Carpal tunnel syndrome in Egyptianhypothyroid patients : Prevalence and relation with clinical , laboratory and electrophysiological findings

Background : Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome. Hypothyroidism is included as an important risk factor for CTS , however, this association is still unclear. Objective : To assessthe prevalence of CT in patients with hypothyroidism and to evaluate the relation between occurrence of CTS in these patients with clinical , laboratory and electrophysiological findings. Patients & Methods : The study included 200 females, divided into 2 groups: 120 patients with primary hypothyroidism , and 80 healthy age - matched controls. All subjects were subjected to full history taking, thorough clinical examination (general and neurological), calculation of body mass index (BMI) and electrodiagnosis for CTS. Laboratory investigations were performed for all patients including measurement of serum levels of thyroid stimulating hormone (TSH) , free thyroxine (FT4) , free tri-iodothyroxine (FT3) , anti-thyroid peroxidase antibodies (anti-TPO) and anti-thyroglobulin antibodies (anti-TG). Results : Hypothyroid patients had a significantly higher prevalence of CTS (35.8 %) as compared to the control group (8.8 %) (p<0.001). There was a significant relation between occurrence of CTS and patients' age and BMI (p<0.001). Patients not taking adequate thyroxine replacement therapy had significantly higher frequency of CTS in comparison to those receiving this therapy (p<0.05). There was a significant difference in serum levels of TSH, FT4, FT3, anti-TPO and anti-TG between hypothyroid patients with CTS andthose without CTS (p<0.001). Conclusion : CTS can be considered a common manifestation associated with hypothyroidism. Initial evaluation ( clinical & electrophysiological ) and regular checking for CTS in hypothyroid patients are recommended.