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[Polyarthralgia disclosing hyperthyroidism. Two case reports]

S Molinier1, J F Paris, S Marlier

  • 1Service de Médecine interne, Hôpital d'Instruction des Armées Sainte-Anne, Toulon Naval.

Presse Medicale (Paris, France : 1983)
|October 21, 1998
PubMed
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Rheumatism associated with hyperthyroidism can resolve with thyroid treatment. Two patients with polymyalgia rheumatica and psoriatic arthritis experienced symptom relief after managing their hyperthyroidism.

Area of Science:

  • Endocrinology
  • Rheumatology
  • Internal Medicine

Background:

  • Hyperthyroidism can present with unusual rheumatic manifestations.
  • Articular complications of hyperthyroidism, such as scalpulo-humeral periarthritis, are recognized but less common.
  • The link between hyperthyroidism and specific rheumatic syndromes like polymyalgia rheumatica and psoriatic arthritis requires further investigation.

Observation:

  • Two patients, aged 79 and 59, presented with symptoms mimicking polymyalgia rheumatica and psoriatic arthritis, respectively.
  • Initial corticosteroid therapy was ineffective for their rheumatic symptoms.
  • Both patients subsequently developed overt hyperthyroidism, which complicated their clinical presentation.

Findings:

  • Treatment of hyperthyroidism in the first patient with carbimazole and in the second with thyroidectomy led to a rapid and complete resolution of arthralgia.

Related Experiment Videos

  • This suggests a direct or indirect causal link between hyperthyroidism and the observed rheumatic conditions.
  • The resolution of symptoms post-thyroid treatment challenges the typical management of such rheumatic diseases.

    • Implications:

    • These cases highlight the importance of considering and screening for hyperthyroidism in patients with refractory rheumatic symptoms.
    • "Thyrotoxicosis rheumatism" may be an underdiagnosed entity.
    • Further research into the mechanisms, potentially direct thyroid hormone toxicity or autoimmune pathways, is warranted to understand this association.