Juvenile polyautoimmunity in a rheumatology setting

Clara, Malagon; Gómez, María del Pilar; Mosquera, Catalina; Vargas, Camilo; González, Tatiana; Arango, Cristine; Martin, Lorena; Pérez, Pilar Ortiz; Amaya-Uribe, Laura; Molano-González, Nicolas; Anaya, Juan Manuel

doi:10.1016/j.autrev.2018.11.006

Cited by 24 publications

(17 citation statements)

References 147 publications

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“…Out of 56 studies included in the systematic review, 25 were case‐control studies, 24‐47 17 were cohort studies 48‐64 and 14 were cross‐sectional studies 65‐78 . No clinical trials met the criteria used in the systematic review.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of latent and overt polyautoimmunity in autoimmune thyroid disease: A systematic review and meta‐analysis

Botello

Herrán

Salcedo

et al. 2020

Clinical Endocrinology

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Background Thyroid autoimmunity is the most frequent condition involved in polyautoimmunity (PolyA). However, the frequency of latent and overt PolyA in patients with autoimmune thyroid disease (AITD) as the index condition is unknown. Therefore, the purpose of this study was to determine the prevalence of these types of PolyA in patients with AITD as the index condition. Methods This study adhered to the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guideline. Searches through MEDLINE, Embase and LILACS were done to find articles in Spanish and English. Relevant vocabulary terms and key terms related to AITD and other autoimmune diseases were used. Two investigators independently screened the eligible studies, extracted data and assessed the quality and risk of bias. Fixed and random effect models were used accordingly. Cluster analysis was used to determine similarities among diseases in the articles included (based on Jaccard index). Results A total of 56 articles fulfilled the inclusion criteria. Of these, 25 were case‐controls, 17 were cohorts, and 14 were cross‐sectional studies. These studies included a total of 47 509 patients. Female was the predominant gender and included 38 950 patients (81.23%, 95% CI: 80.85‐81.60). Graves’ disease (GD) was the most common type of thyroid autoimmunity (69.16%, 95% CI: 68.23‐70.07). Globally, overt PolyA was found in 13.46% of the patients with AITD. This type of PolyA was represented mainly by type 1 diabetes and autoimmune gastritis. Latent PolyA was presented in 17.45% of the patients, and anti‐proinsulin, anti‐parietal cells and dsDNA antibodies were the most common. HT had the highest frequency of overt PolyA in Europe (15.60%, 95% CI: 14.72‐16.53), whereas latent PolyA was most common in patients with GD in Asia (21.03%, 95% CI: 17.76‐24.71). Overt and latent PolyA were associated with gastrointestinal and endocrinological ADs in most of cases and clustered with rheumatological, dermatological and neurological ADs. Conclusions Latent and overt PolyA are common in patients with AITD. These results provide insightful information for early diagnosis and management of concurrent ADs in patients with AITD. Aggregation of ADs in different clusters may help to define different phenotypes associated with thyroid autoimmunity that are critically relevant in clinical settings.

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Section: Resultsmentioning

confidence: 99%

Prevalence of latent and overt polyautoimmunity in autoimmune thyroid disease: A systematic review and meta‐analysis

Botello

Herrán

Salcedo

et al. 2020

Clinical Endocrinology

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“…Most studies that have looked at the familial aggregation of autoimmunity in JIA patients and their relatives, and have focused on the association and the estimated risk of autoimmune diseases among individuals and their relatives. However, the impact of clustering of autoimmunity has not been adequately studied 9,16,17 . There are scarce data published on JIA long‐term outcome in JIA patients with relatives with autoimmune diseases 18 .…”

Section: Introductionmentioning

confidence: 99%

Familial aggregation of juvenile idiopathic arthritis with other autoimmune diseases: Impact on clinical characteristics, disease activity status and disease damage

et al. 2021

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Objectives To evaluate the impact of family history of autoimmune diseases (FHADs) on the clinical characteristics and outcome of juvenile idiopathic arthritis (JIA). Methods We retrospectively reviewed children with JIA seen in 7 pediatric rheumatology clinics from 6 Arab countries. All included patients met the International League of Associations for Rheumatology classification criteria for JIA and had a disease duration greater than 1 year. Data were collected at the last follow‐up visit and comprised clinical findings, including FHADs. Disease activity and disease damage were assessed by Juvenile Arthritis Multidimensional Assessment Report, and juvenile arthritis damage index (JADI) respectively. Disease activity was categorized as remission off treatment, remission on treatment, or active disease. Results A total of 349 (224 females) JIA patients with a disease duration of 5 (interquartile range 2.9‐7.5) years were included. The most frequent JIA categories were polyarticular JIA and oligoarticular JIA, followed by systemic JIA. There were 189 patients with FHADs and 160 patients without FHADs. The most frequent FHADs were diabetes mellitus (21.2%), JIA (18.5%), rheumatoid arthritis (12.7%). Among patients with FHADs, 140/189 (74.1%) achieved clinical remission, while 131/160 (81.9%) patients without FHDs had clinical remission (odds ratio [OR] = 1.2, 95% CI 0.97‐1.5). Rate of consanguinity, enthesitis‐related arthritis (ERA) and psoriatic arthritis were higher in patients with FHADs (OR = 0.6, 95% CI 0.4‐0.9 and OR = 1.2, 95% CI 1.1‐1.4). Also, articular JADI correlated significantly with presence of FHADs (OR = 1.1, 95% CI 1.0‐1.1). Conclusion This study shows that autoimmune diseases cluster within families of patients with JIA with a high proportion of ERA and psoriatic arthritis. JIA patients with FHADs are likely to have more disease damage.

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“…Even though SS is a common autoimmune disease in adults, it is relatively uncommon in the population under 18 years of age. Malagón et al 6 summarized 313 juvenile patients with autoimmune diseases and found only 4 SS patients in this cohort.…”

Section: Discussionmentioning

confidence: 73%

Premature onset of Sjögren's syndrome is prone to be complicated with renal tubular acidosis

Wang

Dai

2020

Int J of Rheum Dis

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Sjögren's syndrome (SS) is a chronic systemic autoimmune disease. It usually occurs among middle-aged women. A hallmark of SS is lymphocytes infiltration of the exocrine glands. 1,2 However, beyond the exocrine glands, SS also presents with various extraglandular manifestations. Renal involvement is relatively uncommon, affecting less than 10% of SS patients. 2,3 It is frequently characterized as interstitial nephritis, resulting in renal tubular acidosis (RTA). Some RTA-induced disorders, especially osteomalacia, are often underdiagnosed/misdiagnosed in SS patients. SS is a rare condition in people under 18 years of age. A common symptom of adolescent SS is swelling of the salivary glands 4 ; however, SS is latent in nearly 47% of juvenile/adolescent cases who are free from salivary glands enlargement, making it very difficult to diagnose in time. 5 Last year we managed 4 cases of SS who shared the common feature that at the onset of SS, the individual was younger than 18 years of age. They did not receive proper treatment due to underdiagnosis and developed into RTA at a relatively young age. Moreover, 3 of them also suffered from severe osteomalacia. They endured a moderate to severe disease activity on admission. In this report, we assume that premature-onset SS may developed into major organ damage and aim to raise the alarm over misdiagnosis/underdiagnosis of the disorder among young people.

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Juvenile polyautoimmunity in a rheumatology setting

Cited by 24 publications

References 147 publications

Prevalence of latent and overt polyautoimmunity in autoimmune thyroid disease: A systematic review and meta‐analysis

Prevalence of latent and overt polyautoimmunity in autoimmune thyroid disease: A systematic review and meta‐analysis

Familial aggregation of juvenile idiopathic arthritis with other autoimmune diseases: Impact on clinical characteristics, disease activity status and disease damage

Premature onset of Sjögren's syndrome is prone to be complicated with renal tubular acidosis

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