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Thyroid Dysfunction in Primary Biliary Cholangitis: A Comparative Study at Two European Centers

Floreani, Annarosa MD1; Mangini, Chiara MD1; Reig, Anna MD2; Franceschet, Irene MD1; Cazzagon, Nora MD1; Perini, Lisa MD1; Caballería, Llorenç MD2; Cocchio, Silvia MD3; Baldo, Vincenzo MD3; Parés, Albert MD, PhD2

American Journal of Gastroenterology: January 2017 - Volume 112 - Issue 1 - p 114–119
doi: 10.1038/ajg.2016.479

OBJECTIVES: Primary biliary cholangitis (PBC) is often associated with other autoimmune diseases, but little is known about the influence of thyroid disease (TD) on the natural history of PBC. Our aim is to analyze the association between PBC and TD, and the latter’s impact on the natural history of PBC at two European centers.

METHODS: The study involved 921 PBC patients enrolled between 1975 and 2015 in Padova (376 patients) and Barcelona (545 patients), with a mean follow-up of 126.9±91.7 months. Data were recorded on patients’ histological stage at diagnosis, biochemical data, associated extrahepatic autoimmune conditions, and clinical events, including hepatic decompensation.

RESULTS: A total of 150 patients (16.3%) had TD, including 94 patients (10.2%) with Hashimoto’s thyroiditis; 15 (1.6%) with Graves’ disease; 22 (2.4%) with multinodular goiter; 7 (0.8%) with thyroid cancer; and 12 (1.3%) with other thyroid conditions. The prevalence of different types of TD was similar in Padova and Barcelona, except for Graves’ disease and thyroid cancer, which were more frequent in the Padova cohort (15.7 vs. 5.0%, and 8.6 vs. 1.3%, respectively,P<0.05). Overall, there were no differences between PBC patients with and without TD in terms of their histological stage at diagnosis, hepatic decompensation events, occurrence of HCC, or liver transplantation rate. The presence of associated TD was not associated with lower survival for PBC patients in either cohort.

CONCLUSIONS: TDs, and autoimmune TD like Hashimoto’s thyroiditis in particular, are often associated with PBC, but the presence of TD does not influence the rate of hepatic complications or the natural history of PBC.

1Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy

2Liver Unit, Hospital Clinic-IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain

3Department of Molecular Medicine, Laboratory of Public Health and Population Studies, University of Padova, Padova, Italy

Correspondence: Professor Annarosa Floreani, Department of Surgery, Oncology and Gastroenterology—DiSCOG, University of Padova, Via Giustiniani, 2, Padova 35128, Italy. E-mail:

Received 01 March 2016; accepted 02 August 2016

Guarantor of the article: Annarosa Floreani, MD.

Specific authors’ contributions: All authors contributed to the planning and conducting of the study, the collection and interpretation of the data, the drafting of the manuscript, and the review of the final manuscript.

Financial support: None.

Potential competing interests: The authors have no conflict of interest to disclose.

© The American College of Gastroenterology 2017. All Rights Reserved.
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