PREVALENCE AND CHARACTERISTICS OF HYPOTHYROIDISM AND ITS ASSOCIATION WITH NON-ORGAN RELATED MANIFESTATIONS IN US PATIENTS WITH SARCOIDOSIS

Abstract

SESSION TITLE: Diffuse Lung Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Little is known about the prevalence, clinical characteristics and impact of hypothyroidism in patients with sarcoidosis. We aimed to determine the prevalence rate and clinical features of hypothyroidism and its relation to organ involvement in patients with sarcoidosis. We also studied its association with non-organ manifestations in sarcoidosis patients. METHODS: We conducted a national registry-based study investigating 3,836 respondents to the Sarcoidosis Advanced Registry for Cures Questionnaire in the period between June 2014 and August 2019. This registry is based on a self-reported, web-based questionnaire that provides data related to demographics, diagnostics, sarcoidosis manifestations and treatment. We compared sarcoidosis patients with and without hypothyroidism. We used multivariable logistic regression and adjusted for gender, race, age at time of sarcoidosis diagnosis, use of steroids, multi-organ involvement and other sarcoidosis related comorbidities to determine the association of hypothyroidism with non-organ sarcoidosis manifestations. RESULTS: Fourteen-percent of the sarcoidosis patients had hypothyroidism and were generally middle-aged white women. Hypothyroidism presented with a cluster of other endocrine diseases and was more likely to be noted in sarcoidosis with multiorgan involvement, especially with cutaneous, ocular and musculoskeletal involvement. Sarcoidosis patients with hypothyroidism more frequently reported depression (29% vs 23%, p=0.003), obesity (26% vs 17%, p<0.001), sleep apnea (27% vs 18%, p<0.001), chronic fatigue (28% vs 18%, p<0.001) and fibromyalgia (18% vs 10%, p=0.049). On multivariable logistic regression analysis adjusting for potential confounders, hypothyroidism was associated with depression (adjusted odd ratio (aOR)= 1.3; 95% confidence interval (CI): 1.01-1.6), use of anti-depressants (aOR=1.3; CI: 1.1-1.7), obesity (aOR=1.5; CI:1.2-1.9), sleep apnea (aOR=1.8; CI:1.4-2.3), chronic fatigue syndrome (aOR=1.5; CI:1.1-1.9) and fibromyalgia (aOR=1.4; CI:1.01-1.8). Physical impairment was more common in patients with hypothyroidism. CONCLUSIONS: Hypothyroidism is a frequent comorbidity in sarcoidosis patients that might be a potentially reversible contributor to fatigue, depression and physical impairment in sarcoidosis. CLINICAL IMPLICATIONS: We recommend considering routine screening for hypothyroidism in sarcoidosis patients especially with multi-organ sarcoidosis, fatigue and depression. Future studies should assess the impact of treatment of hypothyroidism has on the non-organ related symptoms in patients with sarcoidosis DISCLOSURES: No relevant relationships by Tamara Al-Hakim, source=Web Response No relevant relationships by Bashar Alzghoul, source=Web Response Own stock relationship with American airline, United Airlines and Delta Airlines Please note: $1001 - $5000 Added 06/01/2020 by Bara Alzghoul, source=Web Response, value=Own stock No relevant relationships by Farah Amer, source=Web Response No relevant relationships by Chen Bai, source=Web Response No relevant relationships by Diana Gomez Manjarres, source=Web Response No relevant relationships by Ayoub Innabi, source=Web Response No relevant relationships by Mamoun Mardini, source=Web Response No relevant relationships by Divya Patel, source=Web Response No relevant relationships by Noopur Singh, source=Web Response