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Exp Clin Endocrinol Diabetes 2012; 120(07): 401-404
DOI: 10.1055/s-0032-1309008
Article
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Association between Thyroid Autoimmunity and Fibromyalgia

J. H. Suk
1   Department of Internal Medicine, Division of Endocrinology and Metabolism, Maryknoll Medical Center, Busan, Republic of Korea
,
J. H. Lee
2    Department of Internal Medicine, Division of Rheumatology, Maryknoll Medical Center, Busan, Republic of Korea
,
J. M. Kim
3    Department of Internal Medicine, Division of Endocrinology and Metabolism, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
› Author Affiliations
Further Information

Publication History

received 02 December 2011
first decision 26 January 2012

accepted 13 March 2012

Publication Date:
27 April 2012 (online)

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Abstract

Background and aims:

Evidence exists that autoimmune thyroiditis is present in a high percentage of fibromyalgia (FM) and associated with the presence of typical symptoms of FM. However, the role of thyroperoxidase antibody (TPO Ab) in the manifestation of FM is still unclear. The goal of this study was to investigate the prevalence of positive TPO Ab in euthyroid FM patients, and whether TPO Ab positivity is associated with the clinical manifestations in euthyroid FM patients.

Subjects and Methods:

Thyroid assessment was done by free T4, TSH and TPO Ab. The clinical parameters including Fibromyalgia Impact questionnaire (FIQ), pain visual analogical scale (VAS) and tender point counts were evaluated in euthyroid primary FM patients, not associated with autoimmune rheumatic disease. The immunologic tests including rheumatoid factor and antinuclear antibody were measured. We compared the prevalence of positive TPO Ab between FM patients, and healthy control. We also compared clinical and laboratory parameter in FM patients according to the presence of TPO Ab.

Results:

149 patients of FM, 68 healthy controls were recruited. FM patients showed higher prevalence of positive TPO Ab than healthy controls (28 out of 149 patients, 19%; 5 out of 68 healthy controls, 7%; P=0.04). There was no difference of clinical and laboratory parameters in FM patients between 2 groups subdivided by the presence of TPO Ab.

Conclusion:

In our study, euthyroid FM patients showed significantly higher prevalence of positive TPO Ab, as compared to age and sex matched healthy control. However, TPO Ab positivity was relatively low and not associated with the clinical manifestations in euthyroid FM patients. This finding support thyroid autoimmunity may influence the development of FM, but the evidence which support that FM is related to autoimmune etiology is not clear, and FM severity may not be affected by the presence of thyroid autoantibody.

Key words

thyroid - autoimmunity - Fibromyalgia
 

  • References

  • 1 Aarflot T, Bruusgaard D. Association between chronic widespread musculoskeletal complaints and thyroid autoimmunity. Results from a community survey: Scand J Prim Health Care 1996; 14: 111-115
    PubMedSearch in Google Scholar
  • 2 Abeles M, Solitar BM, Pillinger MH et al. Update on fibromyalgia therapy. Am J Med 2008; 121: 555-561
    CrossrefPubMedSearch in Google Scholar
  • 3 Bae SC, Lee JH. Cross-cultural adaptation and validation of the Korean fibromyalgia impact questionnaire in women patients with fibromyalgia for clinical research. Qual Life Res 2004; 13: 857-861
    CrossrefPubMedSearch in Google Scholar
  • 4 Bazzichi L, Rossi A, Giuliano T et al. Association between thyroid autoimmunity and fibromyalgic disease severity. Clin Rheumatol 2007; 26: 2115-2120
    CrossrefPubMedSearch in Google Scholar
  • 5 Bland JH, Frymoyer JW. Rheumatic syndromes of myxedema. N Engl J Med 1970; 282: 1171-1174
    CrossrefPubMedSearch in Google Scholar
  • 6 Buskila D, Sarzi-Puttini P. Biology and therapy of fibromyalgia. Genetic aspects of fibromyalgia syndrome: Arthritis Res Ther 2006; 8: 218
    PubMedSearch in Google Scholar
  • 7 D’Cruz D. Testing for autoimmunity in humans. Toxicol Lett 2002; 127: 93-100
    CrossrefPubMedSearch in Google Scholar
  • 8 Dayan CM, Daniels GH. Chronic autoimmune thyroiditis. N Engl J Med 1996; 335: 99-107
    CrossrefPubMedSearch in Google Scholar
  • 9 Garrison RL, Breeding PC. A metabolic basis for fibromyalgia and its related disorders: the possible role of resistance to thyroid hormone: . Med Hypotheses 2003; 61: 182-189
    CrossrefPubMedSearch in Google Scholar
  • 10 Khaleeli AA, Griffith DG, Edwards RH. The clinical presentation of hypothyroid myopathy and its relationship to abnormalities in structure and function of skeletal muscle. Clin Endocrinol (Oxf) 1983; 19: 365-376
    CrossrefPubMedSearch in Google Scholar
  • 11 Mariotti S, Caturegli P, Piccolo P et al. Antithyroid peroxidase autoantibodies in thyroid diseases. J Clin Endocrinol Metab 1990; 71: 661-669
    CrossrefPubMedSearch in Google Scholar
  • 12 Marquez A, Finol HJ, De Blanco MC et al. Skeletal muscle microvascular alterations in euthyroid and hypothyroid patients with autoimmune thyroid disease. J Submicrosc Cytol Pathol 2001; 33: 425-432
    PubMedSearch in Google Scholar
  • 13 Monzani F, Caraccio N, Siciliano G et al. Clinical and biochemical features of muscle dysfunction in subclinical hypothyroidism. J Clin Endocrinol Metab 1997; 82: 3315-3318
    CrossrefPubMedSearch in Google Scholar
  • 14 Pamuk ON, Cakir N. The frequency of thyroid antibodies in fibromyalgia patients and their relationship with symptoms. Clin Rheumatol 2007; 26: 55-59
    CrossrefPubMedSearch in Google Scholar
  • 15 Pearce EN, Farwell AP, Braverman LE. Thyroiditis: N Engl J Med 2003; 348: 2646-2655
    PubMedSearch in Google Scholar
  • 16 Pedersen IB, Knudsen N, Jorgensen T et al. Thyroid peroxidase and thyroglobulin autoantibodies in a large survey of populations with mild and moderate iodine deficiency. Clin Endocrinol (Oxf) 2003; 58: 36-42
    CrossrefPubMedSearch in Google Scholar
  • 17 Punzi L, Betterle C. Chronic autoimmune thyroiditis and rheumatic manifestations. Joint Bone Spine 2004; 71: 275-283
    CrossrefPubMedSearch in Google Scholar
  • 18 R Development Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2010. URL http://www.R-project.org
    Search in Google Scholar
  • 19 Ribeiro LS, Proietti FA. Interrelations between fibromyalgia, thyroid autoantibodies, and depression. J Rheumatol 2004; 31: 2036-2040
    PubMedSearch in Google Scholar
  • 20 Wolfe F, Smythe HA, Yunus MB et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee: Arthritis Rheum 1990; 33: 160-172
    PubMedSearch in Google Scholar