RESUMO
BACKGROUND: Patients with pernicious anemia (PA) have a higher prevalence of other autoimmune diseases. We assessed the correlation between PA and autoimmune thyroid diseases (AITD), and evaluated the risk factors for this association. METHODS: A longitudinal study was conducted involving patients with PA between 2010 and 2017. RESULTS: A total of 86 patients with PA were evaluated, 74 (86%) female, with a median age of 51.5 years. Thyroid abnormalities were detected in 45 (52.3%) patients, including 28 (32.3%) hypothyroidism, 3 (3.5%) hyperthyroidism and 20 (23.3%) thyroperoxidase antibody positivity. Logistic regression analysis identified risk factors for having AITD in PA patients: weight loss (OR 12.03; 95% CI 1.06-137.02, P=0.045), diabetes mellitus (OR 4.68, 95% CI 1.15-26.58, P=0.047) and gastric antibodies positivity (OR 5.05, 95% CI 1.45-18.24, P=0.013). CONCLUSION: PA and AITD are frequently associated, suggesting all patients with PA should be investigated for occult thyroid disease, especially those with weight loss, diabetes mellitus and gastric autoantibodies
ANTECEDENTES: Los pacientes con anemia perniciosa (AP) tienen una mayor prevalencia de otras enfermedades autoinmunes. Evaluamos la correlación entre AP y enfermedades tiroideas autoinmunes (AITD), así como los factores de riesgo para esta asociación. MÉTODOS: Realizamos un estudio longitudinal que incluyó a pacientes con AP entre 2010 y 2017. RESULTADOS: Evaluamos a un total de 86 pacientes con AP, 74 (86%) mujeres, con una edad media de 51,5 años. Detectamos alteraciones tiroideas en 45 (52,3%) pacientes, incluyendo 28 (32,3%) casos de hipotiroidismo, 3 (3,5%) de hipertiroidismo y 20 (23,3%) de positividad para anticuerpos anti-tiroperoxidasa. El análisis de regresión logística identificó los factores de riesgo de padecer AITD en pacientes de AP: pérdida de peso (OR: 12,03; IC 95%: 1,06-137,02; p = 0,045), diabetes mellitus (OR: 4,68; IC 95%: 1,15-26,58; p = 0,047) y positividad frente a anticuerpos gástricos (OR: 5,05; IC 95%: 1,45-18,24; p = 0,013). CONCLUSIÓN: AP y AITD están frecuentemente asociados, lo cual sugiere que deberían investigarse las enfermedades tiroideas ocultas en todos los pacientes con AP, especialmente aquellos con pérdida de peso, diabetes mellitus y auto-anticuerpos gástricos
Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doenças da Glândula Tireoide/epidemiologia , Anemia Perniciosa/complicações , Valor Preditivo dos Testes , Doenças Autoimunes/epidemiologia , Fatores de Risco , Estudos Longitudinais , Complicações do Diabetes , Análise Multivariada , Deficiência de Vitamina B 12RESUMO
BACKGROUND: Patients with pernicious anemia (PA) have a higher prevalence of other autoimmune diseases. We assessed the correlation between PA and autoimmune thyroid diseases (AITD), and evaluated the risk factors for this association. METHODS: A longitudinal study was conducted involving patients with PA between 2010 and 2017. RESULTS: A total of 86 patients with PA were evaluated, 74 (86%) female, with a median age of 51.5 years. Thyroid abnormalities were detected in 45 (52.3%) patients, including 28 (32.3%) hypothyroidism, 3 (3.5%) hyperthyroidism and 20 (23.3%) thyroperoxidase antibody positivity. Logistic regression analysis identified risk factors for having AITD in PA patients: weight loss (OR 12.03; 95% CI 1.06-137.02, P=0.045), diabetes mellitus (OR 4.68, 95% CI 1.15-26.58, P=0.047) and gastric antibodies positivity (OR 5.05, 95% CI 1.45-18.24, P=0.013). CONCLUSION: PA and AITD are frequently associated, suggesting all patients with PA should be investigated for occult thyroid disease, especially those with weight loss, diabetes mellitus and gastric autoantibodies.
