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os objetivos deste estudo foram avaliar a preval&#234;ncia de anormalidade tireoidiana nos pacientes com psor&#237;ase e analisar sua associa&#231;&#227;o com tr&#234;s fatores&#58; a gravidade &#40;medida pelo <span class="elsevierStyleItalic">Psoriasis Area and Severity Index</span> &#8211; PASI&#41;&#59; a presen&#231;a de artrite psori&#225;sica&#59; e o tratamento com imunobiol&#243;gicos&#46; Adicionalmente&#44; pesquisar publica&#231;&#245;es de interesse&#44; identificar o delineamento e a inclus&#227;o do grupo controle nos estudos&#44; e de acordo com os crit&#233;rios adotados&#44; comparar por metan&#225;lise o grupo de casos deste estudo com o de controles das publica&#231;&#245;es selecionadas&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">Ap&#243;s aprova&#231;&#227;o pelo Comit&#234; de &#201;tica e Pesquisa local&#44; um estudo observacional transversal foi conduzido no departamento de Dermatologia&#46; Dados de 250 pacientes foram analisados&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Todos os pacientes em seguimento no Ambulat&#243;rio de Psor&#237;ase e Imunobiol&#243;gicos da Dermatologia durante o per&#237;odo de janeiro de 2018 a dezembro de 2019 foram considerados eleg&#237;veis&#44; constituindo amostra de conveni&#234;ncia&#46; Os crit&#233;rios de inclus&#227;o foram&#58; diagn&#243;stico de psor&#237;ase vulgar e vig&#234;ncia de tratamento &#8211; considerando uso de t&#243;picos&#44; fototerapia&#44; f&#225;rmacos sist&#234;micos convencionais &#40;acitretina&#44; metotrexato e ciclosporina&#41; ou agentes imunobiol&#243;gicos &#40;infliximabe&#44; etanercepte&#44; adalimumabe&#44; ustequinumabe&#44; secuquinumabe&#41;&#46; Os crit&#233;rios de exclus&#227;o foram&#58; diagn&#243;stico de outras formas de psor&#237;ase que n&#227;o a vulgar&#44; pacientes que n&#227;o concordaram em participar do estudo&#44; menores de 12 anos&#44; tireoidectomia pr&#233;via&#44; tratamento atual com medica&#231;&#245;es que poderiam afetar a fun&#231;&#227;o tireoidiana &#40;l&#237;tio&#44; amiodarona&#44; anticonvulsivantes e interferona&#41; e aus&#234;ncia de registros no prontu&#225;rio em rela&#231;&#227;o aos horm&#244;nios tireoidianos ou anticorpos&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Desenho do estudo</span><p id="par0030" class="elsevierStylePara elsevierViewall">Os dados cl&#237;nicos coletados do prontu&#225;rio foram&#58; idade&#44; sexo&#44; altura&#44; peso&#44; &#237;ndice de massa corp&#243;rea &#40;IMC&#41;&#44; presen&#231;a de artrite psori&#225;sica &#40;e articula&#231;&#227;o acometida&#41;&#44; dura&#231;&#227;o da doen&#231;a &#40;meses&#41;&#44; tratamento pr&#233;vio e atual para psor&#237;ase&#44; dura&#231;&#227;o do tratamento atual &#40;meses&#41;&#44; PASI atual&#44; presen&#231;a de comorbidades &#40;hipertens&#227;o&#44; diabetes&#44; depress&#227;o ou ansiedade&#44; dislipidemia&#44; tabagismo&#44; alcoolismo&#44; doen&#231;a hep&#225;tica n&#227;o alco&#243;lica&#44; osteoartrite&#44; uve&#237;te anterior&#41;&#44; doen&#231;as tireoidianas pr&#233;vias &#40;hipotireoidismo&#44; hipertireoidismo&#44; n&#243;dulo&#41;&#44; doen&#231;as autoimunes pr&#233;vias &#40;l&#250;pus eritematoso sist&#234;mico&#44; diabetes do tipo I&#44; vitiligo&#44; artrite reumatoide&#44; s&#237;ndrome de Sj&#246;gren&#41; e medica&#231;&#245;es em uso&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Os dados laboratoriais coletados foram&#58; tireotrofina s&#233;rica &#40;TSH&#41;&#44; tiroxina livre &#40;T4L&#41;&#44; anticorpos antitireoperoxidase &#40;anti&#8208;TPO&#41;&#44; anticorpos antitireoglobulina &#40;anti&#8208;TG&#41;&#44; glicemia de jejum&#44; colesterol total e fra&#231;&#245;es e triglic&#233;rides&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">O exame f&#237;sico e a coleta de dados foram supervisionados por m&#233;dicos dermatologistas capacitados&#46; Todos os pacientes foram informados sobre o estudo e assinaram o termo de consentimento&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Avalia&#231;&#227;o cl&#237;nica</span><p id="par0045" class="elsevierStylePara elsevierViewall">A gravidade da psor&#237;ase foi classificada clinicamente de acordo com o PASI&#46; Dermatologistas capacitados calcularam o &#237;ndice durante as consultas de seguimento&#46; Como j&#225; bem estabelecido&#44; o <span class="elsevierStyleItalic">score</span>&#44; com varia&#231;&#227;o de 0 a 72&#44; permite a divis&#227;o dos pacientes em dois grupos&#58; psor&#237;ase leve &#40;PASI &#8804; 10&#41; e psor&#237;ase moderada&#47;grave &#40;PASI<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>10&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">20</span></a> Os grupos foram comparados quanto &#224; preval&#234;ncia das anormalidades tireoidianas&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A frequ&#234;ncia da vari&#225;vel foi tamb&#233;m comparada considerando o tratamento vigente &#40;terapia imunobiol&#243;gica <span class="elsevierStyleItalic">vs&#46;</span> n&#227;o imunobiol&#243;gica&#41; e a coexist&#234;ncia de AP &#40;presente <span class="elsevierStyleItalic">vs&#46;</span> ausente&#41;&#46; O diagn&#243;stico reumatol&#243;gico da AP&#44; por sua vez&#44; foi feito com base em crit&#233;rios cl&#237;nicos e laboratoriais&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Anormalidade tireoidiana</span><p id="par0055" class="elsevierStylePara elsevierViewall">A preval&#234;ncia de anormalidade tireoidiana foi definida como presen&#231;a de um dos seguintes aspectos&#58; diagn&#243;stico pr&#233;vio de hipotireoidismo&#44; positividade para um anticorpo &#40;anti&#8208;TPO ou anti&#8208;TG&#41;&#44; valores de TSH s&#233;ricos alterados &#40;&#60; 0&#44;27 mUI&#47;L ou<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>4&#44;5 mUI&#47;L&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos laboratoriais</span><p id="par0060" class="elsevierStylePara elsevierViewall">Os valores s&#233;ricos de TSH&#44; T4L&#44; anti&#8208;TPO e anti&#8208;TG foram mensurados por ensaios de quimioluminesc&#234;ncia&#46; Os valores de refer&#234;ncia foram respectivamente&#58; 0&#44;27&#8211;4&#44;5 mUI&#47;L&#44; 0&#44;93&#8211;1&#44;7 ng&#47;dL&#44; positivo &#62;<span class="elsevierStyleHsp" style=""></span>34 UI&#47;mL e &#62;<span class="elsevierStyleHsp" style=""></span>115 UI&#47;mL&#46; A glicemia de jejum foi estimada por meio do m&#233;todo de hexoquinase&#44; e os n&#237;veis s&#233;ricos de colesterol e de triglic&#233;rides foram avaliados usando m&#233;todo colorim&#233;trico enzim&#225;tico&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Grupo controle da literatura</span><p id="par0065" class="elsevierStylePara elsevierViewall">A revis&#227;o da literatura incluiu as bases de dados do Pubmed&#44; Embase e Scopus&#44; limitada a estudos em humanos e publica&#231;&#227;o nos idiomas ingl&#234;s ou portugu&#234;s&#46; O per&#237;odo de sele&#231;&#227;o compreendeu janeiro de 2002 at&#233; 31 de maio de 2022&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Os descritores utilizados foram&#58; &#40;&#40;Psoriasis &#91;title&#93;&#41; AND &#40;thyroid &#91;title&#93;&#41; OR &#40;hypothyroidism &#91;title&#93;&#41; OR &#40;thyroiditis &#91;title&#93;&#41; OR &#40;hashimoto thyroiditis &#91;title&#93;&#41;&#41; e &#40;&#40;Psoriatic &#91;title&#93;&#41; AND &#40;thyroid &#91;title&#93;&#41; OR &#40;hypothyroidism &#91;title&#93;&#41; OR &#40;thyroiditis &#91;title&#93;&#41; OR &#40;hashimoto thyroiditis&#91;title&#93;&#41;&#41;&#46; N&#227;o foram considerados artigos provenientes de outras fontes&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">O t&#237;tulo e resumo dispon&#237;veis contaram como crit&#233;rios de sele&#231;&#227;o&#44; com exclus&#227;o dos artigos duplicados&#46; Foram considerados eleg&#237;veis os estudos conduzidos com o objetivo de avaliar a frequ&#234;ncia ou associa&#231;&#227;o de doen&#231;a tireoidiana autoimune e doen&#231;a psori&#225;sica&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Os crit&#233;rios de inclus&#227;o foram&#58; desenhos transversal&#44; caso&#8208;controle ou coorte&#44; e presen&#231;a de grupo controle no delineamento do estudo&#46; Os crit&#233;rios de exclus&#227;o foram&#58; estudos com grupo de casos composto exclusivamente por pacientes com artrite psori&#225;sica e aqueles que utilizaram apenas a Classifica&#231;&#227;o Internacional das Doen&#231;as &#40;CID&#41; sem os dados laboratoriais para o diagn&#243;stico de hipotireoidismo na publica&#231;&#227;o&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Os dados coletados dos estudos selecionados com grupo controle inclu&#237;ram&#58; nomes dos autores&#44; ano de publica&#231;&#227;o&#44; n&#250;mero de pacientes pertencentes ao grupo controle&#44; n&#250;mero de pacientes com diagn&#243;stico de hipotireoidismo&#44; n&#250;mero de pacientes com anti&#8208;TPO positivo&#44; anti&#8208;TG positivo e TSH alterado&#44; ou m&#233;dia e desvio padr&#227;o do TSH&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">As informa&#231;&#245;es obtidas por meio de controle da literatura foram agrupadas e avaliadas conforme metan&#225;lise para que os dados fossem utilizados com pondera&#231;&#227;o&#44; de modo a integrar os resultados dos estudos&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">An&#225;lise estat&#237;stica</span><p id="par0095" class="elsevierStylePara elsevierViewall">Para an&#225;lise estat&#237;stica utilizou&#8208;se SAS System for Windows v9&#46;4 &#40;SAS Institute Inc&#46; Cary&#44; NC&#44; EUA&#41; e valores de p &#8804; 0&#44;05 foram considerados significantes&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">O perfil da amostra foi definido por meio do c&#225;lculo da frequ&#234;ncia de vari&#225;veis categ&#243;ricas em n&#250;meros absolutos &#40;n&#41; e percentual &#40;&#37;&#41;&#46; Medidas descritivas &#40;m&#233;dia&#44; desvio padr&#227;o&#44; valores m&#237;nimos&#47;m&#225;ximos e mediana&#41; foram adotadas para vari&#225;veis quantitativas&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Para a an&#225;lise da correla&#231;&#227;o entre vari&#225;veis e caracter&#237;sticas basais e a exist&#234;ncia de comorbidades foi realizado o Qui&#8208;Quadrado ou teste exato de Fisher para vari&#225;veis categ&#243;ricas&#44; e o Teste de Mann&#8208;Whitney para vari&#225;veis num&#233;ricas&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Para an&#225;lise do grupo controle da literatura foi aplicada a metan&#225;lise para estimar a propor&#231;&#227;o ou m&#233;dia e seu respectivo intervalo de confian&#231;a utilizando o modelo aleat&#243;rio via modelos lineares&#46; Para compara&#231;&#227;o do grupo de casos com o grupo controle da literatura foi utilizado o teste Qui&#8208;Quadrado para propor&#231;&#245;es e foi aplicado o teste <span class="elsevierStyleItalic">t</span> de Student para compara&#231;&#227;o de medidas cont&#237;nuas entre dois grupos&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0115" class="elsevierStylePara elsevierViewall">Inicialmente&#44; 250 pacientes foram considerados eleg&#237;veis&#44; por&#233;m 15 n&#227;o foram inclu&#237;dos por terem diagn&#243;stico de psor&#237;ase palmoplantar exclusivo ou de psor&#237;ase pustulosa generalizada&#46; Do total de 235 pacientes inclu&#237;dos no estudo&#44; 74 foram exclu&#237;dos &#40;64 por informa&#231;&#245;es incompletas no prontu&#225;rio&#44; tr&#234;s por uso de medica&#231;&#245;es que alteram a fun&#231;&#227;o tireoidiana e sete por perda de seguimento&#41;&#46; Portanto&#44; a amostra final foi composta por 161 pacientes&#44; cujos dados foram analisados&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Dentre os pacientes da amostra&#59; 64&#44;60&#37; eram do sexo masculino&#44; com m&#233;dia de idade de 55 anos&#46; A preval&#234;ncia da anormalidade tireoidiana foi de 28&#44;57&#37; e do hipotireoidismo de 14&#44;91&#37;&#46; As seguintes doen&#231;as autoimunes foram detectadas na amostra&#58; s&#237;ndrome de Sj&#246;gren&#44; vitiligo e diabetes do tipo I &#40;em um&#44; dois e um pacientes&#44; respectivamente&#41;&#46; Em rela&#231;&#227;o ao tratamento&#58; 44&#44;09&#37; dos pacientes estavam em uso de terapia imunobiol&#243;gica&#44; 37&#44;88&#37; em tratamento sist&#234;mico n&#227;o imunobiol&#243;gico&#44; 3&#44;72&#37; em fototerapia e 14&#44;28&#37; em uso de terapia t&#243;pica exclusiva&#46; Considerando o PASI&#44; 15&#44;55&#37; &#40;21 pacientes&#41; foram considerados com doen&#231;a moderada&#47;grave &#40;<a class="elsevierStyleCrossRefs" href="#tbl0010">tabelas 2 e 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">Foram comparadas vari&#225;veis quantitativas &#40;idade&#44; IMC&#44; dura&#231;&#227;o da doen&#231;a e PASI&#41; com sexo e presen&#231;a ou aus&#234;ncia de comorbidades &#40;hipertens&#227;o&#44; dislipidemia&#44; diabetes&#44; hipotireoidismo e AP&#41;&#46; N&#227;o houve diferen&#231;a da frequ&#234;ncia de AP entre os sexos&#46; Hipertens&#227;o&#44; dislipidemia e hipotireoidismo foram mais prevalentes nas idades mais avan&#231;adas &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;066 &#91;95&#37;IC 1&#44;038&#8211;1&#44;094&#93; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;039 &#91;95&#37;IC 1&#44;014&#8211;1&#44;064&#93; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0025 e OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;048 &#91;95&#37;IC 1&#44;009&#8211;1&#44;077&#93; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0125&#44; respectivamente&#41;&#46; Em paralelo&#44; diabetes apresentou maior frequ&#234;ncia nos pacientes mais velhos &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;048 &#91;95&#37;IC 1&#44;020&#8211;1&#44;076&#93; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0006&#41; e com IMC mais elevado &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;083 &#91;95&#37;IC 1&#44;007&#8211;1&#44;164&#93; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0314&#41;&#46; N&#227;o foi encontrada diferen&#231;a estatisticamente significante considerando hipotireoidismo e PASI&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Os pacientes alocados considerando o PASI &#40;leve ou moderado&#47;grave&#41;&#44; AP &#40;presen&#231;a ou aus&#234;ncia&#41; e tratamento atual &#40;imunobiol&#243;gico ou n&#227;o imunobiol&#243;gico&#41; foram comparados quanto &#224; anormalidade tireoidiana&#46; Conforme observado nas <a class="elsevierStyleCrossRefs" href="#tbl0020">tabelas 4&#44; 5 e 6</a>&#44; n&#227;o foi encontrada diferen&#231;a estatisticamente significante entre esses grupos&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">Os pacientes em terapia n&#227;o imunobiol&#243;gica foram divididos em grupos conforme tipo de tratamento&#58; exclusivamente t&#243;pico&#44; fototerapia e medica&#231;&#227;o sist&#234;mica&#46; N&#227;o houve&#44; entretanto&#44; diferen&#231;a estatisticamente significante entre os grupos para as vari&#225;veis de hipotireoidismo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;10&#41; e anormalidade tireoidiana &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;17&#41;&#46;</p><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Grupo controle</span><p id="par0140" class="elsevierStylePara elsevierViewall">Na revis&#227;o de literatura foram encontrados 80 artigos na base de dados Pubmed&#44; 90 na base de dados Embase e 85 base de dados Scopus&#46; Dos artigos de interesse&#44; 24 artigos duplicados e um artigo escrito no idioma hebraico n&#227;o foram considerados&#46; O total de 17 artigos foi apontado como eleg&#237;vel&#46; Posteriormente&#44; dois foram exclu&#237;dos por relatarem grupo de casos composto exclusivamente por pacientes com artrite psori&#225;sica&#44; quatro por aus&#234;ncia de grupo controle&#44; dois por utilizarem exclusivamente o CID para diagn&#243;stico e tr&#234;s por dados laboratoriais insuficientes no corpo do artigo&#46; Portanto&#44; o total de seis artigos foi enviado para an&#225;lise estat&#237;stica&#44; todos com delineamento transversal ou caso&#8208;controle &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#44;6&#44;11&#44;13&#44;14&#44;21</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">O tamanho amostral dos controles correspondeu a 6&#46;227 pacientes&#46; A amostra avaliada para cada uma das vari&#225;veis diferiu conforme os dados estudados em cada artigo&#46; Portanto&#44; o n&#250;mero total de pacientes inclu&#237;dos para hipotireoidismo foi de 6&#46;035 &#40;quatro artigos&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#44;11&#44;13&#44;21</span></a> anti&#8208;TPO de 6&#46;069 &#40;quatro artigos&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#44;6&#44;11&#44;13</span></a> anti&#8208;TG de 443 &#40;tr&#234;s artigos&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#44;6&#44;13</span></a> TSH alterado 96 &#40;um artigo&#41;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">6</span></a> e TSH m&#233;dio de 6&#46;071 &#40;quatro artigos&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#44;11&#44;13&#44;14</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">A compara&#231;&#227;o entre os resultados dos casos e o dos controles da literatura para as vari&#225;veis de hipotireoidismo&#44; anti&#8208;TPO positivo&#44; anti&#8208;TG positivo e TSH alterado apresentou diferen&#231;a estatisticamente significante para hipotireoidismo&#46; Enquanto no grupo de casos a propor&#231;&#227;o de hipotireoidismo foi de 14&#44;91&#37;&#44; no grupo controle foi de 3&#44;58&#37; &#40;<span class="elsevierStyleItalic">random effects model</span> 0&#44;035 &#91;95&#37;IC 0&#44;016&#8211;0&#44;074&#93; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Para al&#233;m disso&#44; a m&#233;dia do TSH no grupo de casos foi de 2&#44;67 mUI&#47;L&#44; enquanto a m&#233;dia ponderada do TSH no grupo controle foi de 2&#44;06 mUI&#47;L&#44; com diferen&#231;a estatisticamente significante entre os grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;026&#41;&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discuss&#227;o</span><p id="par0160" class="elsevierStylePara elsevierViewall">A rela&#231;&#227;o da psor&#237;ase com diversas comorbidades tem sido importante t&#243;pico de pesquisa&#44; e evid&#234;ncias atuais sugerem aspecto multifatorial da doen&#231;a&#44; expandindo seu espectro e seu impacto para al&#233;m dos &#226;mbitos dermatol&#243;gico e reumatol&#243;gico&#46; Portanto&#44; conhecer poss&#237;veis associa&#231;&#245;es com outras comorbidades&#44; como a doen&#231;a tireoidiana&#44; &#233; elemento chave na melhoria da assist&#234;ncia&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">A ativa&#231;&#227;o da via inflamat&#243;ria pelo fator de necrose tumoral alfa &#40;TNF&#8208;&#945;&#41;&#44; interleucina 23 &#40;IL&#8208;23&#41; e IL&#8208;17 comp&#245;e a fisiopatologia da psor&#237;ase&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">22</span></a> O papel dessa via fisiopatol&#243;gica nas doen&#231;as tireoidianas tem sido estudado&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Trabalhos antigos demonstraram que o <span class="elsevierStyleItalic">status</span> de prolifera&#231;&#227;o epid&#233;rmica sofre altera&#231;&#227;o com a doen&#231;a da tireoide<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">23</span></a> e os horm&#244;nios tireoidianos s&#227;o capazes de induzir a produ&#231;&#227;o do fator de crescimento epid&#233;rmico &#40;EGF&#41;&#44; cuja persist&#234;ncia poderia se associar ao estado hiperproliferativo da psor&#237;ase&#46;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">24&#44;25</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">Atualmente&#44; sabe&#8208;se que a psor&#237;ase tem alta frequ&#234;ncia de Treg&#47;IL17<span class="elsevierStyleSup">&#43;</span> e estudos recentes demonstraram altos n&#237;veis de linf&#243;citos T <span class="elsevierStyleItalic">helper</span> 17 &#40;Th17&#41;&#44; tanto no tecido perif&#233;rico quanto no tecido tireoidiano de pacientes com doen&#231;a tireoidiana autoimune&#44; assim como express&#227;o de Th17 nos pacientes com tireoidite de Hashimoto &#40;TH&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">26&#44;27</span></a> Essa via pode estar relacionada n&#227;o s&#243; com a fisiopatologia da psor&#237;ase&#44; mas com a de doen&#231;as tireoidianas imunomediadas&#44; sugerindo conex&#227;o entre elas&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">A citocina CXCL10 desempenha importante papel na quimioatra&#231;&#227;o de linf&#243;citos Th1 e &#233; encontrada em altos n&#237;veis nos pacientes com AP e TH quando comparados aos pacientes com AP isolada&#44;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">13&#44;28</span></a> representando outro ponto em comum na via fisiopatol&#243;gica&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Embora j&#225; hipotetizado e demonstrado em estudos pr&#233;vios&#44;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">7&#44;8&#44;18</span></a> este &#233; um dos primeiros estudos com dados brasileiros a avaliar a preval&#234;ncia de anormalidade tireoidiana nos pacientes com psor&#237;ase vulgar&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">A preval&#234;ncia de 7&#44;4&#37; do hipotireoidismo e de 16&#44;9&#37; da doen&#231;a autoimune tireoidiana cr&#244;nica na popula&#231;&#227;o brasileira foi previamente estimada&#46;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">29&#44;30</span></a> A preval&#234;ncia de TH no estudo de Valduga et al&#46;&#44; que analisou 60 pacientes brasileiros e 60 controles&#44; foi de 21&#44;6&#37; para o grupo de casos&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">21</span></a> A amostra aqui avaliada&#44; que contou com n&#250;mero mais expressivo de participantes&#44; encontrou preval&#234;ncias de 28&#44;57&#37; para anormalidade tireoidiana e de 14&#44;91&#37; para hipotireoidismo&#46; Al&#233;m disso&#44; 10&#44;29&#37; dos pacientes apresentaram TSH alterado&#44; e positividade para anti&#8208;TPO e anti&#8208;TG foi demonstrada em 8&#44;55&#37; e 4&#44;83&#37;&#44; respectivamente&#46; Entretanto&#44; destaca&#8208;se que o presente estudo foi conduzido em ambulat&#243;rio especializado&#44; n&#227;o sendo&#44; portanto&#44; compar&#225;vel &#224; popula&#231;&#227;o geral brasileira&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Resultados semelhantes foram demonstrados por outros autores&#46; Mallick et al&#46; encontraram frequ&#234;ncia de 15&#44;2&#37; para desordens tireoidianas em amostra de 112 pacientes com psor&#237;ase vulgar&#59;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">16</span></a> Namiki et al&#46; estudaram disfun&#231;&#227;o tireoidiana em 85 pacientes e obtiveram preval&#234;ncia de 8&#37; em pacientes com psor&#237;ase sem AP&#44; 13&#37; em pacientes com AP e 45&#37; nos pacientes com psor&#237;ase pustulosa generalizada &#40;GPP&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">17</span></a> Em contrapartida&#44; neste estudo&#44; os pacientes com GPP foram exclu&#237;dos&#44; embora possam ser inclu&#237;dos em avalia&#231;&#245;es futuras&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Dados demonstram alta frequ&#234;ncia de autoimunidade tireoidiana no sexo feminino&#44; at&#233; oito vezes mais afetado que o masculino&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">31</span></a> Na amostra avaliada&#44; 64&#44;6&#37; dos pacientes eram homens&#44; devendo implicar numa frequ&#234;ncia mais baixa de anormalidade tireoidiana&#44; sugerindo que a alta frequ&#234;ncia encontrada deva ser valorizada e discutida em estudos futuros&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">As medica&#231;&#245;es sist&#234;micas disponibilizadas na psor&#237;ase vulgar s&#227;o reservadas sobretudo para pacientes que apresentam durante a evolu&#231;&#227;o quadro cl&#237;nico moderado a grave&#46; No estudo realizado&#44; 83&#44;84&#37; dos pacientes estavam em uso de terapia medicamentosa sist&#234;mica&#46; No entanto&#44; 15&#44;55&#37; tinham PASI &#62;<span class="elsevierStyleHsp" style=""></span>10&#44; com m&#233;dia e mediana correspondendo a 5&#44;62 e 2&#44;2 &#40;0&#8211;57&#41;&#44; respectivamente&#46; A maioria dos pacientes se encontrava&#44; portanto&#44; em tratamento adequado e em controle durante a pesquisa&#46; N&#227;o houve associa&#231;&#227;o entre PASI e anormalidade tireoidiana&#46; Contudo&#44; o <span class="elsevierStyleItalic">score</span> &#233; din&#226;mico&#44; sofrendo impacto do tratamento e se alterando durante o seguimento&#44; de modo que n&#227;o reflete a gravidade quando coletado de maneira pontual&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Em conson&#226;ncia com outros estudos&#44; Arican et al&#46; estabeleceram associa&#231;&#227;o entre doen&#231;as tireoidianas e PASI&#44; demonstrando valores mais elevados do &#237;ndice nos pacientes com anormalidade tireoidiana&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">14&#44;17</span></a> A suspens&#227;o do tratamento por no m&#237;nimo um m&#234;s&#44; adotada pelos autores&#44; tornou o PASI um <span class="elsevierStyleItalic">score</span> mais confi&#225;vel para a avalia&#231;&#227;o da gravidade&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">A terapia imunobiol&#243;gica&#44; comparada &#224; terapia convencional&#44; n&#227;o se associou &#224; anormalidade tireoidiana &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;13&#41;&#46; De maneira similar&#44; n&#227;o foi encontrada diferen&#231;a estatisticamente significante entre os pacientes quando divididos nos tr&#234;s grupos de tratamento n&#227;o imunobiol&#243;gico&#58; sist&#234;micos&#44; fototerapia e tratamentos t&#243;picos&#44; considerando as vari&#225;veis de hipotireoidismo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;10&#41; e anormalidade tireoidiana &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;17&#41;&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">A AP&#44; prevalente em at&#233; 30&#37; dos pacientes&#44; gera importante impacto na qualidade de vida e se associa &#224; ocorr&#234;ncia de outras comorbidades&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a> A associa&#231;&#227;o com hipotireoidismo&#44; positividade anti&#8208;TPO e achados ultrassonogr&#225;ficos &#40;hipoecogenicidade tireoidiana&#41; foi demonstrada previamente&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">18&#44;19</span></a> Na amostra avaliada&#44; n&#227;o houve associa&#231;&#227;o da AP considerando hipotireoidismo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;65&#41;&#44; anti&#8208;TPO &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;76&#41; ou anormalidade tireoidiana &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;87&#41;&#46; A ultrassonografia para avalia&#231;&#227;o tireoidiana n&#227;o foi realizada neste estudo&#44; o que constitui uma limita&#231;&#227;o&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Controle hist&#243;rico e controle da literatura s&#227;o utilizados com maior frequ&#234;ncia nos ensaios cl&#237;nicos&#44; com benef&#237;cios na redu&#231;&#227;o dos custos e dura&#231;&#227;o do estudo&#46;<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">32&#44;33</span></a> A revis&#227;o da literatura e o uso do grupo controle proveniente dos artigos selecionados para compara&#231;&#227;o complementam o estudo&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">A preval&#234;ncia de hipotireoidismo entre os pacientes com doen&#231;a psori&#225;sica quando comparada aos dados do controle de literatura foi maior&#44; com diferen&#231;a estatisticamente significante&#46; Esse dado&#44; corroborado por aquele observado no estudo brasileiro de Valduga et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">21</span></a> justifica que maior aten&#231;&#227;o seja despendida &#224; fun&#231;&#227;o tireoidiana dos pacientes com psor&#237;ase&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">No entanto&#44; algumas pondera&#231;&#245;es devem ser feitas considerando o delineamento do estudo&#46; A composi&#231;&#227;o do grupo controle dos artigos inclu&#237;dos na metan&#225;lise variou&#44; e foi constitu&#237;do por pacientes com outras doen&#231;as dermatol&#243;gicas nos estudos de Arican et al&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">14</span></a> e Gul et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">6</span></a> enquanto no estudo de Valduga et al&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">21</span></a> foi composto por pacientes provenientes da cl&#237;nica de ginecologia e oftalmologia&#46; Enquanto isso&#44; no artigo de Hansen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">11</span></a> os pacientes pertenciam &#224; base de dados do <span class="elsevierStyleItalic">Danish General Suburban Population Study</span>&#46; Portanto&#44; o grupo controle obtido da revis&#227;o da literatura n&#227;o foi restrito a uma &#250;nica popula&#231;&#227;o&#44; reduzindo&#8208;se o risco da escolha de um grupo controle muito diferente dos casos e enriquecendo a an&#225;lise&#46; No entanto&#44; &#233; limitante o fato de o grupo controle n&#227;o ser proveniente do mesmo centro ou da mesma &#225;rea geogr&#225;fica&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">As formas de diagn&#243;stico de hipotireoidismo tamb&#233;m variaram entre os estudos&#46; O artigo de Hansen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">11</span></a> utilizou a informa&#231;&#227;o autorreferida de hipotireoidismo&#44; enquanto os demais fizeram diagn&#243;stico com base nos dados laboratoriais do pr&#243;prio estudo&#46; Em nossa pesquisa&#44; foram inclu&#237;dos os pacientes com diagn&#243;stico pr&#233;vio de hipotireoidismo e aqueles que apresentaram dados laboratoriais alterados&#44; abrangendo o diagn&#243;stico da anormalidade tireoidiana&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conclus&#227;o</span><p id="par0245" class="elsevierStylePara elsevierViewall">Embora muitos estudos tenham investigado a associa&#231;&#227;o ou a frequ&#234;ncia de anormalidade tireoidiana nos pacientes com psor&#237;ase&#44; este foi um dos primeiros com dados brasileiros&#46; A preval&#234;ncia de anormalidade tireoidiana foi de 28&#44;57&#37; e do hipotireoidismo foi de 14&#44;91&#37;&#46; Para al&#233;m disso&#44; a preval&#234;ncia de hipotireoidismo&#44; quando comparada ao controle da literatura&#44; foi positiva&#46; Essa an&#225;lise complementa o estudo vigente&#44; permitindo compara&#231;&#227;o e avalia&#231;&#227;o mais completas dos dados obtidos de nossa casu&#237;stica&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">Os resultados analisados possibilitam que futuros estudos sejam conduzidos com a finalidade de avaliar a exist&#234;ncia da associa&#231;&#227;o ou o rastreio da autoimunidade tireoidiana nesse grupo da popula&#231;&#227;o&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Suporte financeiro</span><p id="par0255" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Contribui&#231;&#227;o dos autores</span><p id="par0260" class="elsevierStylePara elsevierViewall">Luiza de Castro Fernandes&#58; Concep&#231;&#227;o e o desenho do estudo&#59; levantamento dos dados&#44; ou an&#225;lise e interpreta&#231;&#227;o dos dados&#59; an&#225;lise estat&#237;stica&#59; reda&#231;&#227;o do artigo ou revis&#227;o cr&#237;tica do conte&#250;do intelectual importante&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0265" class="elsevierStylePara elsevierViewall">Ana Carolina Belini Bazan Arruda&#58; Concep&#231;&#227;o e o desenho do estudo&#59; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; reda&#231;&#227;o do artigo ou revis&#227;o cr&#237;tica do conte&#250;do intelectual importante&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">Lisa Gava Baeninger&#58; Concep&#231;&#227;o e o desenho do estudo&#59; levantamento dos dados&#44; reda&#231;&#227;o do artigo&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0275" class="elsevierStylePara elsevierViewall">Debora Pedroso Almeida&#58; Concep&#231;&#227;o e o desenho do estudo&#59; levantamento dos dados&#44; reda&#231;&#227;o do artigo&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0280" class="elsevierStylePara elsevierViewall">Danilo Villagelin&#58; Concep&#231;&#227;o e o desenho do estudo&#59; levantamento dos dados&#44; ou an&#225;lise e interpreta&#231;&#227;o dos dados&#59; an&#225;lise estat&#237;stica&#59; reda&#231;&#227;o do artigo ou revis&#227;o cr&#237;tica do conte&#250;do intelectual importante&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflito de interesses</span><p id="par0285" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A psor&#237;ase &#233; associada a diversas comorbidades&#44; e sua rela&#231;&#227;o com anormalidade tireoidiana tem sido hipotetizada&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Avaliar a preval&#234;ncia de anormalidade tireoidiana em pacientes brasileiros com psor&#237;ase e analisar sua associa&#231;&#227;o com a gravidade&#44; presen&#231;a de artrite psori&#225;sica e tratamento imunobiol&#243;gico&#46; Adicionalmente&#44; comparar resultados com controle da literatura&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Neste estudo observacional foram analisados dados cl&#237;nicos e laboratoriais de pacientes acompanhados de janeiro de 2018 a dezembro de 2019&#46; Anormalidade tireoidiana foi avaliada por meio da hist&#243;ria atual de doen&#231;a tireoidiana e de exames laboratoriais &#8211; tireotrofina &#40;TSH&#41;&#44; tiroxina livre &#40;T4L&#41;&#44; anticorpos antitireoperoxidase &#40;anti&#8208;TPO&#41; e antitireoglobulina &#40;anti&#8208;TG&#41;&#46; Os pacientes foram classificados segundo gravidade da psor&#237;ase &#8211; <span class="elsevierStyleItalic">Psoriasis Area and Severity Index</span> &#40;PASI&#41;&#44; presen&#231;a de artrite psori&#225;sica e tratamento vigente&#46; Posteriormente&#44; foi selecionado grupo controle da revis&#227;o de literatura e os resultados foram comparados&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Dos 250 pacientes inclu&#237;dos&#44; 161 foram eleg&#237;veis&#46; A preval&#234;ncia da anormalidade tireoidiana foi de 28&#44;57&#37; e do hipotireoidismo de 14&#44;91&#37;&#46; A idade m&#233;dia foi de 55 anos e o PASI mediano foi de 2&#44;2&#46; N&#227;o houve associa&#231;&#227;o entre anormalidade tireoidiana e PASI &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;8&#41;&#44; presen&#231;a de artrite psori&#225;sica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;87&#41; ou uso de terapia imunobiol&#243;gica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;13&#41;&#46; O controle da literatura incluiu 6&#46;227 pacientes e houve diferen&#231;a estatisticamente significante para vari&#225;vel de hipotireoidismo &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#245;es do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Aus&#234;ncia de grupo controle proveniente do mesmo centro&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este foi um dos primeiros estudos com dados brasileiros da preval&#234;ncia de anormalidade tireoidiana nos pacientes com psor&#237;ase&#46;</p></span>"
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          5 => array:2 [
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Como citar este artigo&#58; Fernandes LC&#44; Arruda AC&#44; Baeninger LG&#44; Almeida DP&#44; Villagelin D&#46; Thyroid abnormality in patients with psoriasis&#58; prevalence and association with severity&#46; An Bras Dermatol&#46; 2024&#59;99&#58;80&#8211;9&#46;</p>"
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        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Trabalho realizado no Hospital da Pontif&#237;cia Universidade Cat&#243;lica de Campinas&#44; Campinas&#44; SP&#44; Brasil&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Autores&#47;ano de publica&#231;&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Desenho do estudo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Objetivo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;tamanho da amostra&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Pa&#237;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Marcadores tireoidianos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Achados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Arican&#44; Bilgic e Koc&#44; 2004<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&#8208;controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Compara&#231;&#227;o n&#237;vel s&#233;rico horm&#244;nios tireoidianos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">103 pacientes<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>96 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Turquia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3T&#44; T3L&#44; T4T&#44; T4L&#44; TSH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T4T e T3L elevados em pacientes com psor&#237;ase &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; PASI elevado nesses pacientes &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antonelli et al&#46;&#44; 2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&#8208;controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de desordens tireoidianas em pacientes com AP <span class="elsevierStyleItalic">vs&#46;</span> controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pacientes&#58; 80 AP&#47; 112 artrite reumatoide &#47; 400 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">It&#225;lia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3L&#44; T4L&#44; TSH&#44; anti&#8208;TPO&#44; anti&#8208;TG&#44; ultrassonografia tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disfun&#231;&#227;o autoimune tireoidiana &#40;pacientes<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>controles&#41;&#58; 33&#37;<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>18&#37; no sexo feminino e 25&#37;<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>5&#37; no sexo masculino &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gul et al&#46;&#44; 2009<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&#8208;controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associa&#231;&#227;o de doen&#231;as tireoidianas autoimunes com psor&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">105 pacientes<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>96 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Turquia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3L&#44; T4L&#44; TSH&#44; anti&#8208;TPO&#44; anti&#8208;TG&#44; ultrassonografia tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nenhuma diferen&#231;a entre os grupos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">James&#44; Hill e Feldman 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de hipotireoidismo em pacientes com ros&#225;cea ou psor&#237;ase comparados a outras doen&#231;as dermatol&#243;gicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Humana Database &#8211; 1&#46;667&#46;943 pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estados Unidos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CID&#8208;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de hipotireoidismo de 17&#44;5&#37; nos pacientes com psor&#237;ase&#46; Frequ&#234;ncia de hipotireoidismo n&#227;o diferia de outros pacientes dermatol&#243;gicos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lai e Yew 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associa&#231;&#227;o de psor&#237;ase e doen&#231;as tireoidianas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#205;ndia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Horm&#244;nios tireoidianos e autoanticorpos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Baixos n&#237;veis de TSH em pacientes com psor&#237;ase &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;019&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fallahi et al&#46;&#44; 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&#8208;controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Incid&#234;ncia de disfun&#231;&#227;o tireoidiana cl&#237;nica ou subcl&#237;nica em pacientes com AP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97 pacientes<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>97 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">It&#225;lia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T4L&#44; T3L&#44; TSH&#44; anti&#8208;TPO&#44; anti&#8208;TG&#44; ultrassonografia tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Incid&#234;ncia alta de positividade para anti&#8208;TPO &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;017&#41;&#44; hipotireoidismo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;017&#41;&#44; disfun&#231;&#227;o tireoidiana &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#44; hipoecogenicidade &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;009&#41; e autoimunidade tireoidiana &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Khan et al&#46;&#44; 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">An&#225;lise transversal de uma coorte&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associa&#231;&#227;o de anti&#8208;TPO positivo&#44; TSH e T4L com doen&#231;a psori&#225;sica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Popula&#231;&#227;o &#8211; parte do <span class="elsevierStyleItalic">Rotterdam Study</span> &#8211; 8&#46;214 participantes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Holanda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T4L&#44; TSH&#44; anti&#8208;TPO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nenhuma associa&#231;&#227;o considerando doen&#231;a psori&#225;sica incidente ou prevalente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Kiguradze et al&#46;&#44; 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associa&#231;&#227;o entre psor&#237;ase e TH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Popula&#231;&#227;o &#8211; <span class="elsevierStyleItalic">Northwestern Medicine Enterprise Data Warehouse</span> &#8211; 856&#46;615 participantes &#8211; 9&#46;654 diagn&#243;sticos de psor&#237;ase &#8211; 1&#46;745 diagn&#243;stico de TH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estados Unidos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3L&#44; TSH&#44; anti&#8208;TPO&#44; anti&#8208;TG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associa&#231;&#227;o positiva &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;49 &#91;95&#37; IC 1&#44;79&#8211;3&#44;48&#93; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vassilatou et al&#46;&#44; 2017<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&#8208;controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de tireoidite autoimune em pacientes com psor&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">114 pacientes com psor&#237;ase<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>286 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gr&#233;cia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3T&#44; T4T&#44; T4L&#44; TSH&#44; anti&#8208;TPO&#44; anti&#8208;TG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nenhuma diferen&#231;a na preval&#234;ncia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Valejo&#44; Coelho e Brasileiro 2018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de disfun&#231;&#227;o tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55 pacientes com psor&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Portugal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3L&#44; T4L&#44; TSH&#44; anti&#8208;TPO&#44; anti&#8208;TG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de 9&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alidrisi et al&#46;&#44; 2019<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&#8208;controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de TH em pacientes com psor&#237;ase comparados a controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56 pacientes<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>54 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Iraque&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T4L&#44; TSH&#44; anti&#8208;TPO&#44; anti&#8208;TG&#44; ultrassonografia tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia mais alta de anti&#8208;TPO &#40;25&#37;<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>9&#44;3&#37; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#44; anti&#8208;TG &#40;30&#44;4&#37;<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>11&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; hipoecogenicidade &#40;30&#44;4&#37;<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>9&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#44; pseudonodularidade &#40;16&#44;1&#37;<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>0&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; e vascularidade elevada na ultrassonografia nos pacientes com psor&#237;ase &#40;35&#44;7&#37;<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>5&#44;6&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hansen et al&#46;&#44; 2019<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&#8208;controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Avaliar fun&#231;&#227;o tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Popula&#231;&#227;o &#8211; <span class="elsevierStyleItalic">Danish General Population Study</span> &#8211; 1&#46;127 pacientes<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>5&#46;637 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dinamarca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3T&#44; T4L&#44; TSH&#44; anti&#8208;TPO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#237;veis elevados de T3T em pacientes com psor&#237;ase &#40;1&#44;72<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>1&#44;69&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mallick 2019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequ&#234;ncia de desordens tireoidianas em pacientes com psor&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">112 pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paquist&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3L&#44; T4T&#44; TSH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wang et al&#46;&#44; 2019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coorte&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Risco de doen&#231;a tireoidiana em pacientes com psor&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Popula&#231;&#227;o &#8211; <span class="elsevierStyleItalic">Taiwan National Health Insurance Research Database</span> &#8211; 13&#46;266 pacientes com AP&#47; 149&#46;576 com psor&#237;ase isolada&#47; 162&#46;842 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Taiwan&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CID&#8208;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Incid&#234;ncia elevada de hipertireoidismo nos pacientes com psor&#237;ase &#40;aHR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;22&#59; 95&#37;&#160;IC 1&#44;11&#8211;1&#44;33&#41;&#44; doen&#231;a de Graves &#40;aHR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;26&#59; 95&#37; IC 1&#44;13&#8211;1&#44;41&#41;&#44; incid&#234;ncia de hipotireoidismo &#40;aHR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;38&#59; 95&#37; IC 1&#44;23&#8211;1&#44;56&#41; e TH &#40;Ahr<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;47&#59; 95&#37; IC 1&#44;18&#8211;1&#44;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Namiki et al&#46;&#44; 2020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de disfun&#231;&#227;o tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85 pacientes&#58; 51 psor&#237;ase vulgar&#47; 23 AP&#47; 11 GPP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Jap&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3L&#44; T4L&#44; TSH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de 8&#37;&#44; 13&#37; e 45&#37;&#44; respectivamente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wu et al&#46;&#44; 2021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associa&#231;&#227;o de psor&#237;ase com aumento do risco de doen&#231;a tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">National Health and Nutrition Examination Survey</span> &#8211; 15&#46;091 pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estados Unidos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Doen&#231;a autorreferida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associa&#231;&#227;o positiva &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;61 &#91;95&#37; IC 1&#44;01&#8211;2&#44;55&#93; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;043&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Valduga et al&#46;&#44; 2021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de TH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 pacientes<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>60 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Brasil&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TSH&#44; T4L&#44; anti&#8208;TPO&#44; anti&#8208;TG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de TH &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;8 &#91;95&#37; IC 1&#44;18&#8211;12&#44;6&#93; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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        "tipo" => "MULTIMEDIATABLA"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas cl&#237;nicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frequ&#234;ncia &#40;n&#250;mero de pacientes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Porcentagem &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">104&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Artrite psori&#225;sica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#44;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipertens&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Depress&#227;o&#47;ansiedade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dislipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Autoimunidade &#40;exceto hipotireoidismo&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anormalidade tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#44;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipotireoidismo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TSH alterado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TPO positivo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TG positivo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&#237;nimo&#8211;M&#225;ximo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Peso&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">78&#44;78&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">44&#8211;125&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Altura&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#44;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#44;48&#8211;1&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#44;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IMC&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">28&#44;20&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">18&#44;80&#8211;47&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dura&#231;&#227;o da doen&#231;a &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">215&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#8211;720&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">192&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">152&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PASI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#8211;57&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&#44;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "pt" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Medidas descritivas de vari&#225;veis quantitativas</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t" scope="col">PASI&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Moderado&#47;grave &#40;&#62; 10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Leve &#40;&#8804; 10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Vari&#225;veis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">Hipotireoidismo<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">15 &#40;11&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">0&#44;49</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;12&#44;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99 &#40;73&#44;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TSH alterado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;8&#44;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;35</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SH normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;14&#44;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88 &#40;76&#44;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TPO<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3 &#40;2&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;6&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;38</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TPO<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;13&#44;74&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TG<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">4 &#40;3&#44;17&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TG<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Anormalidade tireoidiana<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anormalidade tireoidiana<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84 &#40;62&#44;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Anormalidade tireoidiana e <span class="elsevierStyleItalic">Psoriasis Area and Severity Index</span> &#40;PASI&#41;</p>"
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                  \t\t\t\t" scope="col">Artrite psori&#225;sica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hipotireoidismo<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hipotireoidismo<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">TSH alterado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">TSH normal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">80 &#40;58&#44;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TPO<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;3&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;5&#44;26&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">0&#44;76</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TPO<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46 &#40;30&#44;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93 &#40;61&#44;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TG<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#44;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#44;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">0&#44;42</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TG<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;33&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90 &#40;62&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anormalidade tireoidiana<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;9&#44;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;19&#44;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;87</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anormalidade tireoidiana<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;24&#44;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76 &#40;47&#44;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Anormalidade tireoidiana e artrite psori&#225;sica</p>"
        ]
      ]
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                  \t\t\t\t">TSH alterado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">TSH normal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Anti&#8208;TPO<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Anti&#8208;TPO<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Anti&#8208;TG<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">1&#44;0</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Anti&#8208;TG<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">65 &#40;44&#44;83&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">73 &#40;50&#44;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">Anormalidade tireoidiana<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">30 &#40;18&#44;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">0&#44;13</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Anormalidade tireoidiana<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">55 &#40;34&#44;16&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">60 &#40;37&#44;27&#41;&nbsp;\t\t\t\t\t\t\n
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Artigo original
Anormalidade tireoidiana em pacientes com psoríase: prevalência e associação com gravidade
Luiza de Castro Fernandesa,
Corresponding author
luizacastro.dermatologia@gmail.com

Autor para correspondência.
, Ana Carolina Belini Bazan Arrudab, Lisa Gava Baeningerb, Debora Pedroso Almeidab, Danilo Villagelina,c
a Departamento de Clínica Médica, Universidade Estadual de Campinas, Campinas, SP, Brasil
b Departamento de Dermatologia, Hospital da Pontifícia Universidade Católica de Campinas, Campinas, SP, Brasil
c Departamento de Endocrinologia e Metabologia, Hospital da Pontifícia Universidade Católica de Campinas, Campinas, SP, Brasil
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">A preval&#234;ncia estimada da psor&#237;ase no Brasil &#233; de 1&#44;3&#37;&#44; com frequ&#234;ncias mais elevadas nas regi&#245;es Sul e Sudeste&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">1</span></a> A associa&#231;&#227;o com ampla gama de comorbidades &#233; reconhecida&#44; particularmente artrite psori&#225;sica &#40;AP&#41;&#44; s&#237;ndrome metab&#243;lica&#44; doen&#231;a cardiovascular&#44; diabetes <span class="elsevierStyleItalic">mellitus</span>&#44; desordens psiqui&#225;tricas&#44; asma e doen&#231;a inflamat&#243;ria intestinal&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">2&#44;3</span></a> Doen&#231;as imunomediadas ou autoimunes&#44; como artrite reumatoide&#44; doen&#231;a cel&#237;aca e vitiligo s&#227;o tamb&#233;m associa&#231;&#245;es bem conhecidas&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Embora a associa&#231;&#227;o entre psor&#237;ase e anormalidade tireoidiana tenha sido pesquisada por diversos autores &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#44; estudos de caso&#8208;controle e de base populacional foram publicados sem conclus&#227;o definitiva&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#8211;12</span></a> A correla&#231;&#227;o com a gravidade da psor&#237;ase<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">13&#44;14</span></a> e a frequ&#234;ncia &#40;incid&#234;ncia ou preval&#234;ncia&#41; de anormalidade tireoidiana nos paciente com doen&#231;a psori&#225;sica<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">15&#8211;19</span></a> tamb&#233;m foram pesquisadas previamente&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Considerando a import&#226;ncia da associa&#231;&#227;o para o manejo cl&#237;nico e a escassez desse dado na popula&#231;&#227;o brasileira&#44; os objetivos deste estudo foram avaliar a preval&#234;ncia de anormalidade tireoidiana nos pacientes com psor&#237;ase e analisar sua associa&#231;&#227;o com tr&#234;s fatores&#58; a gravidade &#40;medida pelo <span class="elsevierStyleItalic">Psoriasis Area and Severity Index</span> &#8211; PASI&#41;&#59; a presen&#231;a de artrite psori&#225;sica&#59; e o tratamento com imunobiol&#243;gicos&#46; Adicionalmente&#44; pesquisar publica&#231;&#245;es de interesse&#44; identificar o delineamento e a inclus&#227;o do grupo controle nos estudos&#44; e de acordo com os crit&#233;rios adotados&#44; comparar por metan&#225;lise o grupo de casos deste estudo com o de controles das publica&#231;&#245;es selecionadas&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">Ap&#243;s aprova&#231;&#227;o pelo Comit&#234; de &#201;tica e Pesquisa local&#44; um estudo observacional transversal foi conduzido no departamento de Dermatologia&#46; Dados de 250 pacientes foram analisados&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Todos os pacientes em seguimento no Ambulat&#243;rio de Psor&#237;ase e Imunobiol&#243;gicos da Dermatologia durante o per&#237;odo de janeiro de 2018 a dezembro de 2019 foram considerados eleg&#237;veis&#44; constituindo amostra de conveni&#234;ncia&#46; Os crit&#233;rios de inclus&#227;o foram&#58; diagn&#243;stico de psor&#237;ase vulgar e vig&#234;ncia de tratamento &#8211; considerando uso de t&#243;picos&#44; fototerapia&#44; f&#225;rmacos sist&#234;micos convencionais &#40;acitretina&#44; metotrexato e ciclosporina&#41; ou agentes imunobiol&#243;gicos &#40;infliximabe&#44; etanercepte&#44; adalimumabe&#44; ustequinumabe&#44; secuquinumabe&#41;&#46; Os crit&#233;rios de exclus&#227;o foram&#58; diagn&#243;stico de outras formas de psor&#237;ase que n&#227;o a vulgar&#44; pacientes que n&#227;o concordaram em participar do estudo&#44; menores de 12 anos&#44; tireoidectomia pr&#233;via&#44; tratamento atual com medica&#231;&#245;es que poderiam afetar a fun&#231;&#227;o tireoidiana &#40;l&#237;tio&#44; amiodarona&#44; anticonvulsivantes e interferona&#41; e aus&#234;ncia de registros no prontu&#225;rio em rela&#231;&#227;o aos horm&#244;nios tireoidianos ou anticorpos&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Desenho do estudo</span><p id="par0030" class="elsevierStylePara elsevierViewall">Os dados cl&#237;nicos coletados do prontu&#225;rio foram&#58; idade&#44; sexo&#44; altura&#44; peso&#44; &#237;ndice de massa corp&#243;rea &#40;IMC&#41;&#44; presen&#231;a de artrite psori&#225;sica &#40;e articula&#231;&#227;o acometida&#41;&#44; dura&#231;&#227;o da doen&#231;a &#40;meses&#41;&#44; tratamento pr&#233;vio e atual para psor&#237;ase&#44; dura&#231;&#227;o do tratamento atual &#40;meses&#41;&#44; PASI atual&#44; presen&#231;a de comorbidades &#40;hipertens&#227;o&#44; diabetes&#44; depress&#227;o ou ansiedade&#44; dislipidemia&#44; tabagismo&#44; alcoolismo&#44; doen&#231;a hep&#225;tica n&#227;o alco&#243;lica&#44; osteoartrite&#44; uve&#237;te anterior&#41;&#44; doen&#231;as tireoidianas pr&#233;vias &#40;hipotireoidismo&#44; hipertireoidismo&#44; n&#243;dulo&#41;&#44; doen&#231;as autoimunes pr&#233;vias &#40;l&#250;pus eritematoso sist&#234;mico&#44; diabetes do tipo I&#44; vitiligo&#44; artrite reumatoide&#44; s&#237;ndrome de Sj&#246;gren&#41; e medica&#231;&#245;es em uso&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Os dados laboratoriais coletados foram&#58; tireotrofina s&#233;rica &#40;TSH&#41;&#44; tiroxina livre &#40;T4L&#41;&#44; anticorpos antitireoperoxidase &#40;anti&#8208;TPO&#41;&#44; anticorpos antitireoglobulina &#40;anti&#8208;TG&#41;&#44; glicemia de jejum&#44; colesterol total e fra&#231;&#245;es e triglic&#233;rides&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">O exame f&#237;sico e a coleta de dados foram supervisionados por m&#233;dicos dermatologistas capacitados&#46; Todos os pacientes foram informados sobre o estudo e assinaram o termo de consentimento&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Avalia&#231;&#227;o cl&#237;nica</span><p id="par0045" class="elsevierStylePara elsevierViewall">A gravidade da psor&#237;ase foi classificada clinicamente de acordo com o PASI&#46; Dermatologistas capacitados calcularam o &#237;ndice durante as consultas de seguimento&#46; Como j&#225; bem estabelecido&#44; o <span class="elsevierStyleItalic">score</span>&#44; com varia&#231;&#227;o de 0 a 72&#44; permite a divis&#227;o dos pacientes em dois grupos&#58; psor&#237;ase leve &#40;PASI &#8804; 10&#41; e psor&#237;ase moderada&#47;grave &#40;PASI<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>10&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">20</span></a> Os grupos foram comparados quanto &#224; preval&#234;ncia das anormalidades tireoidianas&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A frequ&#234;ncia da vari&#225;vel foi tamb&#233;m comparada considerando o tratamento vigente &#40;terapia imunobiol&#243;gica <span class="elsevierStyleItalic">vs&#46;</span> n&#227;o imunobiol&#243;gica&#41; e a coexist&#234;ncia de AP &#40;presente <span class="elsevierStyleItalic">vs&#46;</span> ausente&#41;&#46; O diagn&#243;stico reumatol&#243;gico da AP&#44; por sua vez&#44; foi feito com base em crit&#233;rios cl&#237;nicos e laboratoriais&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Anormalidade tireoidiana</span><p id="par0055" class="elsevierStylePara elsevierViewall">A preval&#234;ncia de anormalidade tireoidiana foi definida como presen&#231;a de um dos seguintes aspectos&#58; diagn&#243;stico pr&#233;vio de hipotireoidismo&#44; positividade para um anticorpo &#40;anti&#8208;TPO ou anti&#8208;TG&#41;&#44; valores de TSH s&#233;ricos alterados &#40;&#60; 0&#44;27 mUI&#47;L ou<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>4&#44;5 mUI&#47;L&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos laboratoriais</span><p id="par0060" class="elsevierStylePara elsevierViewall">Os valores s&#233;ricos de TSH&#44; T4L&#44; anti&#8208;TPO e anti&#8208;TG foram mensurados por ensaios de quimioluminesc&#234;ncia&#46; Os valores de refer&#234;ncia foram respectivamente&#58; 0&#44;27&#8211;4&#44;5 mUI&#47;L&#44; 0&#44;93&#8211;1&#44;7 ng&#47;dL&#44; positivo &#62;<span class="elsevierStyleHsp" style=""></span>34 UI&#47;mL e &#62;<span class="elsevierStyleHsp" style=""></span>115 UI&#47;mL&#46; A glicemia de jejum foi estimada por meio do m&#233;todo de hexoquinase&#44; e os n&#237;veis s&#233;ricos de colesterol e de triglic&#233;rides foram avaliados usando m&#233;todo colorim&#233;trico enzim&#225;tico&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Grupo controle da literatura</span><p id="par0065" class="elsevierStylePara elsevierViewall">A revis&#227;o da literatura incluiu as bases de dados do Pubmed&#44; Embase e Scopus&#44; limitada a estudos em humanos e publica&#231;&#227;o nos idiomas ingl&#234;s ou portugu&#234;s&#46; O per&#237;odo de sele&#231;&#227;o compreendeu janeiro de 2002 at&#233; 31 de maio de 2022&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Os descritores utilizados foram&#58; &#40;&#40;Psoriasis &#91;title&#93;&#41; AND &#40;thyroid &#91;title&#93;&#41; OR &#40;hypothyroidism &#91;title&#93;&#41; OR &#40;thyroiditis &#91;title&#93;&#41; OR &#40;hashimoto thyroiditis &#91;title&#93;&#41;&#41; e &#40;&#40;Psoriatic &#91;title&#93;&#41; AND &#40;thyroid &#91;title&#93;&#41; OR &#40;hypothyroidism &#91;title&#93;&#41; OR &#40;thyroiditis &#91;title&#93;&#41; OR &#40;hashimoto thyroiditis&#91;title&#93;&#41;&#41;&#46; N&#227;o foram considerados artigos provenientes de outras fontes&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">O t&#237;tulo e resumo dispon&#237;veis contaram como crit&#233;rios de sele&#231;&#227;o&#44; com exclus&#227;o dos artigos duplicados&#46; Foram considerados eleg&#237;veis os estudos conduzidos com o objetivo de avaliar a frequ&#234;ncia ou associa&#231;&#227;o de doen&#231;a tireoidiana autoimune e doen&#231;a psori&#225;sica&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Os crit&#233;rios de inclus&#227;o foram&#58; desenhos transversal&#44; caso&#8208;controle ou coorte&#44; e presen&#231;a de grupo controle no delineamento do estudo&#46; Os crit&#233;rios de exclus&#227;o foram&#58; estudos com grupo de casos composto exclusivamente por pacientes com artrite psori&#225;sica e aqueles que utilizaram apenas a Classifica&#231;&#227;o Internacional das Doen&#231;as &#40;CID&#41; sem os dados laboratoriais para o diagn&#243;stico de hipotireoidismo na publica&#231;&#227;o&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Os dados coletados dos estudos selecionados com grupo controle inclu&#237;ram&#58; nomes dos autores&#44; ano de publica&#231;&#227;o&#44; n&#250;mero de pacientes pertencentes ao grupo controle&#44; n&#250;mero de pacientes com diagn&#243;stico de hipotireoidismo&#44; n&#250;mero de pacientes com anti&#8208;TPO positivo&#44; anti&#8208;TG positivo e TSH alterado&#44; ou m&#233;dia e desvio padr&#227;o do TSH&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">As informa&#231;&#245;es obtidas por meio de controle da literatura foram agrupadas e avaliadas conforme metan&#225;lise para que os dados fossem utilizados com pondera&#231;&#227;o&#44; de modo a integrar os resultados dos estudos&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">An&#225;lise estat&#237;stica</span><p id="par0095" class="elsevierStylePara elsevierViewall">Para an&#225;lise estat&#237;stica utilizou&#8208;se SAS System for Windows v9&#46;4 &#40;SAS Institute Inc&#46; Cary&#44; NC&#44; EUA&#41; e valores de p &#8804; 0&#44;05 foram considerados significantes&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">O perfil da amostra foi definido por meio do c&#225;lculo da frequ&#234;ncia de vari&#225;veis categ&#243;ricas em n&#250;meros absolutos &#40;n&#41; e percentual &#40;&#37;&#41;&#46; Medidas descritivas &#40;m&#233;dia&#44; desvio padr&#227;o&#44; valores m&#237;nimos&#47;m&#225;ximos e mediana&#41; foram adotadas para vari&#225;veis quantitativas&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Para a an&#225;lise da correla&#231;&#227;o entre vari&#225;veis e caracter&#237;sticas basais e a exist&#234;ncia de comorbidades foi realizado o Qui&#8208;Quadrado ou teste exato de Fisher para vari&#225;veis categ&#243;ricas&#44; e o Teste de Mann&#8208;Whitney para vari&#225;veis num&#233;ricas&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Para an&#225;lise do grupo controle da literatura foi aplicada a metan&#225;lise para estimar a propor&#231;&#227;o ou m&#233;dia e seu respectivo intervalo de confian&#231;a utilizando o modelo aleat&#243;rio via modelos lineares&#46; Para compara&#231;&#227;o do grupo de casos com o grupo controle da literatura foi utilizado o teste Qui&#8208;Quadrado para propor&#231;&#245;es e foi aplicado o teste <span class="elsevierStyleItalic">t</span> de Student para compara&#231;&#227;o de medidas cont&#237;nuas entre dois grupos&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0115" class="elsevierStylePara elsevierViewall">Inicialmente&#44; 250 pacientes foram considerados eleg&#237;veis&#44; por&#233;m 15 n&#227;o foram inclu&#237;dos por terem diagn&#243;stico de psor&#237;ase palmoplantar exclusivo ou de psor&#237;ase pustulosa generalizada&#46; Do total de 235 pacientes inclu&#237;dos no estudo&#44; 74 foram exclu&#237;dos &#40;64 por informa&#231;&#245;es incompletas no prontu&#225;rio&#44; tr&#234;s por uso de medica&#231;&#245;es que alteram a fun&#231;&#227;o tireoidiana e sete por perda de seguimento&#41;&#46; Portanto&#44; a amostra final foi composta por 161 pacientes&#44; cujos dados foram analisados&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Dentre os pacientes da amostra&#59; 64&#44;60&#37; eram do sexo masculino&#44; com m&#233;dia de idade de 55 anos&#46; A preval&#234;ncia da anormalidade tireoidiana foi de 28&#44;57&#37; e do hipotireoidismo de 14&#44;91&#37;&#46; As seguintes doen&#231;as autoimunes foram detectadas na amostra&#58; s&#237;ndrome de Sj&#246;gren&#44; vitiligo e diabetes do tipo I &#40;em um&#44; dois e um pacientes&#44; respectivamente&#41;&#46; Em rela&#231;&#227;o ao tratamento&#58; 44&#44;09&#37; dos pacientes estavam em uso de terapia imunobiol&#243;gica&#44; 37&#44;88&#37; em tratamento sist&#234;mico n&#227;o imunobiol&#243;gico&#44; 3&#44;72&#37; em fototerapia e 14&#44;28&#37; em uso de terapia t&#243;pica exclusiva&#46; Considerando o PASI&#44; 15&#44;55&#37; &#40;21 pacientes&#41; foram considerados com doen&#231;a moderada&#47;grave &#40;<a class="elsevierStyleCrossRefs" href="#tbl0010">tabelas 2 e 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">Foram comparadas vari&#225;veis quantitativas &#40;idade&#44; IMC&#44; dura&#231;&#227;o da doen&#231;a e PASI&#41; com sexo e presen&#231;a ou aus&#234;ncia de comorbidades &#40;hipertens&#227;o&#44; dislipidemia&#44; diabetes&#44; hipotireoidismo e AP&#41;&#46; N&#227;o houve diferen&#231;a da frequ&#234;ncia de AP entre os sexos&#46; Hipertens&#227;o&#44; dislipidemia e hipotireoidismo foram mais prevalentes nas idades mais avan&#231;adas &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;066 &#91;95&#37;IC 1&#44;038&#8211;1&#44;094&#93; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;039 &#91;95&#37;IC 1&#44;014&#8211;1&#44;064&#93; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0025 e OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;048 &#91;95&#37;IC 1&#44;009&#8211;1&#44;077&#93; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0125&#44; respectivamente&#41;&#46; Em paralelo&#44; diabetes apresentou maior frequ&#234;ncia nos pacientes mais velhos &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;048 &#91;95&#37;IC 1&#44;020&#8211;1&#44;076&#93; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0006&#41; e com IMC mais elevado &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;083 &#91;95&#37;IC 1&#44;007&#8211;1&#44;164&#93; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0314&#41;&#46; N&#227;o foi encontrada diferen&#231;a estatisticamente significante considerando hipotireoidismo e PASI&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Os pacientes alocados considerando o PASI &#40;leve ou moderado&#47;grave&#41;&#44; AP &#40;presen&#231;a ou aus&#234;ncia&#41; e tratamento atual &#40;imunobiol&#243;gico ou n&#227;o imunobiol&#243;gico&#41; foram comparados quanto &#224; anormalidade tireoidiana&#46; Conforme observado nas <a class="elsevierStyleCrossRefs" href="#tbl0020">tabelas 4&#44; 5 e 6</a>&#44; n&#227;o foi encontrada diferen&#231;a estatisticamente significante entre esses grupos&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">Os pacientes em terapia n&#227;o imunobiol&#243;gica foram divididos em grupos conforme tipo de tratamento&#58; exclusivamente t&#243;pico&#44; fototerapia e medica&#231;&#227;o sist&#234;mica&#46; N&#227;o houve&#44; entretanto&#44; diferen&#231;a estatisticamente significante entre os grupos para as vari&#225;veis de hipotireoidismo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;10&#41; e anormalidade tireoidiana &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;17&#41;&#46;</p><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Grupo controle</span><p id="par0140" class="elsevierStylePara elsevierViewall">Na revis&#227;o de literatura foram encontrados 80 artigos na base de dados Pubmed&#44; 90 na base de dados Embase e 85 base de dados Scopus&#46; Dos artigos de interesse&#44; 24 artigos duplicados e um artigo escrito no idioma hebraico n&#227;o foram considerados&#46; O total de 17 artigos foi apontado como eleg&#237;vel&#46; Posteriormente&#44; dois foram exclu&#237;dos por relatarem grupo de casos composto exclusivamente por pacientes com artrite psori&#225;sica&#44; quatro por aus&#234;ncia de grupo controle&#44; dois por utilizarem exclusivamente o CID para diagn&#243;stico e tr&#234;s por dados laboratoriais insuficientes no corpo do artigo&#46; Portanto&#44; o total de seis artigos foi enviado para an&#225;lise estat&#237;stica&#44; todos com delineamento transversal ou caso&#8208;controle &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#44;6&#44;11&#44;13&#44;14&#44;21</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">O tamanho amostral dos controles correspondeu a 6&#46;227 pacientes&#46; A amostra avaliada para cada uma das vari&#225;veis diferiu conforme os dados estudados em cada artigo&#46; Portanto&#44; o n&#250;mero total de pacientes inclu&#237;dos para hipotireoidismo foi de 6&#46;035 &#40;quatro artigos&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#44;11&#44;13&#44;21</span></a> anti&#8208;TPO de 6&#46;069 &#40;quatro artigos&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#44;6&#44;11&#44;13</span></a> anti&#8208;TG de 443 &#40;tr&#234;s artigos&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#44;6&#44;13</span></a> TSH alterado 96 &#40;um artigo&#41;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">6</span></a> e TSH m&#233;dio de 6&#46;071 &#40;quatro artigos&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5&#44;11&#44;13&#44;14</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">A compara&#231;&#227;o entre os resultados dos casos e o dos controles da literatura para as vari&#225;veis de hipotireoidismo&#44; anti&#8208;TPO positivo&#44; anti&#8208;TG positivo e TSH alterado apresentou diferen&#231;a estatisticamente significante para hipotireoidismo&#46; Enquanto no grupo de casos a propor&#231;&#227;o de hipotireoidismo foi de 14&#44;91&#37;&#44; no grupo controle foi de 3&#44;58&#37; &#40;<span class="elsevierStyleItalic">random effects model</span> 0&#44;035 &#91;95&#37;IC 0&#44;016&#8211;0&#44;074&#93; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Para al&#233;m disso&#44; a m&#233;dia do TSH no grupo de casos foi de 2&#44;67 mUI&#47;L&#44; enquanto a m&#233;dia ponderada do TSH no grupo controle foi de 2&#44;06 mUI&#47;L&#44; com diferen&#231;a estatisticamente significante entre os grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;026&#41;&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discuss&#227;o</span><p id="par0160" class="elsevierStylePara elsevierViewall">A rela&#231;&#227;o da psor&#237;ase com diversas comorbidades tem sido importante t&#243;pico de pesquisa&#44; e evid&#234;ncias atuais sugerem aspecto multifatorial da doen&#231;a&#44; expandindo seu espectro e seu impacto para al&#233;m dos &#226;mbitos dermatol&#243;gico e reumatol&#243;gico&#46; Portanto&#44; conhecer poss&#237;veis associa&#231;&#245;es com outras comorbidades&#44; como a doen&#231;a tireoidiana&#44; &#233; elemento chave na melhoria da assist&#234;ncia&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">A ativa&#231;&#227;o da via inflamat&#243;ria pelo fator de necrose tumoral alfa &#40;TNF&#8208;&#945;&#41;&#44; interleucina 23 &#40;IL&#8208;23&#41; e IL&#8208;17 comp&#245;e a fisiopatologia da psor&#237;ase&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">22</span></a> O papel dessa via fisiopatol&#243;gica nas doen&#231;as tireoidianas tem sido estudado&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Trabalhos antigos demonstraram que o <span class="elsevierStyleItalic">status</span> de prolifera&#231;&#227;o epid&#233;rmica sofre altera&#231;&#227;o com a doen&#231;a da tireoide<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">23</span></a> e os horm&#244;nios tireoidianos s&#227;o capazes de induzir a produ&#231;&#227;o do fator de crescimento epid&#233;rmico &#40;EGF&#41;&#44; cuja persist&#234;ncia poderia se associar ao estado hiperproliferativo da psor&#237;ase&#46;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">24&#44;25</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">Atualmente&#44; sabe&#8208;se que a psor&#237;ase tem alta frequ&#234;ncia de Treg&#47;IL17<span class="elsevierStyleSup">&#43;</span> e estudos recentes demonstraram altos n&#237;veis de linf&#243;citos T <span class="elsevierStyleItalic">helper</span> 17 &#40;Th17&#41;&#44; tanto no tecido perif&#233;rico quanto no tecido tireoidiano de pacientes com doen&#231;a tireoidiana autoimune&#44; assim como express&#227;o de Th17 nos pacientes com tireoidite de Hashimoto &#40;TH&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">26&#44;27</span></a> Essa via pode estar relacionada n&#227;o s&#243; com a fisiopatologia da psor&#237;ase&#44; mas com a de doen&#231;as tireoidianas imunomediadas&#44; sugerindo conex&#227;o entre elas&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">A citocina CXCL10 desempenha importante papel na quimioatra&#231;&#227;o de linf&#243;citos Th1 e &#233; encontrada em altos n&#237;veis nos pacientes com AP e TH quando comparados aos pacientes com AP isolada&#44;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">13&#44;28</span></a> representando outro ponto em comum na via fisiopatol&#243;gica&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Embora j&#225; hipotetizado e demonstrado em estudos pr&#233;vios&#44;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">7&#44;8&#44;18</span></a> este &#233; um dos primeiros estudos com dados brasileiros a avaliar a preval&#234;ncia de anormalidade tireoidiana nos pacientes com psor&#237;ase vulgar&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">A preval&#234;ncia de 7&#44;4&#37; do hipotireoidismo e de 16&#44;9&#37; da doen&#231;a autoimune tireoidiana cr&#244;nica na popula&#231;&#227;o brasileira foi previamente estimada&#46;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">29&#44;30</span></a> A preval&#234;ncia de TH no estudo de Valduga et al&#46;&#44; que analisou 60 pacientes brasileiros e 60 controles&#44; foi de 21&#44;6&#37; para o grupo de casos&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">21</span></a> A amostra aqui avaliada&#44; que contou com n&#250;mero mais expressivo de participantes&#44; encontrou preval&#234;ncias de 28&#44;57&#37; para anormalidade tireoidiana e de 14&#44;91&#37; para hipotireoidismo&#46; Al&#233;m disso&#44; 10&#44;29&#37; dos pacientes apresentaram TSH alterado&#44; e positividade para anti&#8208;TPO e anti&#8208;TG foi demonstrada em 8&#44;55&#37; e 4&#44;83&#37;&#44; respectivamente&#46; Entretanto&#44; destaca&#8208;se que o presente estudo foi conduzido em ambulat&#243;rio especializado&#44; n&#227;o sendo&#44; portanto&#44; compar&#225;vel &#224; popula&#231;&#227;o geral brasileira&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Resultados semelhantes foram demonstrados por outros autores&#46; Mallick et al&#46; encontraram frequ&#234;ncia de 15&#44;2&#37; para desordens tireoidianas em amostra de 112 pacientes com psor&#237;ase vulgar&#59;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">16</span></a> Namiki et al&#46; estudaram disfun&#231;&#227;o tireoidiana em 85 pacientes e obtiveram preval&#234;ncia de 8&#37; em pacientes com psor&#237;ase sem AP&#44; 13&#37; em pacientes com AP e 45&#37; nos pacientes com psor&#237;ase pustulosa generalizada &#40;GPP&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">17</span></a> Em contrapartida&#44; neste estudo&#44; os pacientes com GPP foram exclu&#237;dos&#44; embora possam ser inclu&#237;dos em avalia&#231;&#245;es futuras&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Dados demonstram alta frequ&#234;ncia de autoimunidade tireoidiana no sexo feminino&#44; at&#233; oito vezes mais afetado que o masculino&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">31</span></a> Na amostra avaliada&#44; 64&#44;6&#37; dos pacientes eram homens&#44; devendo implicar numa frequ&#234;ncia mais baixa de anormalidade tireoidiana&#44; sugerindo que a alta frequ&#234;ncia encontrada deva ser valorizada e discutida em estudos futuros&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">As medica&#231;&#245;es sist&#234;micas disponibilizadas na psor&#237;ase vulgar s&#227;o reservadas sobretudo para pacientes que apresentam durante a evolu&#231;&#227;o quadro cl&#237;nico moderado a grave&#46; No estudo realizado&#44; 83&#44;84&#37; dos pacientes estavam em uso de terapia medicamentosa sist&#234;mica&#46; No entanto&#44; 15&#44;55&#37; tinham PASI &#62;<span class="elsevierStyleHsp" style=""></span>10&#44; com m&#233;dia e mediana correspondendo a 5&#44;62 e 2&#44;2 &#40;0&#8211;57&#41;&#44; respectivamente&#46; A maioria dos pacientes se encontrava&#44; portanto&#44; em tratamento adequado e em controle durante a pesquisa&#46; N&#227;o houve associa&#231;&#227;o entre PASI e anormalidade tireoidiana&#46; Contudo&#44; o <span class="elsevierStyleItalic">score</span> &#233; din&#226;mico&#44; sofrendo impacto do tratamento e se alterando durante o seguimento&#44; de modo que n&#227;o reflete a gravidade quando coletado de maneira pontual&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Em conson&#226;ncia com outros estudos&#44; Arican et al&#46; estabeleceram associa&#231;&#227;o entre doen&#231;as tireoidianas e PASI&#44; demonstrando valores mais elevados do &#237;ndice nos pacientes com anormalidade tireoidiana&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">14&#44;17</span></a> A suspens&#227;o do tratamento por no m&#237;nimo um m&#234;s&#44; adotada pelos autores&#44; tornou o PASI um <span class="elsevierStyleItalic">score</span> mais confi&#225;vel para a avalia&#231;&#227;o da gravidade&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">A terapia imunobiol&#243;gica&#44; comparada &#224; terapia convencional&#44; n&#227;o se associou &#224; anormalidade tireoidiana &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;13&#41;&#46; De maneira similar&#44; n&#227;o foi encontrada diferen&#231;a estatisticamente significante entre os pacientes quando divididos nos tr&#234;s grupos de tratamento n&#227;o imunobiol&#243;gico&#58; sist&#234;micos&#44; fototerapia e tratamentos t&#243;picos&#44; considerando as vari&#225;veis de hipotireoidismo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;10&#41; e anormalidade tireoidiana &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;17&#41;&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">A AP&#44; prevalente em at&#233; 30&#37; dos pacientes&#44; gera importante impacto na qualidade de vida e se associa &#224; ocorr&#234;ncia de outras comorbidades&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a> A associa&#231;&#227;o com hipotireoidismo&#44; positividade anti&#8208;TPO e achados ultrassonogr&#225;ficos &#40;hipoecogenicidade tireoidiana&#41; foi demonstrada previamente&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">18&#44;19</span></a> Na amostra avaliada&#44; n&#227;o houve associa&#231;&#227;o da AP considerando hipotireoidismo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;65&#41;&#44; anti&#8208;TPO &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;76&#41; ou anormalidade tireoidiana &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;87&#41;&#46; A ultrassonografia para avalia&#231;&#227;o tireoidiana n&#227;o foi realizada neste estudo&#44; o que constitui uma limita&#231;&#227;o&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Controle hist&#243;rico e controle da literatura s&#227;o utilizados com maior frequ&#234;ncia nos ensaios cl&#237;nicos&#44; com benef&#237;cios na redu&#231;&#227;o dos custos e dura&#231;&#227;o do estudo&#46;<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">32&#44;33</span></a> A revis&#227;o da literatura e o uso do grupo controle proveniente dos artigos selecionados para compara&#231;&#227;o complementam o estudo&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">A preval&#234;ncia de hipotireoidismo entre os pacientes com doen&#231;a psori&#225;sica quando comparada aos dados do controle de literatura foi maior&#44; com diferen&#231;a estatisticamente significante&#46; Esse dado&#44; corroborado por aquele observado no estudo brasileiro de Valduga et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">21</span></a> justifica que maior aten&#231;&#227;o seja despendida &#224; fun&#231;&#227;o tireoidiana dos pacientes com psor&#237;ase&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">No entanto&#44; algumas pondera&#231;&#245;es devem ser feitas considerando o delineamento do estudo&#46; A composi&#231;&#227;o do grupo controle dos artigos inclu&#237;dos na metan&#225;lise variou&#44; e foi constitu&#237;do por pacientes com outras doen&#231;as dermatol&#243;gicas nos estudos de Arican et al&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">14</span></a> e Gul et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">6</span></a> enquanto no estudo de Valduga et al&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">21</span></a> foi composto por pacientes provenientes da cl&#237;nica de ginecologia e oftalmologia&#46; Enquanto isso&#44; no artigo de Hansen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">11</span></a> os pacientes pertenciam &#224; base de dados do <span class="elsevierStyleItalic">Danish General Suburban Population Study</span>&#46; Portanto&#44; o grupo controle obtido da revis&#227;o da literatura n&#227;o foi restrito a uma &#250;nica popula&#231;&#227;o&#44; reduzindo&#8208;se o risco da escolha de um grupo controle muito diferente dos casos e enriquecendo a an&#225;lise&#46; No entanto&#44; &#233; limitante o fato de o grupo controle n&#227;o ser proveniente do mesmo centro ou da mesma &#225;rea geogr&#225;fica&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">As formas de diagn&#243;stico de hipotireoidismo tamb&#233;m variaram entre os estudos&#46; O artigo de Hansen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">11</span></a> utilizou a informa&#231;&#227;o autorreferida de hipotireoidismo&#44; enquanto os demais fizeram diagn&#243;stico com base nos dados laboratoriais do pr&#243;prio estudo&#46; Em nossa pesquisa&#44; foram inclu&#237;dos os pacientes com diagn&#243;stico pr&#233;vio de hipotireoidismo e aqueles que apresentaram dados laboratoriais alterados&#44; abrangendo o diagn&#243;stico da anormalidade tireoidiana&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conclus&#227;o</span><p id="par0245" class="elsevierStylePara elsevierViewall">Embora muitos estudos tenham investigado a associa&#231;&#227;o ou a frequ&#234;ncia de anormalidade tireoidiana nos pacientes com psor&#237;ase&#44; este foi um dos primeiros com dados brasileiros&#46; A preval&#234;ncia de anormalidade tireoidiana foi de 28&#44;57&#37; e do hipotireoidismo foi de 14&#44;91&#37;&#46; Para al&#233;m disso&#44; a preval&#234;ncia de hipotireoidismo&#44; quando comparada ao controle da literatura&#44; foi positiva&#46; Essa an&#225;lise complementa o estudo vigente&#44; permitindo compara&#231;&#227;o e avalia&#231;&#227;o mais completas dos dados obtidos de nossa casu&#237;stica&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">Os resultados analisados possibilitam que futuros estudos sejam conduzidos com a finalidade de avaliar a exist&#234;ncia da associa&#231;&#227;o ou o rastreio da autoimunidade tireoidiana nesse grupo da popula&#231;&#227;o&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Suporte financeiro</span><p id="par0255" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Contribui&#231;&#227;o dos autores</span><p id="par0260" class="elsevierStylePara elsevierViewall">Luiza de Castro Fernandes&#58; Concep&#231;&#227;o e o desenho do estudo&#59; levantamento dos dados&#44; ou an&#225;lise e interpreta&#231;&#227;o dos dados&#59; an&#225;lise estat&#237;stica&#59; reda&#231;&#227;o do artigo ou revis&#227;o cr&#237;tica do conte&#250;do intelectual importante&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0265" class="elsevierStylePara elsevierViewall">Ana Carolina Belini Bazan Arruda&#58; Concep&#231;&#227;o e o desenho do estudo&#59; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; reda&#231;&#227;o do artigo ou revis&#227;o cr&#237;tica do conte&#250;do intelectual importante&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">Lisa Gava Baeninger&#58; Concep&#231;&#227;o e o desenho do estudo&#59; levantamento dos dados&#44; reda&#231;&#227;o do artigo&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0275" class="elsevierStylePara elsevierViewall">Debora Pedroso Almeida&#58; Concep&#231;&#227;o e o desenho do estudo&#59; levantamento dos dados&#44; reda&#231;&#227;o do artigo&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0280" class="elsevierStylePara elsevierViewall">Danilo Villagelin&#58; Concep&#231;&#227;o e o desenho do estudo&#59; levantamento dos dados&#44; ou an&#225;lise e interpreta&#231;&#227;o dos dados&#59; an&#225;lise estat&#237;stica&#59; reda&#231;&#227;o do artigo ou revis&#227;o cr&#237;tica do conte&#250;do intelectual importante&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflito de interesses</span><p id="par0285" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A psor&#237;ase &#233; associada a diversas comorbidades&#44; e sua rela&#231;&#227;o com anormalidade tireoidiana tem sido hipotetizada&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Avaliar a preval&#234;ncia de anormalidade tireoidiana em pacientes brasileiros com psor&#237;ase e analisar sua associa&#231;&#227;o com a gravidade&#44; presen&#231;a de artrite psori&#225;sica e tratamento imunobiol&#243;gico&#46; Adicionalmente&#44; comparar resultados com controle da literatura&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Neste estudo observacional foram analisados dados cl&#237;nicos e laboratoriais de pacientes acompanhados de janeiro de 2018 a dezembro de 2019&#46; Anormalidade tireoidiana foi avaliada por meio da hist&#243;ria atual de doen&#231;a tireoidiana e de exames laboratoriais &#8211; tireotrofina &#40;TSH&#41;&#44; tiroxina livre &#40;T4L&#41;&#44; anticorpos antitireoperoxidase &#40;anti&#8208;TPO&#41; e antitireoglobulina &#40;anti&#8208;TG&#41;&#46; Os pacientes foram classificados segundo gravidade da psor&#237;ase &#8211; <span class="elsevierStyleItalic">Psoriasis Area and Severity Index</span> &#40;PASI&#41;&#44; presen&#231;a de artrite psori&#225;sica e tratamento vigente&#46; Posteriormente&#44; foi selecionado grupo controle da revis&#227;o de literatura e os resultados foram comparados&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Dos 250 pacientes inclu&#237;dos&#44; 161 foram eleg&#237;veis&#46; A preval&#234;ncia da anormalidade tireoidiana foi de 28&#44;57&#37; e do hipotireoidismo de 14&#44;91&#37;&#46; A idade m&#233;dia foi de 55 anos e o PASI mediano foi de 2&#44;2&#46; N&#227;o houve associa&#231;&#227;o entre anormalidade tireoidiana e PASI &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;8&#41;&#44; presen&#231;a de artrite psori&#225;sica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;87&#41; ou uso de terapia imunobiol&#243;gica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;13&#41;&#46; O controle da literatura incluiu 6&#46;227 pacientes e houve diferen&#231;a estatisticamente significante para vari&#225;vel de hipotireoidismo &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#245;es do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Aus&#234;ncia de grupo controle proveniente do mesmo centro&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este foi um dos primeiros estudos com dados brasileiros da preval&#234;ncia de anormalidade tireoidiana nos pacientes com psor&#237;ase&#46;</p></span>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;tamanho da amostra&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Pa&#237;s&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Marcadores tireoidianos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Achados&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Arican&#44; Bilgic e Koc&#44; 2004<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">Caso&#8208;controle&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Compara&#231;&#227;o n&#237;vel s&#233;rico horm&#244;nios tireoidianos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">103 pacientes<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>96 controles&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Turquia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">T3T&#44; T3L&#44; T4T&#44; T4L&#44; TSH&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antonelli et al&#46;&#44; 2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&#8208;controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de desordens tireoidianas em pacientes com AP <span class="elsevierStyleItalic">vs&#46;</span> controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pacientes&#58; 80 AP&#47; 112 artrite reumatoide &#47; 400 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">It&#225;lia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3L&#44; T4L&#44; TSH&#44; anti&#8208;TPO&#44; anti&#8208;TG&#44; ultrassonografia tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disfun&#231;&#227;o autoimune tireoidiana &#40;pacientes<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>controles&#41;&#58; 33&#37;<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>18&#37; no sexo feminino e 25&#37;<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>5&#37; no sexo masculino &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gul et al&#46;&#44; 2009<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&#8208;controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associa&#231;&#227;o de doen&#231;as tireoidianas autoimunes com psor&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">105 pacientes<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>96 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Turquia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3L&#44; T4L&#44; TSH&#44; anti&#8208;TPO&#44; anti&#8208;TG&#44; ultrassonografia tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nenhuma diferen&#231;a entre os grupos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">James&#44; Hill e Feldman 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de hipotireoidismo em pacientes com ros&#225;cea ou psor&#237;ase comparados a outras doen&#231;as dermatol&#243;gicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Humana Database &#8211; 1&#46;667&#46;943 pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estados Unidos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CID&#8208;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de hipotireoidismo de 17&#44;5&#37; nos pacientes com psor&#237;ase&#46; Frequ&#234;ncia de hipotireoidismo n&#227;o diferia de outros pacientes dermatol&#243;gicos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lai e Yew 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associa&#231;&#227;o de psor&#237;ase e doen&#231;as tireoidianas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#205;ndia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Horm&#244;nios tireoidianos e autoanticorpos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Baixos n&#237;veis de TSH em pacientes com psor&#237;ase &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;019&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fallahi et al&#46;&#44; 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&#8208;controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Incid&#234;ncia de disfun&#231;&#227;o tireoidiana cl&#237;nica ou subcl&#237;nica em pacientes com AP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97 pacientes<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>97 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">It&#225;lia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T4L&#44; T3L&#44; TSH&#44; anti&#8208;TPO&#44; anti&#8208;TG&#44; ultrassonografia tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Incid&#234;ncia alta de positividade para anti&#8208;TPO &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;017&#41;&#44; hipotireoidismo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;017&#41;&#44; disfun&#231;&#227;o tireoidiana &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#44; hipoecogenicidade &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;009&#41; e autoimunidade tireoidiana &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Khan et al&#46;&#44; 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">An&#225;lise transversal de uma coorte&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associa&#231;&#227;o de anti&#8208;TPO positivo&#44; TSH e T4L com doen&#231;a psori&#225;sica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Popula&#231;&#227;o &#8211; parte do <span class="elsevierStyleItalic">Rotterdam Study</span> &#8211; 8&#46;214 participantes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Holanda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T4L&#44; TSH&#44; anti&#8208;TPO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nenhuma associa&#231;&#227;o considerando doen&#231;a psori&#225;sica incidente ou prevalente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Kiguradze et al&#46;&#44; 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associa&#231;&#227;o entre psor&#237;ase e TH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Popula&#231;&#227;o &#8211; <span class="elsevierStyleItalic">Northwestern Medicine Enterprise Data Warehouse</span> &#8211; 856&#46;615 participantes &#8211; 9&#46;654 diagn&#243;sticos de psor&#237;ase &#8211; 1&#46;745 diagn&#243;stico de TH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estados Unidos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3L&#44; TSH&#44; anti&#8208;TPO&#44; anti&#8208;TG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associa&#231;&#227;o positiva &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;49 &#91;95&#37; IC 1&#44;79&#8211;3&#44;48&#93; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vassilatou et al&#46;&#44; 2017<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&#8208;controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de tireoidite autoimune em pacientes com psor&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">114 pacientes com psor&#237;ase<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>286 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gr&#233;cia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3T&#44; T4T&#44; T4L&#44; TSH&#44; anti&#8208;TPO&#44; anti&#8208;TG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nenhuma diferen&#231;a na preval&#234;ncia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Valejo&#44; Coelho e Brasileiro 2018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de disfun&#231;&#227;o tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55 pacientes com psor&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Portugal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3L&#44; T4L&#44; TSH&#44; anti&#8208;TPO&#44; anti&#8208;TG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de 9&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alidrisi et al&#46;&#44; 2019<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&#8208;controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de TH em pacientes com psor&#237;ase comparados a controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56 pacientes<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>54 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Iraque&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T4L&#44; TSH&#44; anti&#8208;TPO&#44; anti&#8208;TG&#44; ultrassonografia tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia mais alta de anti&#8208;TPO &#40;25&#37;<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>9&#44;3&#37; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#44; anti&#8208;TG &#40;30&#44;4&#37;<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>11&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; hipoecogenicidade &#40;30&#44;4&#37;<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>9&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#44; pseudonodularidade &#40;16&#44;1&#37;<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>0&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; e vascularidade elevada na ultrassonografia nos pacientes com psor&#237;ase &#40;35&#44;7&#37;<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>5&#44;6&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hansen et al&#46;&#44; 2019<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&#8208;controle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Avaliar fun&#231;&#227;o tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Popula&#231;&#227;o &#8211; <span class="elsevierStyleItalic">Danish General Population Study</span> &#8211; 1&#46;127 pacientes<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>5&#46;637 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dinamarca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3T&#44; T4L&#44; TSH&#44; anti&#8208;TPO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#237;veis elevados de T3T em pacientes com psor&#237;ase &#40;1&#44;72<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>1&#44;69&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mallick 2019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequ&#234;ncia de desordens tireoidianas em pacientes com psor&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">112 pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paquist&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3L&#44; T4T&#44; TSH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wang et al&#46;&#44; 2019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coorte&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Risco de doen&#231;a tireoidiana em pacientes com psor&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Popula&#231;&#227;o &#8211; <span class="elsevierStyleItalic">Taiwan National Health Insurance Research Database</span> &#8211; 13&#46;266 pacientes com AP&#47; 149&#46;576 com psor&#237;ase isolada&#47; 162&#46;842 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Taiwan&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CID&#8208;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Incid&#234;ncia elevada de hipertireoidismo nos pacientes com psor&#237;ase &#40;aHR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;22&#59; 95&#37;&#160;IC 1&#44;11&#8211;1&#44;33&#41;&#44; doen&#231;a de Graves &#40;aHR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;26&#59; 95&#37; IC 1&#44;13&#8211;1&#44;41&#41;&#44; incid&#234;ncia de hipotireoidismo &#40;aHR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;38&#59; 95&#37; IC 1&#44;23&#8211;1&#44;56&#41; e TH &#40;Ahr<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;47&#59; 95&#37; IC 1&#44;18&#8211;1&#44;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Namiki et al&#46;&#44; 2020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de disfun&#231;&#227;o tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85 pacientes&#58; 51 psor&#237;ase vulgar&#47; 23 AP&#47; 11 GPP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Jap&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">T3L&#44; T4L&#44; TSH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de 8&#37;&#44; 13&#37; e 45&#37;&#44; respectivamente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wu et al&#46;&#44; 2021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associa&#231;&#227;o de psor&#237;ase com aumento do risco de doen&#231;a tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">National Health and Nutrition Examination Survey</span> &#8211; 15&#46;091 pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estados Unidos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Doen&#231;a autorreferida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associa&#231;&#227;o positiva &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;61 &#91;95&#37; IC 1&#44;01&#8211;2&#44;55&#93; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;043&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Valduga et al&#46;&#44; 2021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transversal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de TH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 pacientes<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>60 controles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Brasil&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TSH&#44; T4L&#44; anti&#8208;TPO&#44; anti&#8208;TG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preval&#234;ncia de TH &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;8 &#91;95&#37; IC 1&#44;18&#8211;12&#44;6&#93; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas cl&#237;nicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frequ&#234;ncia &#40;n&#250;mero de pacientes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Porcentagem &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">104&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Artrite psori&#225;sica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#44;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipertens&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Depress&#227;o&#47;ansiedade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dislipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Autoimunidade &#40;exceto hipotireoidismo&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anormalidade tireoidiana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#44;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipotireoidismo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TSH alterado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TPO positivo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TG positivo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3426298.png"
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Frequ&#234;ncias gerais da amostra</p>"
        ]
      ]
      2 => array:8 [
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        "etiqueta" => "Tabela 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">IMC</span>&#44; &#237;ndice de massa corp&#243;rea&#59; <span class="elsevierStyleItalic">PASI</span>&#44; <span class="elsevierStyleItalic">Psoriasis Area and Severity Index</span>&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Vari&#225;vel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&#233;dia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&#237;nimo&#8211;M&#225;ximo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mediana&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Desvio padr&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#8211;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78&#44;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#8211;125&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Altura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;48&#8211;1&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;80&#8211;47&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dura&#231;&#227;o da doen&#231;a &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">215&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#8211;720&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">192&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">152&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PASI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#8211;57&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  <table border="0" frame="\n
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                  \t\t\t\t" scope="col">PASI&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Moderado&#47;grave &#40;&#62; 10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Leve &#40;&#8804; 10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Vari&#225;veis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipotireoidismo<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;2&#44;96&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">15 &#40;11&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">0&#44;49</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipotireoidismo<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">17 &#40;12&#44;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99 &#40;73&#44;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">TSH alterado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10 &#40;8&#44;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;35</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">SH normal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">17 &#40;14&#44;78&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">88 &#40;76&#44;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TPO<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3 &#40;2&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8 &#40;6&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">0&#44;38</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TPO<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">18 &#40;13&#44;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">102 &#40;77&#44;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TG<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#44;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;3&#44;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
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                  \t\t\t\t">0&#44;58</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TG<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;15&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102 &#40;80&#44;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anormalidade tireoidiana<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;3&#44;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;22&#44;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;80</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anormalidade tireoidiana<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;11&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84 &#40;62&#44;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t" scope="col">Artrite psori&#225;sica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Vari&#225;vel&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipotireoidismo<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;5&#44;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;9&#44;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;65</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipotireoidismo<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;27&#44;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92 &#40;57&#44;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TSH alterado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;2&#44;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;8&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;38</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TSH normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;30&#44;88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80 &#40;58&#44;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TPO<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;3&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;5&#44;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;76</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TPO<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46 &#40;30&#44;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93 &#40;61&#44;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TG<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#44;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#44;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;42</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TG<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;33&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90 &#40;62&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anormalidade tireoidiana<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;9&#44;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;87</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anormalidade tireoidiana<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;24&#44;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76 &#40;47&#44;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3426300.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Anormalidade tireoidiana e artrite psori&#225;sica</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0030"
        "etiqueta" => "Tabela 6"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at6"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Tratamento atual&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Imunobiol&#243;gico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">N&#227;o imunobiol&#243;gico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor p</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Vari&#225;vel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipotireoidismo<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;5&#44;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;9&#44;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;48</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hipotireoidismo&#8208;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62 &#40;38&#44;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75 &#40;46&#44;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TSH alterado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;2&#44;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;7&#44;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;17</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TSH normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58 &#40;42&#44;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64 &#40;47&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TPO<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;3&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;5&#44;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;56</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TPO<span class="elsevierStyleHsp" style=""></span>&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65 &#40;42&#44;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74 &#40;48&#44;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti&#8208;TG<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;2&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;2&#44;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;0</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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Article information
ISSN: 26662752
Original language: Portuguese
DOI:10.1016/j.abdp.2023.08.002
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