A Clinical Study of Thyroid Abnormalities and Autoantibodies in Patients Diagnosed With Anti-nuclear Antibody Positive Autoimmune Connective Tissue Disorders: An Observational Cross-Sectional Study

Saimounika Adapa; Varsha R Bhatt; Govind Shiddapur; Nilesh Jagdale; Vutukuru Kalyan Kumar Reddy; Mohith Prakash Kondapalli; Sonali Agarwal; Diksha Sabharwal; Advait Jha

doi:10.7759/cureus.65950

A Clinical Study of Thyroid Abnormalities and Autoantibodies in Patients Diagnosed With Anti-nuclear Antibody Positive Autoimmune Connective Tissue Disorders: An Observational Cross-Sectional Study

Cureus. 2024 Aug 1;16(8):e65950. doi: 10.7759/cureus.65950. eCollection 2024 Aug.

Authors

Saimounika Adapa¹, Varsha R Bhatt², Govind Shiddapur¹, Nilesh Jagdale¹, Vutukuru Kalyan Kumar Reddy¹, Mohith Prakash Kondapalli¹, Sonali Agarwal¹, Diksha Sabharwal¹, Advait Jha¹

Affiliations

¹ Department of General Medicine, Dr. D. Y. Patil College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND.
² Department of Clinical Immunology and Rheumatology, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Pune, IND.

Abstract

Introduction: Autoimmune connective tissue disorders (CTDs) are characterized by inflammation of the connective tissue structures and immune system aberrations, such as autoantibody production. This study investigates the prevalence and clinical significance of thyroid abnormalities in patients with anti-nuclear antibody (ANA)-positive autoimmune CTDs.

Methods: This prospective cross-sectional observational study was conducted at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, from September 2022 to June 2024. Eighty patients diagnosed with ANA-positive CTDs were included. Comprehensive histories were collected from them and clinical examinations and routine investigations were performed. Blood samples were collected for thyroid function tests and autoantibody tests. Thyroid ultrasound investigations were also performed. Ethical approval and informed consent were obtained.

Results: The study revealed a significant prevalence of thyroid dysfunction among participants, with 39 (48.75%) exhibiting some form of thyroid abnormality. Subclinical hypothyroidism was the most common condition in 18 (22.50%) participants, predominantly affecting females. Thyroid autoantibodies were present in 32 (40%) participants, with thyroid peroxidase antibodies (anti-TPO Ab) being the most common seen in 17 (21.25%) participants. Systemic lupus erythematosus (SLE) was the most prevalent CTD among participants, seen in 44 (55%) participants, followed by Sjogren's syndrome (SS) seen in 19 (23.75%) participants.

Conclusion: The study underscores the necessity of routine thyroid function screening in patients with ANA-positive CTDs to facilitate early detection and management of thyroid abnormalities, thereby preventing progression to overt hypothyroidism or hyperthyroidism. The findings highlight the significant association between thyroid dysfunction and autoimmune CTDs, advocating for a holistic approach to patient care.

Keywords: anti-nuclear antibody (ana); autoimmune connective tissue disorders (ctds); subclinical hypothyroidism (such); thyroid abnormaliities; thyroid function tests (tfts).