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Masked Thyroid Dysfunction in Elderly Patients With Atrial Fibrillation-Reply

Philip Greenland, MD; JoAnne L. Cobler, MD; Mark E. Williams, MD
Arch Intern Med. 1985;145(6):1140. doi:10.1001/archinte.1985.00360060208037.
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Dr Tajiri et al report findings quite similar to ours. In addition to the data we reported in the September Archives concerning the prevalence of hyperthyroidism in institutionalized elderly patients, we also found two (8%) patients with hypothyroidism in the group of 25 patients with atrial fibrillation. We did not report these data on hypothyroidism since our "control" group, ie, institutionalized elderly persons at the same chronic-care facility without atrial fibrillation, was found to have a hypothyroidism prevalence of 16%! We cannot rule out euthyroid sick syndrome in many of these patients. Also, since the prevalence of hypothyroidism associated with atrial fibrillation in our series was actually less than that in the well-matched controls, we did not feel such information warranted reporting.

Perhaps a lesson to be learned from our data and those of Tajiri et al is that a variety of thyroid abnormalities appear to be quite common


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