title: Subclinical hypothyroidism is a risk factor for delayed clinical complete response in patients with systemic lupus erythematosus (SLE).
abstract: The objective of the study was to investigate whether subclinical hypothyroidism is a risk factor for a delayed clinical complete response in patients with SLE. This study included 363 patients with SLE classified according to the ACR classification criteria. These patients were divided into three groups: those who had subclinical hypothyroidism, a euthyroid state, and clinical hypothyroidism. The first group contained 41 cases with SLE and subclinical hypothyroidism, the second group contained 7 cases with SLE and clinical hypothyroidism, and the third group contained 315 positive control cases with SLE and a euthyroid state. Patients were observed for general observational parameters, and an efficacy assessment was performed using SLEDAI, PGA, and SLICC.
  
  
  RESULTS
  Patients in the subclinical hypothyroidism group without supplementary treatment had no higher immune activity indicators, SLE activity, and organ damage than those SLE with euthyroid state. These parameters were also no higher than in those who were given treatment in the SLE with clinical hypothyroidism group at 6 months; Immune activity indicators, SLE activity, organ damage, and remission rate were improved after 3 months' supplementary treatment in 14 subclinical hypothyroidism cases that did not display remission non-remission cases at 6 months. Additionally, no significant difference in remission rate was observed in comparison with the group of SLE patients with a euthyroid state after 6 months' supplementary treatment.
  
  
  CONCLUSIONS
  Subclinical hypothyroidism can the slow remission rate of SLE. Supplementary treatment should be performed earlier to improve the remission rate.
authors.affiliation: Department of Clinical Immunology and Rheumatology, The Affiliated Hospital of Guilin Medical College Guilin 541001, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Dong
authors.affiliation: Department of Clinical Immunology and Rheumatology, The Affiliated Hospital of Guilin Medical College Guilin 541001, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Jia
authors.affiliation: Department of Clinical Immunology and Rheumatology, The Affiliated Hospital of Guilin Medical College Guilin 541001, China.
authors.forename: Xuezhi
authors.initials: X
authors.lastname: Hong
authors.affiliation: Department of Internal Medicine 3, University of Erlangen-Nuremberg Erlangen, Germany.
authors.forename: Guangliang
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Clinical Immunology and Rheumatology, The Affiliated Hospital of Guilin Medical College Guilin 541001, China.
authors.forename: Hanyou
authors.initials: H
authors.lastname: Mo
keywords: SLEDAI; Subclinical hypothyroidism; clinical complete response; systemic lupus erythematosus