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Original Research: SARCOIDOSIS |

Prevalence of Hypothyroidism and Graves Disease in Sarcoidosis*

Alessandro Antonelli, MD; Piera Fazzi, MD; Poupak Fallahi, MD; Silvia Martina Ferrari, PhD; Ele Ferrannini, MD
Author and Funding Information

*From the Metabolism Unit (Drs. Antonelli, Fallahi, and Ferrannini, and Ms. Ferrari), Department of Internal Medicine, and Respiratory Pathophysiology Section (Dr. Fazzi), Cardiac and Thoracic Department, University of Pisa, Pisa, Italy.

Correspondence to: Alessandro Antonelli, MD, Department of Internal Medicine, University of Pisa, via Roma, 67, 56100, Pisa, Italy; e-mail: a.antonelli@med.unipi.it



Chest. 2006;130(2):526-532. doi:10.1378/chest.130.2.526
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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.


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