The autoimmune burden in juvenile idiopathic arthritis

Abstract

BackgroundJuvenile idiopathic arthritis (JIA) is a chronic inflammatory arthritis of unknown origin which can be considered an autoimmune disease (AD). The aim of this study is to analyse the presence of two or more autoimmune diseases (polyautoimmunity) in patients suffering from JIA and to evaluate the occurrence of ADs in their families.MethodsSeventy-nine patients diagnosed with JIA aged 0–21 years, admitted to the Paediatric Rheumatology Unit, Sant’Orsola-Malpighi Hospital, Bologna were screened for ADs. Parents were asked about the presence of ADs in the living relatives of first and second degree.ResultsTwelve of 79 patients (15.2%) had at least 1 AD associated with JIA. Eight patients (10.1%) suffered from autoimmune thyroid disease (AITD), three patients had celiac disease, three patients suffered from psoriasis, one from alopecia and 1 from insulin-dependent diabetes mellitus. The average age at diagnosis was 13.2 years and the cumulative incidence of AITD was 36%. Seventy-six families were studied for a total of 438 relatives. The prevalence of ADs was 13%, greater in first-degree relatives (16.7%) than in second-degree ones (11.1%). The most common AD was AITD; there was no difference in JIA’s age of presentation between patients with positive and negative familiarity with ADs (p > 0.05).ConclusionChildren and adolescents with JIA present a high autoimmunity burden, most commonly represented by AITD. Familial autoimmunity is not negligible in patients suffering from JIA (almost 50% of patients have at least one relative with an AD) and it should always be carefully examined.

Prevalence of co-existing autoimmune disease in juvenile idiopathic arthritis: a cross-sectional study

“…Patients with one autoimmune disease may be at a higher risk of developing a second one [43]. While a few studies have quantified the occurrence of co-existing autoimmune diseases in patients with JIA, to our knowledge, no large studies have been performed [22][23][24][25][26][27][28]. In a single-center study in Italy of 79 patients with JIA (aged ≤ 21 years), 15.2% of patients had at least one autoimmune disease in addition to JIA, with autoimmune thyroid diseases, such as Graves' disease, being the most common (10.1%) [28].…”

“…Several studies have reported the prevalence of JIA; however, there is limited knowledge about the frequency of the cooccurrence of other autoimmune diseases in patients with JIA [15,16], with the exception of uveitis, which is known to occur in 12-31% of patients with JIA [17,18]. In addition, for JIA, the majority of publications are case reports [19][20][21] or small clinical/hospital studies [22][23][24][25][26][27][28] involving one or a select few autoimmune diseases. These studies show that co-existing autoimmune diseases, particularly thyroid conditions, are common in patients with JIA.…”

“…Comorbid conditions in patients with JIA, including coexisting autoimmune diseases, negatively impact quality of life, disability, and mortality [31,32]. In a single-center study of 79 patients with JIA, 10.1% had one additional autoimmune disease and 5.1% had two [28]. As such, understanding the presence of overlapping autoimmune diseases is important in developing treatment strategies, particularly as some autoimmune diseases can arise or be worsened by common treatments, such as tumor necrosis factor inhibitors, which are commonly used in the treatment of diseases such as JIA and RA [8,33,34].…”

Adult outcome of juvenile idiopathic arthritis: A nationwide population‐based retrospective cohort study in Taiwan

“…JIA has been reported to be associated with autoimmune diseases, such as autoimmune thyroid disorders and celiac diseases . Furthermore, it has an important feature of an increased prevalence of familial autoimmunity, in which rheumatoid arthritis (RA), psoriasis and autoimmune thyroiditis are the most frequent autoimmune disorders found in the relatives of the JIA patients …”

AB1118 Procalcitonin differentiates infection from active disease in patients with juvenile idiopathic arthritis (JIA)

“…:[1] Sönmez HE,Batu ED,Demir S,Bilginer Y,Özen S. Background: Patients with JIA often present with signs and symptoms suggestive of infection. However, differentiation of infectious from non-infectious presentation in routine clinical care is challenging.…”