Endocrine Abstracts

Systemic lupus erythematosus is a serious autoimmune disease characterised by the production of antinuclear antibodies directed particularly against native DNA. Its presence increases the susceptibility to develop other autoimmune diseases including autoimmune dysthyroidism. We present the case of a patient who presented with profound hypothyroidism as part of the work-up for lupus nephropathy. Female patient, 40 years old, reports physical asthenia for 2 months. On clinical examination: normal BMI, discrete bilateral IMO, homogeneous goitre; erythematous lupus lesions on the face. Thyroid assessment: TSH elevated: 100 IU/l; T4l: 1.9 IU/l; T3l: 1, cervical echo: aspect of thyroiditis. Renal check-up: GFR: 20ml/24h; 24h proteinuria: 2.64g/24h; albumin: 30g/l; protein: 69g/l, Immunological check-up: anti TPO + and anti-nuclear and anti-DNA positive; renal biopsy in favour of a membrano-proliferative glomerulonephritis (GNMP). Cardiovascular work-up: normal ECG and TTE without any particularity with LVEF recommended at 65%, normal lipid profile. The patient had been put on levothyrox 25 µg/d with a progressive increase and a corticotherapie for her lupus nephropathy. Most of the studies presented in the literature show a high prevalence and incidence of new cases of hypothyroidism and autoimmune thyroiditis (AIT) in patients with systemic lupus erythematosus (SLE), globally in women. In the presence of lupus, it is advisable to look for thyroid disorders that need to be treated. In the absence of thyroid disorders, long-term monitoring for thyroid disorders is important as thyroid dysfunction has a high probability of occurring later not only because of the autoimmune terrain but also because of glomerulopathy which can be complicated by a nephrotic syndrome with leakage of thyroid hormones.