Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Current Rheumatology Reports
Published in: Current Rheumatology Reports 2/2015

01-02-2015 | Orphan Diseases (B Manger, Section Editor)

Rheumatic Symptoms in Autoimmune Thyroiditis

Author: Clement E. Tagoe

Published in: Current Rheumatology Reports | Issue 2/2015

Login to get access

Abstract

Autoimmune thyroiditis (ATD) is generally regarded as a classic example of single organ autoimmunity with a high association with endocrine thyroid disorders. However, it is closely associated with several autoimmune diseases including rheumatologic syndromes and has long been known to have several rheumatic manifestations particularly in association with hypothyroidism. More recently, it has also been implicated in rheumatologic syndromes in the absence of hypothyroidism or subclinical hypothyroidism. There is also an emerging body of evidence that ATD is highly linked to chronic generalized pain syndromes including fibromyalgia. This review examines the rheumatic symptoms of ATD described in the current literature and discusses the clinical relevance of ATD in general rheumatology.
Literature
1.
Bindra A, Braunstein GD. Thyroiditis. Am Fam Physician. 2006;73:1769–76.PubMed
2.
Brown RS. Autoimmune thyroid disease: unlocking a complex puzzle. Curr Opin Pediatr. 2009;21:523–8.CrossRefPubMed
3.
Czarnocka B. Thyroperoxidase, thyroglobulin, Na(+)/I(−) symporter, pendrin in thyroid autoimmunity. Front Biosci. 2011;16:783–802 (Landmark Ed).CrossRef
4.
5.
Caturegli P, De Remigis A, Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmun Rev. 2014;13:391–7.CrossRefPubMed
6.
Weetman AP. Autoimmune thyroid disease: propagation and progression. Eur J Endocrinol. 2003;148:1–9.CrossRefPubMed
7.
Pedersen OM, Aardal NP, Larssen TB, Varhaug JE, Myking O, Vik-Mo H. The value of ultrasonography in predicting autoimmune thyroid disease. Thyroid. 2000;10:251–9.CrossRefPubMed
8.
Schott M, Scherbaum WA. Autoimmune thyroid disease. Deut Ärzteblatt. 2006;103:A 3023–32.
9.
Macchia E, Concetti R, Borgoni F, Cetani F, Fenzi GF, Pinchera A. Assays of TSH-receptor antibodies in 576 patients with various thyroid disorders: their incidence, significance and clinical usefulness. Autoimmunity. 1989;3:103–12.CrossRefPubMed
10.
Staii A, Mirocha S, Todorova-Koteva K, Glinberg S, Jaume JC. Hashimoto thyroiditis is more frequent than expected when diagnosed by cytology which uncovers a pre-clinical state. Thyroid Res. 2010;3:11.CrossRefPubMedCentralPubMed
11.
Zois C, Stavrou I, Kalogera C, et al. High prevalence of autoimmune thyroiditis in schoolchildren after elimination of iodine deficiency in northwestern Greece. Thyroid. 2003;13:485–9.CrossRefPubMed
12.
Lazurova I, Benhatchi K, Rovensky J, et al. Autoimmune thyroid disease and autoimmune rheumatic disorders: a two-sided analysis. Ann N Y Acad Sci. 2009;1173:211–6.CrossRefPubMed
13.••
Tagoe CE, Zezon A, Khattri S, Castellanos P. Rheumatic manifestations of euthyroid, anti-thyroid antibody-positive patients. Rheumatol Int. 2013;33:1745–52. This article for the first time looks solely at a population of patients with autoimmune thyroiditis and no well-defined rheumatic syndrome and finds very high levels of fibromyalgia, chronic pain and arthritis. This is the first paper suggesting that autoimmune thyroiditis itself may have more generalized, systemic sequelae and may not always be a single organ autoimmune syndrome.CrossRefPubMed
14.
Jacobson DL, Gange SJ, Rose NR, Graham NM. Epidemiology and estimated population burden of selected autoimmune diseases in the United States. Clin Immunol Immunopathol. 1997;84:223–43.CrossRefPubMed
15.
Hollowell JG, Staehling NW, Flanders WD, et al. 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. 2002;87:489–99.CrossRefPubMed
16.
Bjoro T, Holmen J, Kruger O, et al. Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-Trondelag (HUNT). Eur J Endocrinol. 2000;143:639–47.CrossRefPubMed
17.
Boelaert K, Newby PR, Simmonds MJ, et al. Prevalence and relative risk of other autoimmune diseases in subjects with autoimmune thyroid disease. Am J Med;123:183 e1-9.
18.
19.
Becker KL, Ferguson RH, Mc CW. The connective-tissue diseases and symptoms associated with Hashimoto’s thyroiditis. N Engl J Med. 1963;268:277–80.CrossRefPubMed
20.
Biro E, Szekanecz Z, Czirjak L, et al. Association of systemic and thyroid autoimmune diseases. Clin Rheumatol. 2006;25:240–5.CrossRefPubMed
21.
Somers EC, Thomas SL, Smeeth L, Hall AJ. Autoimmune diseases co-occurring within individuals and within families: a systematic review. Epidemiology. 2006;17:202–17.CrossRefPubMed
22.
Cho JH, Gregersen PK. Genomics and the multifactorial nature of human autoimmune disease. N Engl J Med. 2011;365:1612–23.CrossRefPubMed
23.
24.
Cho JH, Gregersen PK. Genomics and the multifactorial nature of human autoimmune disease. N Engl J Med;365:1612–23.
25.
26.
27.
Blackard JT, Kong L, Huber AK, Tomer Y. Hepatitis C virus infection of a thyroid cell line: implications for pathogenesis of hepatitis C virus and thyroiditis. Thyroid. 2013;23:863–70.CrossRefPubMedCentralPubMed
28.
Doyle L. Myxoedema: some early reports and contributions by British authors, 1873–1898. J R Soc Med. 1991;84:103–6.PubMedCentralPubMed
29.
Saravanan P, Dayan CM. Thyroid autoantibodies. Endocrinol Metab Clin N Am. 2001;30:315–37. viii.CrossRef
30.
Gillan MM, Scofield RH, Harley JB. Hashimoto’s thyroiditis presenting as bilateral knee arthropathy. J Okla State Med Assoc. 2002;95:323–5.PubMed
31.
Longato L, Tarocco RP, Anania A, Corino D, Quaranta L, Perotti L. Arthropathies and thyroid diseases. Minerva Endocrinol. 2004;29:55–62.PubMed
32.
33.
Bland JH, Frymoyer JW, Newberg AH, Revers R, Norman RJ. Rheumatic syndromes in endocrine disease. Semin Arthritis Rheum. 1979;9:23–65.CrossRefPubMed
34.
35.
Punzi L, Sfriso P, Pianon M, et al. Clinical manifestations and outcome of polyarthralgia associated with chronic lymphocytic thyroiditis. Semin Arthritis Rheum. 2002;32:51–5.CrossRefPubMed
36.
Nakamura H, Usa T, Motomura M, et al. Prevalence of interrelated autoantibodies in thyroid diseases and autoimmune disorders. J Endocrinol Investig. 2008;31:861–5.CrossRef
37.
Atzeni F, Doria A, Ghirardello A, et al. Anti-thyroid antibodies and thyroid dysfunction in rheumatoid arthritis: prevalence and clinical value. Autoimmunity. 2008;41:111–5.CrossRefPubMed
38.
Karsh J, Pavlidis N, Weintraub BD, Moutsopoulos HM. Thyroid disease in Sjogren’s syndrome. Arthritis Rheum. 1980;23:1326–9.CrossRefPubMed
39.
Ramos-Casals M, Garcia-Carrasco M, Cervera R, et al. Thyroid disease in primary Sjogren syndrome. Study in a series of 160 patients. Medicine (Baltimore). 2000;79:103–8.CrossRef
40.
Perez B, Kraus A, Lopez G, Cifuentes M, Alarcon-Segovia D. Autoimmune thyroid disease in primary Sjogren’s syndrome. Am J Med. 1995;99:480–4.CrossRefPubMed
41.
Milic VD, Radunovic G, Boricic I, et al. High prevalence of autoimmune thyroid disease in subjects with sicca symptoms without Sjogren’s syndrome. Rheumatology (Oxford). 2013;52:754–5.CrossRef
42.
Kramer PA. Prevalence and distribution of spinal osteoarthritis in women. Spine (Phila Pa 1976). 2006;31:2843–8.CrossRef
43.
Helmick CG, Felson DT, Lawrence RC, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. Arthritis Rheum. 2008;58:15–25.CrossRefPubMed
44.
Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008;58:26–35.CrossRefPubMedCentralPubMed
45.
Blake DR, McGregor AM, Stansfield E, Smith BR. Antithyroid-antibody activity in the snyovial fluid of patients with various arthritides. Lancet. 1979;2:224–6.CrossRefPubMed
46.
Cogni G, Chiovato L. An overview of the pathogenesis of thyroid autoimmunity. Horm. 2013;12:19–29 (Athens).
47.
Molina F, Bouanani M, Pau B, Granier C. Characterization of the type-1 repeat from thyroglobulin, a cysteine-rich module found in proteins from different families. Eur J Biochem. 1996;240:125–33.CrossRefPubMed
48.
Branco JC, Bannwarth B, Failde I, et al. Prevalence of fibromyalgia: a survey in five European countries. Semin Arthritis Rheum. 2010;39:448–53.CrossRefPubMed
49.
50.
Schaefer C, Chandran A, Hufstader M, et al. The comparative burden of mild, moderate and severe fibromyalgia: results from a cross-sectional survey in the United States. Health Qual Life Outcomes. 2011;9:71.CrossRefPubMedCentralPubMed
51.
52.
53.
Wolfe F, Smythe HA, Yunus MB, et al. The American college of rheumatology 1990 criteria for the classification of fibromyalgia. report of the multicenter criteria committee. Arthritis Rheum. 1990;33:160–72.CrossRefPubMed
54.
Pamuk ON, Cakir N. The frequency of thyroid antibodies in fibromyalgia patients and their relationship with symptoms. Clin Rheumatol. 2007;26:55–9.CrossRefPubMed
55.••
Bazzichi L, Rossi A, Giuliano T, et al. Association between thyroid autoimmunity and fibromyalgic disease severity. Clin Rheumatol. 2007;26:2115–20. In this article the authors make a strong argument for listing autoimmune thyroiditis as an important cause of fibromyalgia based on accumulating evidence in the literature.CrossRefPubMed
56.
Bazzichi L, Rossi A, Zirafa C, et al. Thyroid autoimmunity may represent a predisposition for the development of fibromyalgia? Rheumatol Int. 2012;32:335–41.CrossRefPubMed
57.••
Suk JH, Lee JH, Kim JM. Association between thyroid autoimmunity and fibromyalgia. Exp Clin Endocrinol Diabetes. 2012;120:401–4. This article reported by endocrinologists comments of the very high prevalence of fibromyalgia in patients not previously selected for arthritis or rheumatologic complaints. It therefore removes the bias seen in some rheumatology reports.CrossRefPubMed
58.
Ahmad J, Blumen H, George C, Shrestha A, Tagoe CE. Association of anti-thyroid autoantibodies with fibromyalgia in rheumatoid arthritis. Arthritis Rheum. 2014;66:S171.CrossRef
59.
Barkoff MS, Kocherginsky M, Anselmo J, Weiss RE, Refetoff S. Autoimmunity in patients with resistance to thyroid hormone. J Clin Endocrinol Metab;95:3189–93.
60.
Parikh S, Ando S, Schneider A, Skarulis MC, Sarlis NJ, Yen PM. Resistance to thyroid hormone in a patient without thyroid hormone receptor mutations. Thyroid. 2002;12:81–6.CrossRefPubMed
61.
Tjorve E, Tjorve KM, Olsen JO, Senum R, Oftebro H. On commonness and rarity of thyroid hormone resistance: a discussion based on mechanisms of reduced sensitivity in peripheral tissues. Med Hypotheses. 2007;69:913–21.CrossRefPubMed
62.
Shrestha A, Cohen H, Tagoe CE. Autoimmune thyroid disease is associated with a higher frequency of spinal degenerative disc disease. Arthritis Rheum. 2014;66:S980.CrossRef
63.•
Ahmad J, Tagoe CE. Fibromyalgia and chronic widespread pain in autoimmune thyroid disease. Clin Rheumatol. 2014;33:885–91. This article is a comprehensive review of the evidence for involvement of autoimmune thyroiditis in chronic pain syndromes and speculates on possible mechanisms of pain generation.CrossRefPubMed
Metadata
Title
Rheumatic Symptoms in Autoimmune Thyroiditis
Author
Clement E. Tagoe
Publication date
01-02-2015
Publisher
Springer US
Published in
Current Rheumatology Reports / Issue 2/2015
Print ISSN: 1523-3774
Electronic ISSN: 1534-6307
DOI
https://doi.org/10.1007/s11926-014-0479-7

Other articles of this Issue 2/2015

Current Rheumatology Reports 2/2015 Go to the issue

Spondyloarthritis (MA Khan, Section Editor)

Spondyloarthritis and the Microbiome: New Insights From an Ancient Hypothesis

Antiphospholipid Syndrome (D Erkan, Section Editor)

The Challenge of Bleeding in Antiphospholipid Antibody-Positive Patients

Surgery and Perioperative Care (CR MacKenzie and SM Goodman, Section Editors)

Cervical Spine Disease in Rheumatoid Arthritis: Incidence, Manifestations, and Therapy

Biosimilars (E Mysler, Section Editor)

Biosimilars: Clinical Interpretation and Implications for Drug Development

Vasculitis (L Espinoza, Section Editor)

Giant Cell Arteritis and Polymyalgia Rheumatica: an Update

Surgery and Perioperative Care (CR MacKenzie and SM Goodman, Section Editors)

Postoperative Risk of Venous Thromboembolism in Rheumatic Disease Patients

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24 to hear Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits