Aksiyal spondiloartritli hastalarda anti-tümör nekroz faktör tedavisinin tiroid nodülü ve tiroid fonksiyonlari üzerine etkisi

Spondyloarthritis are diseases that usually present to the clinic with inflammatory low back pain and can involve many organs other than the joints. Axial spondyloarthropathy (AxSpA) is the general name for spondyloarthritis without radiographic findings and ankylosing spondylitis with radiographic axial findings. Tumor necrosis factor (TNF) inhibitors are used as the main therapeutic agent for the treatment of patients with axSpA who have inadequate response or intolerance to non-steroidal anti-inflammatory drugs (NSAIDs). Anti-TNF therapy has many side effects, including increased incidence of infection and increased risk of malignancy. Thyroid function plays an important role in the regulation of metabolism. Thyroid nodules (TNs) are important lesions with a different structure compared to normal tissues in the thyroid gland due to the risk of malignancy. Thyroid fine needle aspiration biopsy (FNAB) is performed in TNs with suspected cancer. In our study, 58 patients with axSpA receiving NSAIDs and 48 patients with axSpA receiving anti-TNF therapy were examined in terms of biochemical and thyroid ultrasonographic (USG) characteristics to investigate the side effects of anti-TNFs on thyroid function and thyroid gland structure. No significant difference was found between the groups in terms of thyroid stimulating hormone (TSH), free T4 (fT4), presence of TN, anti thyroid peroxidase (anti-TPO) levels. However, thyroid volume increased with increasing age. In addition, nodule size was larger and nodules were more frequently multiple in the anti-TNF group. Moreover, the number of nodules requiring TIAB indication was found to be higher in the anti-TNF group than in the NSAID group. Therefore, investigation of axSpA patients receiving anti-TNF with USG in terms of TN and thyroid cancer screening may provide early diagnosis of possible thyroid carcinoma in these patients.