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Table of Contents | |
SCLERODERMA
Scleroderma is a chronic hardening and thickening of the skin.
Ann Dermatol Venereol 1989;116(10):701-6 |
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[Scleroderma and thyroid diseases].
[Article in French]
Mourier-Clavreul MC, Rousset H, Claudy A
Service de Dermatologie, CHRU, Saint-Etienne, Saint-Priest-en-Jarez.
The authors report a prospective study of the thyroid function of 18
consecutive patients with systemic scleroderma and 7 patients with morphea.
A history was taken and patients were examined for thyroid disease. The
patients were tested for free thyroxin, TSH, cholesterolemia, circulating
TeBG, anti-microsomial and anti-thyroglobulin antibodies and had a TRH test.
The incidence of thyroid diseases was correlated with an age and sex-matched
control population consisting of 2,534 subjects of the Loire department.
None of the patients with morphea had a history of thyroid pathology and the
thyroid screenings were within normal limits. A familial history of
thyroid disease was found in 7 out of 18 patients with systemic scleroderma,
and 8 out of 18 patients had a thyreopathy (one Hashimoto's disease, one
Graves' disease, one toxic adenoma, one hypothyroidism, two euthyroid
goiters, two nodular thyroids). The TRH test only revealed a toxic
adenoma. A thyroid disease preceded systemic scleroderma in 5 out of 18
cases with delays ranging from 1 to 38 years. In 3 cases, the thyroid
disease occurred within two years after the onset of systemic scleroderma. The
prevalence of thyroid disease was significantly higher than in a comparable
population sample of subjects from the same geographic region (p less than
0.01). The authors review the literature and discuss the
physiopathologic relationships between the two clinical entities. The
authors suggest to perform a thyroid screening (ultrasensitive TSH assay) on
all patients with systemic sclerosis and especially on those whose clinical
follow-up is atypical and on those with a familial and/or personal history
of thyroid disease.
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