Rheumatoid Arthritis (RA) and thyroid disorders have autoimmunity as one of the aetiological factors. This study aims to find the thyroid profile in RA patients. This is a descriptive cross-sectional study of 164 RA patients who attended Rheumatology OP department of Government Medical College Thiruvananthapuram over a period of one year in 2016, diagnosed according to ACR/EULAR 2010 criteria for RA. Activity index is calculated using DAS 28 scoring based on ESR. All the patients were tested for TSH, FT4, FT3, and Anti-TPO by chemiluminescent Immunoassay method. Thyroid status is defined based on the Dutch National Healthcare Consensus Committee. The mean age at diagnosis of RA was 43.3 years ±11.7 years and mean duration of symptoms of RA were 4.7± 2.3 years. 90.2% were females and 9.8% were males. Thyroid abnormalities are found in 29.3% and relatively more among those between 41-50 years. 24.4% were hypothyroid, 3.7% had subclinical hypothyroidism, and 2% had subclinical hyperthyroidism. 14.6%) had Thyroid swelling, 6.1% had multi nodular goitre, and 8.5% had diffuse goitre. Among the patients with thyroid dysfunction, all had constitutional symptoms and 24.4% had morning stiffness for more than an hour. Mean duration of symptoms of thyroid dysfunction were 5.1±3.0 years compared to 4.5±1.8 years in normal. There was significant correlation of patients with thyroid dysfunction to positive anti TPO antibodies. 27 patients with thyroid abnormalities were on treatment with NSAIDS or DMARDs. There was a significant correlation between RA and thyroid dysfunction and the commonest abnormality was hypothyroidism.

Keywords: Rheumatoid arthritis, Thyroid dysfunction, Hypothyroidism, Anti-TPO antibody, DAS score.

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Dr Aruna R

Additional Professor, Department of Medicine, Government Medical College Thiruvananthapuram, Kerala