Hypothyroidism in vasculitis

Tanaz A. Kermani, David Cuthbertson, Simon Carette, Nader A. Khalidi, Curry L. Koening, Carol A. Langford, Carol A. McAlear, Paul A. Monach, Larry Moreland, Christian Pagnoux, Philip Seo, Ulrich Specks, Antoine Sreih, Kenneth J. Warrington, Peter A. Merkel

Research output: Contribution to journalArticlepeer-review


Objective: To study the prevalence, risk and clinical associations of hypothyroidism among several forms of vasculitis. Methods: Patients with GCA, Takayasu's arteritis (TAK), PAN and the three forms of ANCA-Associated vasculitis [AAV; granulomatosis with polyangiitis (GPA), microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (EGPA)] enrolled in a prospective, multicentre, longitudinal study were included. Results: The study included data on 2085 patients [63% female, 90% White] with a mean age of 54.6 years (s.d. 17.2). Diagnoses were GCA (20%), TAK (11%), PAN (5%), GPA (42%), microscopic polyangiitis (8%) and EGPA (14%). Hypothyroidism was present in 217 patients (10%) (83% female), with a mean age 59.8 years (s.d. 14.5). Age-and sex-Adjusted risk of hypothyroidism was GCA, odds ratio (OR) 0.61 (95% CI 0.41, 0.90); TAK, OR 0.57 (95% CI 0.31, 1.03); PAN, OR 0.59 (95% CI 0.25, 1.38); GPA, OR 1.51 (95% CI 1.12, 2.05); microscopic polyangiitis, OR 1.81 (95% CI 1.18, 2.80) and EGPA, OR 0.82 (95% CI 0.52, 1.30). Among patients with AAV, age-and sex-Adjusted risk of hypothyroidism was higher with positive MPO-ANCA [OR 1.89 (95% CI 1.39, 2.76)]. The clinical manifestations of vasculitis were similar in patients with and without hypothyroidism, except transient ischaemic attacks, which were more frequently observed in patients with GCA and hypothyroidism (12% vs 2%; P = 0.001). Conclusions: Differences in the risk of hypothyroidism among vasculitides may be due to genetic susceptibilities or immune responses. This study confirms an association of hypothyroidism with MPO-ANCA.

Original languageEnglish (US)
Pages (from-to)2942-2950
Number of pages9
JournalRevmatologiia (Bulgaria)
Issue number7
StatePublished - Jul 1 2022


  • GCA
  • Takayasu's arteritis
  • antineutrophil cytoplasmic antibody
  • eosinophilic granulomatosis with polyangiitis
  • granulomatosis with polyangiitis
  • hypothyroidism
  • microscopic polyangiitis
  • polyarteritis nodosa
  • vasculitis

ASJC Scopus subject areas

  • Rheumatology


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