Non-specific rheumatic manifestations in patients with Hashimoto’s thyroiditis: a pilot cross-sectional study

  • G. GiuffridaEmail author
  • G. Bagnato
  • A. Campennì
  • S. Giovinazzo
  • K. P. Keller
  • A. Alibrandi
  • W. N. Roberts
  • F. Trimarchi
  • R. M. Ruggeri
Original Article



Hashimoto’s thyroiditis (HT) is often associated with rheumatic disorders (arthritis, etc.), but many HT patients report non-specific rheumatic signs and symptoms in the absence of clinically evident rheumatic diseases. Aim of this study was to evaluate the prevalence of non-specific rheumatic manifestations (RMs) in HT subjects without classified autoimmune comorbidities.


500 HT patients (467 F, 33 M; median age 41 years, range 14–69) and 310 age- and sex-matched controls, consecutively referred to the Endocrine Unit of Messina University Hospital, were evaluated for non-specific RMs. None took l-thyroxine. Exclusion criteria: autoimmune comorbidities, infectious, and/or inflammatory diseases, history of neoplasia, BMI > 30 kg/m2.


In our HT cohort, 100 patients (20%) complained of one or more RMs, vs 21 controls (6.8%; P < 0.001). There were minimal differences between the manifestations recorded in the two groups, the most common being polyarthralgias and myalgias/fibromyalgia, but non-specific RMs occurred threefold more in HT patients. Comparing HT patients with RMs (96 F and 4 M) with those affected by HT alone, female sex was prevalent (F:M ratio 24:1 vs 5:1) with higher age at diagnosis (median 43 vs 37 years; P < 0.001). HT patients with RMs (62%) were mostly euthyroid (median TSH 2.0 µIU/L) and only 7% overtly hypothyroid, discouraging a possible causal relationship between thyroid dysfunction per se and RMs.


A significant percentage of HT patients complains of non-specific rheumatic signs and symptoms, in the absence of other diagnosed systemic comorbidities and regardless of thyroid functional status, deserving careful evaluation and prolonged follow-up.


Autoimmune diseases Hashimoto’s thyroiditis Thyroid autoimmunity Rheumatic manifestations Connective tissue diseases 



This work was not supported by any grant.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent from each subject and Ethics Committee approval were obtained.

Animal studies

No animals were used for this study.


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Copyright information

© Italian Society of Endocrinology (SIE) 2019

Authors and Affiliations

  • G. Giuffrida
    • 1
    • 2
    Email author
  • G. Bagnato
    • 3
  • A. Campennì
    • 4
  • S. Giovinazzo
    • 2
  • K. P. Keller
    • 5
  • A. Alibrandi
    • 6
  • W. N. Roberts
    • 5
  • F. Trimarchi
    • 7
  • R. M. Ruggeri
    • 1
    • 2
  1. 1.Unit of Endocrinology, Department of Clinical and Experimental Medicine, Gaetano Martino University HospitalUniversity of MessinaMessinaItaly
  2. 2.Endocrine Unit at University Hospital of MessinaMessinaItaly
  3. 3.NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust and Leeds Institute of Rheumatic and Musculoskeletal MedicineUniversity of LeedsLeedsUK
  4. 4.Unit of Nuclear Medicine, Department of Biomedical and Dental Sciences and Morphofunctional ImagingUniversity of MessinaMessinaItaly
  5. 5.Unit of Rheumatology, Division of MedicineUniversity of KentuckyLexingtonUSA
  6. 6.Department of Economics, Unit of Statistical and Mathematical SciencesUniversity of MessinaMessinaItaly
  7. 7.Accademia Peloritana dei Pericolanti at the University of MessinaMessinaItaly

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