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Frequency of autoimmune complications like immune anemia or immune thrombocytopenia has increased in patients with chronic lymphocytic leukemia (CLL). However, there is no data in the literature investigating the relation of the other autoimmune disorders including thyroid gland diseases with CLL.

Thyroid function tests, thyroid autoantibodies (antithyroglobulin antibody [anti-TG], antithyroid peroxidase antibody [anti-TPO]), thyroid ultrasonographies (USG) and scintigraphies of CLL patients were performed. Demographic data, Rai-stages, and established thyroid disorders were recorded.

One hundred CLL patients were included into the study (65 male, mean age was 62,9±10,4). Free T3 (fT3) was within normal limits in 96 cases (96%), was low in 2 cases (2%), was high in 2 cases (2%); free T4 (fT4) was normal within normal limits in 89 cases (89%), was low in 7 cases (7%), was high in 4 cases (4%).TSH was within normal limits in 90 cases (90%), was low in 7 cases (7%), was high in 3 cases (3%). Anti-TPO and anti-TG were positive in 10 cases (11.8%) and in 18 cases (21.2%), respectively. While USG was normal in 36 cases, multinodular goiter (MNG) in 21, chronic thyroiditis in 20, MNG associated with thyroiditis in 10, uninodular goiter (UNG) in 8, UNG associated with thyroiditis in 4, and diffuse goiter in 1 case were determined by USG. Toxic adenoma in 3 cases, toxic MNG in 2 cases, and thyroiditis in 1 case were determined in 6 patients in whom thyroid scintigraphy was performed for hyperthyroidism. After evaluation of all the tests; while no thyroid disease was determined in 33 of the cases (33%), MNG in 25 (25%), thyroiditis according to the results of USG in 12 (12%), UNG in 11 (11%), Hashimoto thyroiditis in 9 (9%), toxic MNG in 3 (3%), subclinical hyperthyroidism in 3 (3%) cases, subclinical hypothyroidism in 1 case (1%), lymphocytic thyroiditis in 1 case (1%), toxic UNG in 1 case (1%), and euthyroid sickness syndrome in 1 case (1%) were determined. The patients were divided into 2 groups according to their Rai-stages and ages. Accordingly; Rai-stage 0 - I - II (n=80) and Rai-stage III - IV (n=20), <65 years (n=56) and ≥65 years (n=44). Anti-TPO positivity was similar in 2 Rai-stages groups and in both sexes (p=0,999, p=0,167, respectively). Anti-TG positivity was also similar in 2 Rai-stages groups and in both sexes (p=0,507, p=0,223, respectively). However, anti-TPO positivity was statistically different between age groups; anti-TPO was positive in 3 patients in <65 years old age group, and was positive in 7 patients in ≥65 years old age group (p=0.049). Anti-TG was positive in 7 patients in <65 years old age group, and was positive in 11 patients in ≥65 years old age group (p=0.053). There was not a statistically difference in thyroid function tests according to the Rai-stages, ages and sexes.

We determined that incidence of hypothyroidism or hyperthyroidism associated with all reasons do not increase in patients with CLL when compared with general population. However, we also determined that the incidence of Hashimoto thyroiditis was higher than general population (incidence of Hashimoto thyroiditis in general population is 2-5%). Anti-TG positivity was also higher than general population (positivity of anti-TG in general population is 5-20%). In addition, the positivity of 2 antibodies increased with advanced ages. Patients with CLL -especially the elderly cases- in both sexes and in all Rai-stages should be examined for thyroid gland disorders, mainly for Hashimoto thyroiditis.