The autoimmune burden in juvenile idiopathic arthritis.
The autoimmune burden in juvenile idiopathic arthritis.
复制标题
DOI：
10.1186/s13052-017-0373-9
复制
发表时间：
2017-06-14
影响因子：
3.6
通讯作者：
Pession A
中科院分区：
文献类型：
--
作者：
Tronconi E;Miniaci A;Pession A
幼年特发性关节炎（JIA）是一种病因不明的慢性炎症性关节炎，可被认为是一种自身免疫性疾病（AD）。本研究的目的是分析存在两个或两个以上的自身免疫性疾病（多发性自身免疫性疾病）的患者患有JIA和评估AD的发生在他们的家庭。79例诊断为JIA的患者，年龄0-21岁，入住博洛尼亚Sant'Orsola-Malpighi医院儿科风湿病科，接受AD筛查。父母被问及一级和二级亲属中是否存在AD。79例患者中有12例（15.2%）至少有1例与JIA相关的AD。8例（10.1%）患者患有自身免疫性甲状腺疾病（AITD），3例患者患有乳糜泻，3例患者患有银屑病，1例患者患有脱发，1例患者患有胰岛素依赖型糖尿病。平均诊断年龄为13.2岁，AITD的累积发病率为36%。76个家庭共438名亲属进行了研究。AD患病率为13%，一级亲属（16.7%）高于二级亲属（11.1%）。最常见的AD是AITD;对AD熟悉程度为阳性和阴性的患者，JIA的发病年龄无差异（p > 0.05）。患有JIA的儿童和青少年呈现高自身免疫负担，最常见的是AITD。家族性自身免疫在JIA患者中不可忽略（几乎50%的患者至少有一个亲属患有AD），应始终仔细检查。
Juvenile 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. Seventy-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. Twelve 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). Children 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.