The Frequency and Related Factors of Primary Headaches in Patients with Hashimoto Thyroiditis

ISSN : 1300-0012 E-ISSN 2458-9446

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Volume: 34 Issue: 2 Year: 2022

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The Frequency and Related Factors of Primary Headaches in Patients with Hashimoto Thyroiditis [A�r�]

A�r�. Ahead of Print: AGRI-04874 | DOI: 10.14744/agri.2021.04874

The Frequency and Related Factors of Primary Headaches in Patients with Hashimoto Thyroiditis

Rabia Gokcen Gozubatik-Celik¹, Derya Uluduz², Esra Hatipoglu³, Yalcin Hac�oglu⁴, Bengi Gul Alparslan², Mehmet Ali Sungur⁵, Baki Goksan², Sabahattin Saip², Aksel Siva²
¹Department of Neurology, Bakirkoy Research And Training Hospital For Neurologic And Psychiatric Diseases, University Of Health Science, Istanbul, Turkey
²Department of Neurology, Cerrahpasa School Of Medicine, Istanbul, Turkey.
³Department of Internal Medicine, Istanbul Cam Sakura City Hospital, Istanbul, Turkey
⁴Department of Family Medicine, Istanbul Training And Research Hospital, Istanbul Turkey
⁵Department Of Biostatistics and Medical Informatics, Duzce University Medical Faculty, Duzce, Turkey

Introduction: The purpose of this study was to evaluate the incidence of primary headache and potential biomarkers in patients diagnosed with Hashimoto thyroiditis.
Methods and Materials: Patients with Hashimoto thyroiditis referred to the outpatient endocrinology clinic were included in the study. The demographic data, thyroid function test results and autoantibody titer were recorded. The headache's clinical characteristics were also determined. The same researcher used the visual analog scale (VAS) for headache severity rating in all patients.
Results: There were 95 (61.3%) cases diagnosed with primary headache consisting of 20 (21.1%) migraine cases, 17 (17.9%) tension type headaches (TTHs), and 20 (21.1%) new daily persistent headaches (NDPHs). 38 of 155 (24.5%) had hypothyroidism-related-headaches (HRHs). There was no statistically significant relationship between the headache type and a high blood antibody level (anti-TPO) (p=0.135), while a positive correlation was found with thyroid stimulating hormone (TSH) (p<0.001). Hashimoto patients with migraine (n=14, 70.0%) were found to have higher blood antibody levels, while these ratios were found as 86.8% (n=33) in HRH-patients, 76.5% (n=13) in TTH-patients and 60.0% (n=12) in NDPH-patients. 57 (60.0%) patients reported new onset headaches after a Hashimoto's thyroiditis diagnosis, and the headaches persisted without hormone therapy in 48 (84.2%) of these patients. This was interpreted as demonstrating co-morbidity between Hashimoto�s disease and primary headaches, particularly migraine and TTH.
Conclusion: Detection of only the relationship between TSH level and headache suggested that different mechanisms play a role in the pathophysiology. In the diagnosis of primary headache, it is important to look into secondary reasons.

Keywords: Hashimoto thyroiditis, primary headaches, autoimmunity, comorbidity, TSH

Hashimoto Tiroiditi Hastalar�nda Primer Ba� A�r�s�n�n S�kl�� ve �li�kili Fakt�rler

Rabia Gokcen Gozubatik-Celik¹, Derya Uluduz², Esra Hatipoglu³, Yalcin Hac�oglu⁴, Bengi Gul Alparslan², Mehmet Ali Sungur⁵, Baki Goksan², Sabahattin Saip², Aksel Siva²
¹S.B.� Bak�rk�y Prof Dr Mazhar Osman Ruh Sa�l�� Ve Si̇nir Hastal�klar� E�itim Ve Ara�t�rma Hastahanesi, �stanbul, T�rkiye
²Cerrahpa�a T�p Fak�ltesi N�roloji Ana Bilim Dal�, �stanbul, Turkiye
³�stanbul �am Sakura �ehir Hastahanesi, Dahiliye B�l�m�,�stabul,T�rkiye
⁴Istanbul E�itim Ve Ara�t�rma Hastahanesi, Aile Hekimli�i B�l�m�,i̇stanbul T�rkiye
⁵D�zce �niversitesi T�p Fak�ltesi, Biyoistatistik Ve T�p Bili�imi Anabilim Dal�, D�zce, T�rkiye

Ama�: Hashimoto tiroiditi tan�s� alan hastalarda primer ba� a�r�s� insidans�n� ve potansiyel biyobelirte�leri de�erlendirmektir.
Gere� ve Y�ntemler: Endokrinoloji poliklini�ine ba�vuran Hashimoto tiroiditi olan hastalar �al��maya dahil edildi. Demografik veriler, tiroid fonksiyon test sonu�lar� ve otoantikor titreleri kaydedildi. Ba� a�r�s�n�n klinik �zellikleri de belirlendi. Ayn� ara�t�rmac�, t�m hastalarda ba� a�r�s� �iddeti derecelendirmesi i�in g�rsel analog �l�e�i (VAS) kullanm��t�r.
Bulgular: 95(%61.3) primer ba� a�r�s� olan hastalardan 20�si (%21.1) migren, 17�si (%17.9) gerilim tipi ba� a�r�s� (TTH) ve 20�si (%21.1) yeni g�nl�k kal�c� ba� a�r�s� (NDPH) tan�s� ald�. 155 ki�iden 38'inde (%24,5) hipotiroidizme ba�l� ba� a�r�s� (HRH) tespit edildi. Ba� a�r�s� tipi ile y�ksek kan antikor d�zeyi (anti-TPO) aras�nda istatistiksel olarak anlaml� ili�ki bulunmazken (p=0.135), tiroid uyar�c� hormon (TSH) ile pozitif korelasyon saptand� (p<0.001). Migrenli Hashimoto hastalar�nda (n=14, %70.0) daha y�ksek kan antikor d�zeyleri bulunurken, bu oranlar HRH�de %86.8 (n=33), TTH hastalar�nda %76.5 (n=13), NDPH hastalar�nda %60,0 (n=12) olarak saptand�. 57 hasta Hashimato tan�s� ald�ktan sonra yeni bir ba�a�r�s� tan�mlarken, hormone tedavisi sonras� ba� a�r�s� devam eden hasta say�s� 48�di. Bu da primer ba� a�r�s� ve Hashimato Hastal�� komorbiditeyi g�stermekteydi.
Tart��ma: Ba� a�r�s� ile ili�kili tek fakt�r�n TSH d�zeyi olmas� patofizyolojide farkl� mekanizmalar�n rol oynad��n� d��nd�rm��t�r. Primer ba� a�r�s� tan�s�nda tedavi edilebilen sekonder nedenlerin detayl� ara�t�r�lmas� �nem ta��maktad�r.

Anahtar Kelimeler: Hashimato tiroiditi, primer ba� a�r�s�, otoimmunite, komorbidite, TSH

Corresponding Author: Rabia Gokcen Gozubatik-Celik, T�rkiye

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