Rheumatic manifestations in primary hypothyroidism

BackgroundPrimary hypothyroidism is one of the major endocrine diseases involving various organs including the musculoskeletal system leading to increased morbidity.ObjectiveTo observe the different rheumatic manifestations in patients suffering from primary hypothyroidism.Patients and methodsA total of 120 patients suffering from primary hypothyroidism with different rheumatic manifestations were evaluated.ResultsMale to female ratio was 1:3 with mean age of 27 (±4.6) years and the mean body mass index (BMI) was 29.3 (±3.4) kg/m2. Musculoskeletal disorders observed were – body ache and myalgia in 100 (83.33%), muscle cramps and stiffness in 100 (83.33%), low back pain in 60 (50%), arthralgia in 30 (25%), adhesive capsulitis in 25 (20.8%), limited joint mobility in 20 (16.67%), myopathy in 10 (8.33%), carpal tunnel syndrome in 8 (6.6%), trigger finger in 5 (4.1%), Dupuytren's contracture in 4 (3.33%) and tarsal tunnel syndrome in two patients (1.6%). Rheumatologic disorders associated were – osteoarthritis in 80 (66.7%), mild inflammatory arthritis involving hand joints in 60 (50%), rheumatoid arthritis in 20 (16.67%), SLE in 10 (8.33%), fibromyalgia in 6 (5%), Raynaud's phenomenon in 2 (1.66%) and mixed connective tissue disease in 2 patients (1.66%). Other autoimmune disorders associated were vitiligo in 6 (5%), lichen planus in 4 (3.33%), recurrent aphthous stomatitis in 4 (3.33%) and alopecia areata in 4 patients (3.33%). Laboratory abnormalities detected were thyroid autoantibody (anti-TPO) in 40 (33.3%), elevated CPK enzyme in 40 (33.3%), rheumatoid factor in 14 (11.7%) and ANA in 4 (3.3%) cases.ConclusionRheumatic disorders in patients with primary hypothyroidism were significant disease manifestations and early identification along with effective management is essential.