Background Autoimmune thyroid disease is the most prevalent autoimmune disorder,affecting about 10% of the population,and is a recognized cause of fibromyalgia (FM) and chronic widespread pain.
Objectives The aims of this study are to evaluate fibromyalgia (FM) in patients with euthyroid Hashimoto's throiditis (HT) and whether TPOAb positivity is associated with the FM.
Methods We have studied 167 patients with HT and 83 healthy controls followed in our hospital.Single researcher took the history and did physical examination including manuel tender point examination according to Manuel Tender Point Survey instructions.For the diagnosis FM, 2010 American College of Rheumatology Classification Criteria for the FM was used. Thyroid assessment was done by free T4,free T3,TSH,antithyroglobulin antibody (TgAb) and TPOAb.Patients were excluded from the study if they had any other serious disease,and if there was any history of drug use that interferes with the symptoms of FM.
Results FM was found in 40% (67 out of 167 patients) of in HT patients, in 7% (6 out of 83 healthy controls, p<0,001) of controls.The average age was significant higher in patients with FM than controls (43,78±10,48 yrs vs 40,43±10,52 yrs, p=0.02).TSH (2,97±2,03 vs 2,20±1,33, p=0,001),TPOAb (240,92±268,6 vs 197,05±288,14, p=0,006) and TgAb levels (300,68±528,79 vs 153,76±411,51, p=0,003) where notable higher in patients with FM,according to patients without FM.Widespread pain index (WPI),symptom severity scale (SSS) and tender point examination (TPE) showed no significant difference between the patient and control group.On the other hand WPI,SSS and TPE showed a positive correlation with TSH (r:0,184, p=0,004; r:0,204, p=0,001; r:0,167, p=0,009 respectively).Also TgAb showed positive correlation with SSS (r:0,168, p=0,02).Increasing age in patients with HT showed positive relationship with WPI and tenTPE (r=0,193, p=0,012 and r=0,170, p=0,02 respectively)
Conclusions In our study, euthyroid HT patients showed significantly higher prevalence of FM, as compared to healthy control. This finding support thyroid autoimmunity may influence the development of FM, but the evidence which support that FM is related to autoimmune etiology is not clear, and FM severity may not be affected by the presence of thyroid autoantibody.
Ahmad J1, Tagoe CE. Fibromyalgia and chronic widespread pain in autoimmune thyroid disease. Clin Rheumatol. 2014 Jul;33(7):885-91. doi: 10.1007/s10067-014-2490-9.
Suk JH1, Lee JH, Kim JM. Association between thyroid autoimmunity and fibromyalgia. Exp Clin Endocrinol Diabetes. 2012 Jul;120(7):401-4. doi: 10.1055/s-0032-1309008.
Bazzichi L1, Rossi A, Zirafa C, Monzani F, Tognini S, Dardano A, Santini F, Tonacchera M, De Servi M, Giacomelli C, De Feo F, Doveri M, Massimetti G, Bombardieri S. Thyroid autoimmunity may represent a predisposition for the development of fibromyalgia? Rheumatol Int. 2012 Feb;32(2):335-41. doi: 10.1007/s00296-010-1620-1.
Bazzichi L1, Rossi A, Giuliano T, De Feo F, Giacomelli C, Consensi A, Ciapparelli A, Consoli G, Dell'osso L, Bombardieri S. Association between thyroid autoimmunity and fibromyalgic disease severity. Clin Rheumatol. 2007 Dec;26(12):2115-20.
Disclosure of Interest None declared