THU0474 PREVALENCE OF TIREOIDIAN DISORDERS IN A POPULATION WITH FIBROMYALGIA
2019
Background Fibromyalgia (FM) is a clinical syndrome characterized by diffuse pain associated with other symptoms such as fatigue, sleep disturbance and mood. It presents a series of differential diagnoses such as thyroid disorders, hypoparathyroidism, systemic inflammatory diseases and myopathies. Hypothyroidism is a disease with a prevalence of 4-6% of the population, having many symptoms in common with FM, such as fatigue, mood changes, constipation, and diffuse pain in some cases. Objectives The purpose is to evaluate the association between FM and thyroid disorders. Methods A retrospective monocentric case-control study in a tertiary hospital, with patients and controls having regular follow-up. The cases were composed of women over 40 years old, diagnosed with FM by the criteria ACR 1990 and ACR 2010, without autoimmune disease or other confounding diseases for pain. The control consisted of women over 40 years old, without autoimmune diseases. Laboratory tests included TSH and free T4 in all patients. Evaluation by ANA, anti-TPO and anti-thyroglobulin antibodies, only when appropriate. The sample was classified into euthyroid, clinical and subclinical hyperthyroid, clinical and subclinical hypothyroid. Statistical analysis included Fischer’s T-tests and others where appropriate. The p value was significant when ≤ 0.05. Results The sample consisted of 142 patients (median age of 58 years) and controls with 136 patients (median age of 67 years). Patients with FM had a greater number of thyroid disorders (31.7%) than controls (14.7%) (p = 0,001). FM patients had a TSH higher than the controls (mean 9.06 vs 2.96; p = 0,0026), with a lower free T4 (mean 1.06 vs 1.31; p = 0,0001). ANA, anti-TPO and anti-thyroglobulin antibodies analysis showed no differences between both groups (p = 1; p = 0,08, p = 1; respectively), when performed. Because of the small difference in median age between the two groups, a sub analysis was performed separating patients between the ages of 40 to 60 years and over 60 years. The same results previously seen were found. Conclusion Patients with FM had a greater association with clinical hypothyroidism. However, we did not find any association with autoantibodies in our casuistic. References [1] Claw, DJ, JAMA, volume 311, pagina 1547, 2014. [2] Hollowell JG, J Clin Endocrinol Metab, 87:489, 2002. [3] Suk, JH, Experimental and Clinical Endocrinology and Diabetes, 120: 401, 2012. [4] J.Rodriguez-Espinosa, Reumatologia Clinica, 2:70, 2006. [5] J. Ahmad, Rheumatology International, 35:1415, 2015. Disclosure of Interests Marco Antonio G Pontes Filho Speakers bureau: Novartis and Janssen, DIOGO SOUZA DOMICIANO: None declared, Rafael Pontes Andreussi: None declared, Leonardo Rodrigues da Silva: None declared
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