Thyroid Disease and Pruritus
Evidence for the Association
- The British Journal of Dermatology guidelines conclude that if thyroid disease is causative in pruritus, it is uncommon, affecting only about 27% of patients with thyroid disease 1
- A study of 220 newly diagnosed thyroid disease patients found chronic nonspecific pruritus was significantly more common than in healthy controls, but still affected only 27% of the thyroid disease group 1
- A retrospective study following 263 patients with pruritus for 3 years found only 3 instances of associated thyroid disease 1
Clinical Approach: When to Test Thyroid Function
- The British Journal of Dermatology recommends against routine thyroid function tests for isolated generalized pruritus, but suggests testing if the patient has additional clinical features suggesting thyroid disease 3, 2, 4
- Iron deficiency should be checked in all patients with pruritus, as it is a common cause 4
- Liver disease and hematological disorders should also be considered as potential causes of pruritus, and investigated with liver function tests and other relevant tests 4
Other Causes of Pruritus
- Chronic kidney disease is a common cause of pruritus, affecting 42-60% of dialysis patients, and should be prioritized in the investigation of generalized pruritus without rash 5