THYROID DYSFUNCTION AMONG PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS IN BANGLADESH

Faysal Ahmmed* and Shahana Ferdous

ABSTRACT

Background: It's fairly uncommon for one autoimmune illness to coexist with another. Systemic Lupus Erythematosus (SLE) and underactive thyroid are two of the most frequent autoimmune disorders. They could have some kind of connection. Objective: To evaluate the association between Thyroid Dysfunction Among Patients with Systemic Lupus Erythematosus in Bangladesh. Method: This was a retrospective study in which we reviewed a total 150 patients older than 18 years of age who had a con-firmed diagnosis of SLE according to the Systemic Lupus International Collaborating Clinics classification criteria[7] and were treated at our rheumatology clinics. Data on clinical manifestations and laboratory findings at the time of presentation were obtained from the medical records of the outpatient clinics of Khulna City Medical College and hospital between January 2022 and December 2022.Data obtained from patients’ files included demographic data, sex, age at diagnosis of SLE, history of thyroid dis-eases and treatment for thyroid disease. Laboratory evaluations included complete blood count, thyroid function test (TFT), anti-nuclear antibody (ANA) detection by indirect immunofluorescence, anti-double stranded deoxyribonucleic acid (anti-dsDNA) antibody detection with a standardized enzyme-linked immunosorbent assay, serum complement (C3 and C4), TPO and Tg.The Safety of Estrogens in Lupus National Assess-ment–Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) was used to determine disease activity in patients with SLE. Results: During the study, 21-25 years age group, 31%. Followed by 26% belong to >18-20 years age group, 18% belong to 26-30 years age group. Plus majority were female. The main clinical manifestations in our cohort consisted of skin rash in 82 (53.33%), photosensitivity in 55 (36.67%), mucosal ulcers in 36 (34%) and hair loss 30 (20%) patients. 31 patients (20.67%) had thyroid dysfunction. 12 patients (8%) had subclinical hypothyroidism, and 9 patients (6%) had hypothyroidism. Five patients (3.3%) had subclinical hyperthyroidism, and 2 patient (1.33%) had hyperthyroidism. 3 patients (2%) had sick euthyroid status. Besides that, five of nine (55%) patients with hypothyroidism had positive Tg and TPO. One patient with hyperthyroidism tested negative for thyroid auto-antibodies. No association was observed between thyroid dysfunction and SLE disease activity, specifically the SELENA-SLEDAI score, anti-dsDNA level, C3 level and 24-h urine protein. Conclusion: We found no association between SLE activity and thyroid problems, but a high prevalence of both subclinical and overt hypothyroid-ism in SLE patients. While treating individuals with SLE, doctors should keep the likelihood of a thyroid problem in mind.

Keywords: Thyroid Dysfunction, Systemic Lupus Erythematosus (SLE), hypothyroidism.