Female sex, ANA positivity predict higher risk for autoimmune thyroid disease in JIA
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Patients with juvenile idiopathic arthritis who demonstrate female sex, antinuclear antibody positivity and a positive family history have a higher risk for autoimmune thyroid disease, according to data published in Pediatric Rheumatology.
“Although there is some evidence about an increased incidence of autoimmune thyroid disease (AITD) in juvenile idiopathic arthritis, little is known about the association between the two diseases,” Joeri W. van Straalen, MSc, of the department of pediatric immunology and rheumatology at Wilhelmina Children’s Hospital, in the Netherlands, told Healio. “Since undiagnosed thyroid disease can lead to several hormonal imbalance related complaints, it would be useful to know which JIA patients are at an increased risk of developing AITD and thus might benefit from serological screening.”
To examine the rate and potential indicators of autoimmune thyroid disease in patients with JIA, van Straalen and colleagues analyzed data from the Pharmachild registry, which includes patients with JIA who are receiving therapy with NSAIDs, corticosteroids or disease-modifying antirheumatic drugs.
The main outcome of interest was the presence of symptomatic autoimmune thyroid disease. The researchers additionally classified autoimmune thyroid disease as either Hashimoto’s thyroiditis, Graves’ disease or otherwise nonspecific autoimmune thyroid disease.
For the purposes of the analysis, specific codes were considered autoimmune thyroid disease by the researchers, including hypothyroidism, autoimmune thyroiditis, thyroiditis, hyperthyroidism and Basedow’s disease. In cases where specific codes did not exist, but autoimmune thyroid disease was mentioned, the researchers evaluated the cases individually. In addition to mentions of autoimmune thyroid disease, researchers considered potential overlapping conditions.
The analysis included 8,965 patients. Following a median observational period of 5.5 years, the researchers identified 96 (1.1%) patients with autoimmune thyroid disease. According to the researchers, patients who developed autoimmune thyroid disease were more likely to demonstrate female sex, rheumatoid factor positivity and ANA positivity than those who did not develop autoimmune thyroid disease. Additionally, these patients were more likely to present with JIA at an older age, have polyarthritis or have a family history of autoimmune thyroid disease.
“AITD is most likely to occur in female ANA-positive JIA patients with a positive family history for AITD,” van Straalen said. “These patients might therefore benefit from yearly screening for AITD using standard blood tests. This study mainly included JIA patients with a more severe disease course in need of DMARD treatment, our results might therefore not be applicable to JIA patients with low disease activity.”
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