Prevalence of hypothyroidism and Graves disease in sarcoidosis.
BACKGROUND
The association of sarcoidosis (S) and thyroid autoimmunity has been reported by several studies in a wide range of variability. The aim of our study was to evaluate the prevalence of clinical and subclinical thyroid disorders in patients with S vs gender-matched and age-matched control subjects.


METHODS
Thyroid hormones and antithyroid antibodies, thyroid ultrasonography and fine-needle aspiration were performed in 111 patients with S who had been consecutively referred to the Respiratory Pathophysiology Section of the University of Pisa, and the results were compared to 333 gender-matched and age-matched control subjects from the same geographic area.


RESULTS
The odds ratio for subclinical hypothyroidism for female patients with S vs control subjects was 2.7 (95% confidence interval [CI], 1.3 to 5.9); for anti-thyroid peroxidase antibody titer (AbTPO) positivity, 2.2 (95% CI, 1.2 to 3.9); and for thyroid autoimmunity, 1.9 (95% CI, 1.1 to 3.2). The mean values of thyroid-stimulating hormone and AbTPO were higher in female S patients than in control subjects (p < 0.01). A significantly higher prevalence of clinical hypothyroidism (four patients) and Graves disease (three patients) was observed in female S patients than in control subjects (none; p = 0.005 and 0.0026, respectively). Two cases of papillary thyroid cancer were detected in S patients. No significant difference between S patients and control subjects was detected for free triiodothyronine and thyroxine, antithyroglobulin autoantibodies, thyroid volume and nodularity, and subclinical hyperthyroidism.


CONCLUSIONS
Thyroid function, AbTPO antibodies, and ultrasonography should be tested as part of the clinical profile in female S patients. Subjects who are at high risk (female subjects, those with positive AbTPOs, and those with hypoechoic and small thyroid) should have thyroid function follow-up and appropriate treatment in due course.
Antonelli
Alessandro
A
Metabolism Unit, University of Pisa, Italy. a.antonelli@med.unipi.it
Fazzi
Piera
P
Fallahi
Poupak
P
Ferrari
Silvia Martina
SM
Ferrannini
Ele
E
D017677:Age Distribution; D044963:Biopsy, Fine-Needle; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007037:Hypothyroidism / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012507:Sarcoidosis / Q000097:blood / Q000150:complications*; D017678:Sex Distribution; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology; D013963:Thyroid Hormones / Q000097:blood; D014463:Ultrasonography
D013963:Thyroid Hormones