Review
Fatigue in patients with systemic sclerosis and hypothyroidism. A review of the literature and report of our experience
A. Antonelli1, P. Fallahi2, F. Di Bari3, D. Giuggioli4, S.M. Ferrari5, C. Ferri6
- Department of Clinical and Experimental Medicine, University of Pisa, Italy. alessandro.antonelli@med.unipi.it
- Department of Clinical and Experimental Medicine, University of Pisa, Italy.
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University of Messina, Italy.
- Department of Medical, Surgical, Maternal, Paediatric and Adult Sciences, University of Modena & Reggio Emilia, Modena, Italy.
- Department of Clinical and Experimental Medicine, University of Pisa, Italy.
- Department of Medical, Surgical, Maternal, Paediatric and Adult Sciences, University of Modena & Reggio Emilia, Modena, Italy.
CER9691
2017 Vol.35, N°4 ,Suppl.106
PI 0193, PF 0197
Review
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PMID: 28375832 [PubMed]
Received: 28/06/2016
Accepted : 28/11/2016
In Press: 04/04/2017
Published: 12/10/2017
Abstract
Persistent fatigue (defined as ongoing exhaustion, disproportionate to exertion and not adequately alleviated by rest) reduces health-related quality of life of systemic sclerosis (SSc) patients. Fatigue in SSc is associated with reduced capacity to carry out daily activities, work disability and impaired physical function. Clinical studies demonstrated a high prevalence of autoimmune thyroiditis and hypothyroidism in patients with SSc. Since hypothyroidism and the associated fatigue symptoms could be cured by L-thyroxine (L-T4) substitutive therapy, the evolution of fatigue symptoms in SSc hypothyroid patients treated with substitutive therapy has been recently evaluated, showing an amelioration of the fatigue symptoms. We have treated 10 clinical hypothyroid and 23 subclinical hypothyroid female SSc patients (all with diffuse scleroderma) with L-T4 substitutive therapy. Mean baseline General Fatigue Index scores in hypothyroid SSc (15.7±5.1) were significantly higher (greater fatigue; p<0.01) than in the same patients after reaching euthyroidism at 4 months (9.6±3.1). The results suggest that female SSc patients could be screened for thyroid function, overall in presence of fatigue symptoms, and that an appropriate L-T4 substitutive therapy could be useful to mitigate these symptoms. Further studies are needed in larger samples of hypothyroid patients with SSc to confirm these data. Further longitudinal studies could be also aimed to evaluate if L-T4 therapy could be useful in alleviating complications of SSc (such as skin thickness, pulmonary hypertension, etc.).
