Evidence for the association of Hashimoto's thyroiditis with psoriasis: a cross‐sectional retrospective study

Abstract

Background Current information indicates that psoriasis is a metabolic disorder with systemic manifestations. Reports have revealed an association between psoriasis and several chronic autoimmune disorders. For one of these disorders, Hashimoto’s thyroiditis, there are scarce, and relatively unconfirmed, reports of an association with psoriasis. We sought to determine if such an association is detectable in a large medical record data repository. Methods We searched one institution’s electronic medical record data repository from January 2010 to December 2013. Patients were identified by ICD-9 codes (psoriasis: 696.0; 696.1, Hashimoto’s thyroiditis: 245.2). Only data from patients with laboratory-confirmed Hashimoto’s thyroiditis (anti-thyroid peroxidase (anti-TPO) antibodies; thyroglobulin antibodies; serum TSH and free T3) were eligible for inclusion. Logistic regression analysis was used to obtain an odds ratio (OR) to establish an association between psoriasis and Hashimoto’s thyroiditis. Stratified analyses were performed to test for confounding variable and effect modification. Results Medical records for 856,615 individuals with documented encounters between January 1, 2010 and December 31, 2013 were detected. 9,654 had a diagnosis of psoriasis and 1,745 had a diagnosis of Hashimoto’s thyroiditis. Of these, 41 subjects were diagnosed with both conditions. A significant association existed for psoriasis and Hashimoto’s thyroiditis, even after adjusting for confounding variables that included sex, age, psoriatic arthropathy and the use of systemic anti-psoriatic agents (OR=2.49; 95%CI 1.79–3.48; p <0.0001). Conclusions This association has broad clinical impact and deserves further attention with regards to patient care, clinical research, and developmental therapeutics.

Thyroid dysfunction in patients with psoriasis: Higher prevalence of thyroid dysfunction in patients with generalized pustular psoriasis

“…Recently, Hansen et al 1 reported that in the Danish General Suburban Population Study, self-reported psoriasis was linked with an increased level of total triiodothyronine (tT3) but not with positivity for thyroid peroxidase antibodies (TPO-Ab) or clinical or subclinical thyroid dysfunction. 2 A meta-analysis conducted by Kiguradze et al 3 suggested that TPO-Ab positivity, hypothyroidism and hyperthyroidism may be associated with prevalent psoriatic disease. However, they concluded that additional prospective data are needed to assess the association of autoimmune thyroid disease with incident psoriatic disease due to limitations and bias in the study.…”

Autoimmunity and autoimmune co‐morbidities in psoriasis

“…Consistent with the autoimmune nature of psoriasis, numerous other autoimmune diseases, including autoimmune bullous diseases, 125 vitiligo, 126 alopecia 127 and thyroiditis, 128 are co-morbid with psoriasis. Among them, autoimmune bullous diseases, such as bullous pemphigoid and anti-laminin c1 (p200) pemphigoid, are consistently documented.…”

“…A significant association exists for psoriasis and Hashimoto's thyroiditis even after adjusting for confounding variables, including gender, age, psoriatic arthropathy and the use of systemic anti-psoriatic agents (OR 2Á49; 95% CI 1Á79-3Á48). 128 However, Vassilatou et al 136 did not identify any tendency of association between psoriasis and autoimmune thyroiditis in their 114 patients with psoriasis.…”

“…In a hospital‐based cross‐sectional study of 856 615 patients, 9615 patients were diagnosed with psoriasis, and 1745 patients had Hashimoto's thyroiditis. A significant association exists for psoriasis and Hashimoto's thyroiditis even after adjusting for confounding variables, including gender, age, psoriatic arthropathy and the use of systemic anti‐psoriatic agents (OR 2·49; 95% CI 1·79–3·48) . However, Vassilatou et al .…”

Disfunção Tiroideia: Uma Nova Associação com a Psoríase?

“…43 Corroborando os resultados obtidos por Gul e colaboradores, 41 num estudo retrospetivo publicado em 2017 por Kiguradze e colaboradores foi estabelecida uma associação forte entre tiroidite de Hashimoto e psoríase mesmo após ajuste dos dados ao sexo, idade, presença de artrite e terapêutica sistémica instituída. 45 Contrariamente, também em 2017 foi publicado um estudo no qual os autores negaram a hipótese de uma associação entre estas duas entidades após observarem que os doentes com psoríase, com ou sem artrite, não apresentavam um risco acrescido para tiroidite autoimune. 46 …”