Impacts of Hashimoto’s Thyroiditis on Rheumatoid Arthritis Activity and Its Complication Among Iraqi Patients with Rheumatoid Arthritis

Abstract

Background: Rheumatoid arthritis (RA) is an autoimmune disorder. Autoimmune thyroid disease often coexists with RA and is associated with elevated cardiovascular (CV) risk. This risk was pronounced in women and the elderly. RA patients should be closely monitored to prevent the development of hypothyroidism. Objectives: The purpose of this study was to investigate the impacts of Hashimoto’s thyroiditis on rheumatoid arthritis activity and its complication among Iraqi patients with rheumatoid arthritis. Materials and Methods: This study is a cross-sectional observational study involving 140 participants diagnosed with RA (according to rheumatologist physicians in accordance with ACR/EULAR 2010 criteria). Enzyme-linked immunosorbent assay (ELISA) was used to assess serum levels of anti-CCP, Ab-TPO, TSH, T4, and lipid profile. As well as troponin, myoglobin, and creatine kinase were measured. RA activity was estimated according to DAS-28-ESR and CDAI. Patients included 16 males and 124 females, ranging between the ages of 20 and 60 years. Results: The current study revealed a significant difference between anti-TPO levels in the serum of RA patients with DAS-28ESR (P = 0.006). Also, the study showed a strong positive correlation (r = 0.436) between anti-TPO and DAS-28-ESR. Conclusion: HT is frequent among patients with RA. Therefore, there is a need for screening of thyroid hormone dysfunction as well as the presence of anti-TPO in RA patients particularly in young patients, females, and those with high disease activity. No significant differences in the occurrence of CVD among RA patients with HT and euthyroid RA patients.