To investigate how autoimmune thyroiditis (ATD) affects the clinical presentation of established rheumatoid arthritis (RA) with particular reference to fibromyalgia and chronic widespread pain (CWP). A cohort of 204 patients with RA for whom the presence or absence of autoimmune thyroid antibodies was documented was examined for the relationships between thyroid autoantibodies and fibromyalgia or CWP. We identified 29 % who tested positive for antithyroid peroxidase antibodies (TPOAb). The anti-thyroglobulin antibody (TgAb) was found in 24 %. Among the thyroid autoantibody-positive patients, 40 % had a diagnosis of fibromyalgia or CWP versus 17 % for antibody negative patients. Logistic regression analyses (adjusted by age, sex, diabetes and BMI) indicated that TPOAb-positive patients were more likely to have fibromyalgia or CWP, with an odds ratio (OR) of 4.641, 95 % confidence interval (CI) (2.110–10.207) P < .001. Adjusting for spinal degenerative disc disease did not change the association with fibromyalgia, OR 4.458, 95 % CI (1.950–10.191), P < .001. The OR between TgAb and fibromyalgia was not significant (P > .05). Additional logistic regression analyses (adjusted by age, sex and BMI) indicated a significant relationship between TPOAb and fibromyalgia or CWP in patients without diabetes and those without hypothyroidism (OR of 4.873, 95 % CI (1.877–12.653), P = .001 and OR of 4.615 95 % CI (1.810–11.770), P = .001, respectively). There may be a positive association between the ATD antibody TPOAb, and fibromyalgia syndrome and CWP in patients with established RA.
This is a preview of subscription content, log in to check access.
Conflict of interest
The authors have no conflicts of interest to declare.
Jacobson DL, Gange SJ, Rose NR, Graham NM (1997) Epidemiology and estimated population burden of selected autoimmune diseases in the United States. Clin Immunol Immunopathol 84:223–243PubMedCrossRefGoogle Scholar
Hollowell JG, Staehling NW, Flanders WD et al (2002) Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 87:489–499PubMedCrossRefGoogle Scholar
Lazurova I, Benhatchi K, Rovensky J et al (2009) Autoimmune thyroid disease and autoimmune rheumatic disorders: a two-sided analysis. Ann NY Acad Sci 1173:211–216PubMedCrossRefGoogle Scholar
Ramos-Casals M, Garcia-Carrasco M, Cervera R et al (2000) Thyroid disease in primary Sjogren syndrome. Study in a series of 160 patients. Medicine (Baltimore) 79:103–108CrossRefGoogle Scholar
Biro E, Szekanecz Z, Czirjak L et al (2006) Association of systemic and thyroid autoimmune diseases. Clin Rheumatol 25:240–245PubMedCrossRefGoogle Scholar
Boelaert K, Newby PR, Simmonds MJ et al (2010) Prevalence and relative risk of other autoimmune diseases in subjects with autoimmune thyroid disease. Am J Med 123(183):e1–e9PubMedGoogle Scholar
Tagoe CE, Zezon A, Khattri S (2012) Rheumatic manifestations of autoimmune thyroid disease: the other autoimmune disease. J Rheumatol 39:1125–1129PubMedCrossRefGoogle Scholar
Becker KL, Ferguson RH, Mc CW (1963) The connective-tissue diseases and symptoms associated with Hashimoto’s thyroiditis. N Engl J Med 268:277–280PubMedCrossRefGoogle Scholar
Ott J, Promberger R, Kober F et al (2011) Hashimoto’s thyroiditis affects symptom load and quality of life unrelated to hypothyroidism: a prospective case-control study in women undergoing thyroidectomy for benign goiter. Thyroid 21:161–167PubMedCrossRefGoogle Scholar
Tagoe CE, Zezon A, Khattri S, Castellanos P (2013) Rheumatic manifestations of euthyroid, anti-thyroid antibody-positive patients. Rheumatol Int 33:1745–1752PubMedCrossRefGoogle Scholar
Soy M, Guldiken S, Arikan E, Altun BU, Tugrul A (2007) Frequency of rheumatic diseases in patients with autoimmune thyroid disease. Rheumatol Int 27:575–577PubMedCrossRefGoogle Scholar
Altman R, Asch E, Bloch D et al (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 29:1039–1049PubMedCrossRefGoogle Scholar
Altman R, Alarcon G, Appelrouth D et al (1991) The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 34:505–514PubMedCrossRefGoogle Scholar
Altman R, Alarcon G, Appelrouth D et al (1990) The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum 33:1601–1610PubMedCrossRefGoogle Scholar
Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324PubMedCrossRefGoogle Scholar
Aletaha D, Neogi T, Silman AJ et al (2010) 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62:2569–2581PubMedCrossRefGoogle Scholar
Wolfe F, Smythe HA, Yunus MB et al (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 33:160–172PubMedCrossRefGoogle Scholar
Ahmad J, Tagoe CE (2014) Fibromyalgia and chronic widespread pain in autoimmune thyroid disease. Clin Rheumatol 33:885–891PubMedCrossRefGoogle Scholar
Anderson J, Caplan L, Yazdany J et al (2012) Rheumatoid arthritis disease activity measures: American College of Rheumatology recommendations for use in clinical practice. Arthritis Care Res (Hoboken) 64:640–647CrossRefGoogle Scholar