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Clinical and histological features of patients with primary Sjögren’s syndrome and autoimmune thyroiditis: a national multicentre cross-sectional study

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21

 

  1. Rheumatology Unit, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy. serena.colafrancesco@uniroma1.it
  2. Rheumatology Unit, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy.
  3. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
  4. Rheumatology Unit, Department of Medicine, University of Udine, Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy.
  5. Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, Italy.
  6. Department of Life, Health and Environmental Sciences, University of L’Aquila; Internal Medicine and Nephrology Division, ASL 1 Avezzano-Sulmona-L’Aquila, San Salvatore Hospital, L’Aquila, Italy.
  7. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Florence, Italy.
  8. Rheumatology Unit, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy.
  9. Department of Radiologic, Oncologic and Pathologic Sciences, Sapienza University of Rome, Italy.
  10. Department of Radiologic, Oncologic and Pathologic Sciences, Sapienza University of Rome, Italy.
  11. Department of Radiologic, Oncologic and Pathologic Sciences, Sapienza University of Rome, Italy.
  12. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
  13. Rheumatology Unit, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy.
  14. Rheumatology Unit, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy.
  15. Rheumatology Unit, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy.
  16. Rheumatology Unit, Department of Medicine, University of Udine, Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy.
  17. Rheumatology Unit, Department of Medicine, University of Udine, Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy.
  18. Rheumatology Unit, Department of Medicine and Surgery, University of Perugia, Italy.
  19. Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Campus Biomedico, Rome; and Rheumatology and Clinical Immunology, Department of Medicine, University of Rome Campus Biomedico, School of Medicine, Rome, Italy.
  20. Rheumatology Unit, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy.
  21. Rheumatology Unit, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, and Saint Camillus International University of Health Science, UniCamillus, Rome, Italy.

CER16754
2023 Vol.41, N°12
PI 2389, PF 2396
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PMID: 38149510 [PubMed]

Received: 13/04/2023
Accepted : 29/06/2023
In Press: 23/12/2023
Published: 23/12/2023

Abstract

OBJECTIVES:
Primary Sjögren’s syndrome (pSS) is frequently associated with autoimmune thyroiditis (AT). The aim of this study was to evaluate the prevalence of AT in a national cohort of pSS and to describe the clinical and histological phenotype of patients with pSS and associated AT.
METHODS:
In this multicentre cross-sectional study, data from 2546 pSS were collected and the presence of AT was reported. In a subgroup, the histology of minor salivary glands was evaluated. Differences between pSS with and without AT were evaluated.
RESULTS:
A concomitant pSS and AT was detected in 19.6% of cases. Patients with pSS and AT displayed a lower prevalence of lymphoma, male sex and disease-modifying anti-rheumatic drugs (DMARDs) use and a higher prevalence of fibromyalgia, coeliac disease and hypergammaglobulinaemia. Multivariable analysis confirmed a higher prevalence of fibromyalgia and coeliac disease and lower use of DMARDs. In a subgroup of patients (n=232), a significantly higher focus score and number of foci was detected in pSS without AT (n=169) as compared to pSS with AT (n=54).
CONCLUSIONS:
This is the largest study evaluating the coexistence of pSS and AT. We confirm a high association between pSS and AT and describe the presence of a different phenotype characterized by a higher rate of celiac disease and fibromyalgia. Although not significant, the lower prevalence of both lymphoma and intake of DMARDs, along with a significantly lower focus score and number of foci, possibly suggest a more favourable outcome in concomitant pSS and AT which further deserve future investigations.

DOI: https://doi.org/10.55563/clinexprheumatol/eh36vs

Rheumatology Article