It is a retrospective study of 223 patients with SS attending a tertiary referral center. Patients
were under rheumatology surveillance and might have attended other clinics, including internal
medicine and/or endocrinology. We registered glandular and extraglandular features, serology
and scored the activity (ESSDAI) and the accrual damage (SSDDI) indexes. We also identified any
thyroid function tests (TFT) performed, anti-thyroid antibodies, images, and histological thyroid examinations.
A single endocrinologist reviewed all data.
Results: One hundred forty-nine patients had at least one set of TFT. Younger age was associated
with a lack of screening (OR 0.98, 95 % CI 0.95-0.99, p=0.01). Sixty-nine patients had thyroid disease,
with the most common diagnosis being ATD (n=24). Patients with ATD had a lower prevalence
of Ro/SSA and anti-La/SSB antibodies but similar cumulative SS activity and damage
scores.
Conclusion: At least one-third of our patients were not screened for thyroid disease, with these patients
being the youngest. Thyroid disorders were found in about 40 % of patients with SS, with
ATD being the most common. Having SS/ATD did not confer more disease activity or damage accrual.
These results highlight the importance of making treating physicians aware of screening for
thyroid disease in this population.
