Thyroid nodules in Hispanic patients with systemic lupus erythematosus

Lupus. 2013 Dec;22(14):1509-13. doi: 10.1177/0961203313504631. Epub 2013 Sep 19.

Abstract

A thyroid nodule (TN) is a discrete lesion in the thyroid gland radiologically distinct from the adjacent parenchyma, with a prevalence variable depending on the diagnostic method used and the study population. Thyroid disorders have been identified in more than 50% of patients with systemic lupus erythematosus (SLE); however, the prevalence of TN has not been frequently studied. We identified a prevalence of 27% TN in 55 SLE patients > 16 years of age. One-third of TN were >1 cm with radiological features of malignancy. The mean age of patients with TN was 39 ± 11 years, 93% women, and SLE duration 10 ± 6 years. Among patients, we reported family history of cancer in three cases (20%), thyroid disease in one (7%), and autoimmune disease in six (40%). Regarding treatment, 50% of patients with TN were treated with azathioprine vs. 23% of patients without TN (p = 0.02), with an OR of 3.94 (95% CI 1.12-13.84, p = 0.03). As a conclusion a high prevalence of TN in SLE patients was found. Prevalence of TN correlated only with history of azathioprine use. We don't know the long-term implications of our findings; however, a functional and morphological evaluation of the thyroid gland is warranted in all patients with SLE.

Keywords: Hispanic; Lupus; thyroid nodule.

MeSH terms

  • Adult
  • Azathioprine / adverse effects
  • Azathioprine / therapeutic use
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / epidemiology*
  • Male
  • Mexico / epidemiology
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Thyroid Neoplasms / complications
  • Thyroid Neoplasms / epidemiology*
  • Thyroid Neoplasms / etiology
  • Thyroid Nodule / epidemiology*
  • Thyroid Nodule / etiology
  • Young Adult

Substances

  • Immunosuppressive Agents
  • Azathioprine