Association between Systemic Lupus Erythematosus and Autoimmune Thyroid Dysfunction in Pediatric Population Cross Sectional Study, Single Center Experience

Abstract

Background Thyroid disease is more frequent in patients with systemic lupus erythematosus (SLE) than in the general population. The main purpose of this study is to evaluate the occurrence of immunological thyroid dysfunctions in Egyptian children with SLE in a single center and its relation to the disease activity and duration. Methods This is a cross-sectional observational study. The study included 50 children and adolescents with SLE. All patients were subjected to complete history taking, thorough physical examination. Thyroid profile, anti-thyroglobulin and anti-thyroid peroxidase antibodies were assayed using an enzyme-linked immunosorbent assay (ELISA) technique. Results Out of 50 patients, six were males (12%), and 44 were females (88%), with female to male ratio (F: M = 7: 1). Their ages ranged from 5–17 years, with a median of 12 years. Thirty-two of patients (64%) had thyroid dysfunctions, 19 (38%) were diagnosed with euthyroid sick syndrome, ten (20%) had overt hypothyroidism, three (6%) had subclinical hypothyroidism, and none of the patients had hyperthyroidism. Antithyroglobulin antibodies (Anti-TG) was normal in all patients of the studied group, and antithyroid peroxidase (anti-TPO) was elevated in one (2%) out of 50 patients. There was a significant negative correlation between free thyroxine (FT4) and disease duration with a p-value of 0.007. Moreover, by comparing the duration of the disease and thyroid antibodies (anti-TG, and anti-TPO), there was a significant negative correlation with p-values of 0.015 and 0.028. Conclusions Intermittent biochemical screening of thyroid function and anti-thyroid antibodies is recommended as part of the clinical profile in SLE patients, to identify clinical/subclinical thyroid disease. To intervene with the most convenient therapy whenever indicated.