Previous studies have documented an association between thyroid dysfunction, predominant hypothyroidism, and antibody positivity in patients with systemic sclerosis (SSc). There are no studies reporting the relationship between thyroid volume and thyroid functions in patients with SSc. This study was conducted to correlate thyroid dysfunction with thyroid volume as measured on ultrasound and antibody positivity. Complete thyroid workup was done in 106 patients of SSc which included thyroid function test, antithyroid peroxidase (TPO) antibody, antithyroid-stimulating hormone receptor (TSHR) antibody, antithyroglobulin antibody, and thyroid ultrasound to assess thyroid volume, echogenicity and blood flow, and fine needle aspiration cytology of suspicious thyroid lesions. Prevalence of subclinical hypothyroidism was 8.5 %, overt hypothyroidism 1.9 %, subclinical hyperthyroidism 2.8 %, and overt hyperthyroidism in 0.9 % of the patients. Antithyroid peroxidase antibody was positive in 16 %, anti-TSH receptor antibody in 5.7 %, and antithyroglobulin antibody in none of the patients. Thyroid volume was in the range of atrophy (<4.5 ml) in 57.5 % patients, echogenicity altered in 15.1 %, and blood flow increased in 15.1 %. Thyroid volume correlated strongly with the pulmonary function test (FEV1). Routine thyroid ultrasound and thyroid function tests may be included in the workup of patients with SSc for the early detection of hypothyroidism since a small but significant percentage of patients developed thyroid dysfunction. Antithyroid antibodies may not correlate with the thyroid functions and hence should not be recommended.
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Mayes MD, Lacey JV Jr, Beebe-Dimmer J, Gillespie BW, Cooper B, Laing TJ, Schottenfeld D (2003) Prevalence, incidence, survival, and disease characteristics of systemic sclerosis in a large US population. Arthritis Rheum 48:2246–2255CrossRefPubMedGoogle Scholar
Antonelli A, Fallahi P, Ferrari SM, Mancusi C, Giuggioli D, Colaci M, Ferri C (2013) Incidence of thyroid disorders in systemic sclerosis: results from a longitudinal follow-up. J Clin Endocrinol Metab 98:E1198–1202CrossRefPubMedGoogle Scholar
Antonelli A, Ferri C, Fallahi P, Cazzato M, Ferrari SM, Sebastiani M, Ferrannini E (2007) Clinical and subclinical autoimmune thyroid disorders in systemic sclerosis. Eur J Endocrinol 156:431–437CrossRefPubMedGoogle Scholar
Gordon MB, Klein I, Dekker A, Rodnan GP, Medsger TA Jr (1981) Thyroid disease in progressive systemic sclerosis: increased frequency of glandular fibrosis and hypothyroidism. Ann Intern Med 95:431–435CrossRefPubMedGoogle Scholar
van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A et al (2013) 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum 65:2737–2747CrossRefPubMedPubMedCentralGoogle Scholar
Marwaha RK, Tandon N, Ganie MA, Kanwar R, Sastry A, Garg MK et al (2012) Status of thyroid function in Indian adults: two decades after universal salt iodization. J Assoc Physicians India 60:32–36PubMedGoogle Scholar
Schwarz W, Schell H, Hornstein OP (1981) Serum levels of thyreotropin in progressive scleroderma. Arch Dermatol Res 271:451–453CrossRefPubMedGoogle Scholar
Serup J, Hangdrup H (1986) Thyroid hormones in generalized scleroderma. A controlled study. Acta Derm Venereol 66:35–38PubMedGoogle Scholar
Kahl LE, Medsger TA Jr, Klein I (1986) Prospective evaluation of thyroid function in patients with systemic sclerosis (scleroderma). J Rheumatol 13:103–107PubMedGoogle Scholar
Molnar I, Balazs C, Szabo E, Czirjak L (1992) Anti-thyroid antibodies and hypothyroidism in systemic sclerosis. J Endocrinol Invest 15:311CrossRefPubMedGoogle Scholar
Miccoli P, Minuto MN, Orlandini C, Galleri D, Massi M, Berti P (2006) Ultrasonography estimated thyroid volume: a prospective study about its reliability. Thyroid 16:37–39CrossRefPubMedGoogle Scholar
Brauer VF, Eder P, Miehle K, Wiesner TD, Hasenclever H, Paschke R (2005) Interobserver variation for ultrasound determination of thyroid nodule volumes. Thyroid 15:1169–1175CrossRefPubMedGoogle Scholar
Ying M, Yung DM, Ho KK (2008) Two-dimensional ultrasound measurement of thyroid gland volume: a new equation with higher correlation with 3-D ultrasound measurement. Ultrasound Med Biol 34:56–63CrossRefPubMedGoogle Scholar
Andermann P, Schlogl S, Mader U, Luster M, Lassmann M, Reiners C (2007) Intra- and interobserver variability of thyroid volume measurements in healthy adults by 2D versus 3D ultrasound. Nuklearmedizin 46:1–7PubMedGoogle Scholar
Raber W, Gessl A, Nowotny P, Vierhapper H (2002) Thyroid ultrasound versus antithyroid peroxidase antibody determination: a cohort study of four hundred fifty-one subjects. Thyroid 12:725–731CrossRefPubMedGoogle Scholar
Vitti P, Lampis M, Piga M, Loviselli A, Brogioni S, Rago T et al (1994) Diagnostic usefulness of thyroid ultrasonography in atrophic thyroiditis. J Clin Ultrasound 22:375–379CrossRefPubMedGoogle Scholar