A NEW study highlights the significant health implications for patients with primary Sjögren’s syndrome (pSS) who also have thyroid diseases (TD). Researchers found that this dual diagnosis is associated with a higher incidence of malignancy and osteoporosis (OP), shedding light on the potential role of immune cell changes in driving these risks.
The study analysed data from 329 patients diagnosed with pSS between January 2018 and September 2023, dividing them into groups based on the presence or absence of TD. Among those with TD, the most common conditions were thyroid nodules (40.4%) and autoimmune thyroid diseases (28.4%). Patients with TD were found to have nearly double the risk of malignancy (14.7% vs. 6.4%) and a significantly higher likelihood of developing osteoporosis (23.9% vs. 14.1%).
Using advanced statistical models, the researchers identified TD as an independent risk factor for both malignancy (hazard ratio [HR] 4.7) and osteoporosis (HR 3.7). These findings suggest that thyroid conditions exacerbate the already heightened health risks associated with pSS.
The study also delved into the immunological mechanisms that might explain this link. Patients with both pSS and TD exhibited elevated levels of PD1+ T cells, a subset of immune cells associated with chronic inflammation and immune dysregulation. These elevated levels were observed in both peripheral blood and salivary glands, indicating a systemic immune imbalance that could contribute to the development of malignancy and osteoporosis.
This research has important implications for clinical practice. The authors suggest that pSS patients with TD should be closely monitored for signs of malignancy and osteoporosis, and targeted therapies addressing immune system dysregulation may offer new avenues for treatment.
Aleksandra Zurowska, EMJ
Reference
Cui X et al. Increased risk of malignancy and osteoporosis in primary Sjögren’s syndrome with thyroid diseases: potential implication from T cells. Rheumatology. 2024; DOI: 10.1093/rheumatology/keae627.
