Respiratory symptoms in patients with treated hypothyroidism and inflammatory bowel disease
- S S Birring1,
- A J Morgan1,
- B Prudon1,
- T M McKeever4,
- S A Lewis4,
- J F Falconer Smith2,
- R J Robinson3,
- J R Britton4,
- I D Pavord1
- 1Institute for Lung Health, Department of Respiratory Medicine, Glenfield Hospital, Leicester LE3 9QP, UK
- 2Department of Chemical Pathology, Glenfield Hospital, Leicester
- 3Department of Gastroenterology, Glenfield Hospital, Leicester
- 4Division of Respiratory Medicine, City Hospital, Nottingham NG5 1PB, UK
- Correspondence to:
Dr S S Birring, Institute for Lung Health, Department of Respiratory Medicine, Glenfield Hospital, Leicester, LE3 9QP, UK;
- Accepted 3 March 2003
Background: Patients with idiopathic chronic cough and unexplained airflow obstruction in non-smokers have been shown to have an increased prevalence of hypothyroidism and other organ specific autoimmune disorders. Whether patients with hypothyroidism have an increased prevalence of respiratory symptoms is unknown.
Methods: The prevalence of respiratory symptoms was assessed in 124 patients with treated hypothyroidism recruited from primary and secondary care, 64 outpatients with inflammatory bowel disease, and 1346 control adults recruited randomly from the electoral register in a case-control study. Respiratory symptoms and smoking history were assessed by a respiratory symptom questionnaire.
Results: After adjustment for age, sex and smoking, symptoms of breathlessness and sputum production were more prevalent in both patient populations than in controls (odds ratios for hypothyroidism and inflammatory bowel disease; breathlessness: 3.1 (95% CI 2.1 to 4.6) and 3.4 (95% CI 2.0 to 6.0), respectively; sputum production: 2.7 (95% CI 1.6 to 4.5) and 2.5 (95% CI 1.2 to 5.0), respectively). Cough during the day and night was significantly more prevalent in patients with hypothyroidism (1.8 (95% CI 1.2 to 2.9)) and approached significance in those with inflammatory bowel disease (1.8 (95% CI 1.0 to 3.4)). Wheeze and nocturnal cough were no more prevalent in either disease population than in controls.
Conclusion: There is a significantly increased prevalence of respiratory symptoms in patients with hypothyroidism or inflammatory bowel disease compared with controls recruited from the general population. Further work is required to determine whether similar differences are seen in comparison with hospital based controls. These findings support the hypothesis that there is a link between autoimmune hypothyroidism and respiratory disease.
SSB is a British Lung Foundation clinical research fellow. This study was funded by the University Hospitals of Leicester NHS Trust.