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Investigation of the Presence of Acropachy in Patients With Autoimmune Thyroid Diseases

Ekmekci, Tugba R. MD*; Ucak, Sema MD†; Sakiz, Damlanur MD‡; Bankaoğlu, Müjdat§; Koslu, Adem MD*; Altuntas, Yuksel†

doi: 10.1097/01.ten.0000257446.18214.46
Case Report
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Thyroid acropachy is an extremely rare but well-recognized manifestation of autoimmune thyroid disease. Although many isolated cases of acropachy have appeared in the medical literature, the prevalance of acropachy is unknown in autoimmune thyroid diseases. Likewise, histopathologic features of acropachy have not been previously reported. We investigated the presence of acropachy and early stage changes in patients with autoimmune thyroid disease. Clinical, radiologic, and histopathologic slides were done. The study was performed in 52 adults (32 to 58-years-old), 40 patients with autoimmune thyroid disease (35 Hashimoto thyroiditis, 5 Basedow Graves), and 12 healthy individuals. After subjects underwent detailed dermatologic examinations, anteroposterior radiography of their hands and feet was performed and punch biopsies were done from volar aspects of the distal ends of the fourth digits of their left hands. On dermatologic examination, only 1 patient had fusiform of soft tissue swellings of hand fingers. Radiography of the hands and feet was normal in all patients. Mucin accumulation was seen in 5 patients and these patients were accepted as having acropachy histopathologically. All these patients had Hashimoto thyroiditis and none had opthalmopathy and dermopathy. There were no significant correlations of histopathologic findings with opthalmopathy, the duration of the disease, titers of antibodies, and thyroid status. We consider that these changes seen pathologically are early stage changes of acropachy.

From the Departments of *Dermatology, †Internal Medicine, ‡Pathology, and §Radiology, Sisli Etfal Teaching and Research Hospital, Istanbul, Turkey.

Reprints: Tugba Rezan Ekmekci, Ihlamurdere Cad. No:153/19, 80690 Besiktas, Istanbul, Turkey. E-mail: tre@ttnet.net.tr.

© 2007 Lippincott Williams & Wilkins, Inc.