The association between thyroid dysfunction, autoimmune thyroid disease, and rheumatoid arthritis disease severity

Area of Science:

• Immunology
• Endocrinology
• Rheumatology

Background:

• Rheumatoid Arthritis (RA) and autoimmune thyroid disease (AITD) frequently coexist due to shared autoimmune pathogenesis.
• Understanding the impact of AITD on RA severity is crucial for comprehensive patient management.

Purpose of the Study:

• To investigate the association between thyroid dysfunction, anti-thyroid peroxidase (anti-TPO) antibody positivity, AITD, and RA disease severity.
• To analyze these associations within the Iranian population.

Main Methods:

• A cross-sectional study involving 350 RA patients at a tertiary care center in Qom, Iran.
• Data collection included medical records, interviews, physical examinations, and laboratory tests.
• RA disease activity was assessed using the DAS-28-ESR score, categorizing patients into remission, mild-to-moderate, and severe disease activity groups.

Main Results:

• Anti-TPO antibody positivity was 2.93 times more prevalent in severe RA patients compared to those in remission (P < 0.001).
• Patients with severe RA were 2.71 times more likely to have AITD (P < 0.001) and 82% more likely to have thyroid dysfunction (P = 0.006) than those in remission.

Conclusions:

• Thyroid dysfunction, anti-TPO antibody positivity, and AITD are significantly associated with increased RA disease severity.
• These findings highlight the importance of screening for thyroid conditions in RA patients, particularly those with severe disease activity.