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Year : 2013  |  Volume : 8  |  Issue : 1  |  Page : 8-13

Rheumatic manifestations in primary hypothyroidism

1 Department of Medicine, North Bengal Medical College, Darjeeling, India
2 Department of Medicine, Infectious Disease Hospital, Kolkata, India
3 B P Poddar Medical Research & Hospital, Kolkata, India

Correspondence Address:
Alakes Kumar Kole
Department of Medicine, North Bengal Medical College, Darjeeling
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Source of Support: None, Conflict of Interest: None

DOI: 10.1016/j.injr.2012.12.005

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Background: Primary hypothyroidism is one of the major endocrine diseases involving various organs including the musculoskeletal system leading to increased morbidity. Objective: To observe the different rheumatic manifestations in patients suffering from primary hypothyroidism. Patients and methods: A total of 120 patients suffering from primary hypothyroidism with different rheumatic manifestations were evaluated. Results: Male to female ratio was 1:3 with mean age of 27 (±4.6) years and the mean body mass index (BMI) was 29.3 (±3.4) kg/m2. Musculoskeletal disorders observed were e body ache and myalgia in 100 (83.33%), muscle cramps and stiffness in 100 (83.33%), low back pain in 60 (50%), arthralgia in 30 (25%), adhesive capsulitis in 25 (20.8%), limited joint mobility in 20 (16.67%), myopathy in 10 (8.33%), carpal tunnel syndrome in 8 (6.6%), trigger finger in 5 (4.1%), Dupuytren's contracture in 4 (3.33%) and tarsal tunnel syndrome in two patients (1.6%). Rheumatologic disorders associated were e osteoarthritis in 80 (66.7%), mild inflammatory arthritis involving hand joints in 60 (50%), rheumatoid arthritis in 20 (16.67%), SLE in 10 (8.33%), fibromyalgia in 6 (5%), Raynaud's phenomenon in 2 (1.66%) and mixed connective tissue disease in 2 patients (1.66%). Other autoimmune disorders asso- ciated were vitiligo in 6 (5%), lichen planus in 4 (3.33%), recurrent aphthous stomatitis in 4 (3.33%) and alopecia areata in 4 patients (3.33%). Laboratory abnormalities detected were thyroid autoantibody (anti-TPO) in 40 (33.3%), elevated CPK enzyme in 40 (33.3%), rheu- matoid factor in 14 (11.7%) and ANA in 4 (3.3%) cases. Conclusion: Rheumatic disorders in patients with primary hypothyroidism were significant disease manifestations and early identification along with effective management is essential.

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