Sapountzi Evdoxia, Tsinopoulou Vasiliki-Rengina, Kotanidou Eleni P, Giza Styliani, Galli-Tsinopoulou Assimina
2nd Department of Pediatrics, Aristotle University of Thessaloniki, AHEPA University General Hospital, Thessaloniki, GRC.
Cureus. 2023 Aug 30;15(8):e44384. doi: 10.7759/cureus.44384. eCollection 2023 Aug.
Autoimmune thyroid disease seems to occur more often in children with juvenile idiopathic arthritis (JIA) than in the general pediatric population. We investigated the prevalence of autoimmune thyroiditis (Hashimoto's thyroiditis) in young patients with JIA in Greece, which has not been evaluated previously.
This descriptive study included patients with JIA followed up at the Pediatric Rheumatology Unit of the Second Department of Pediatrics of a tertiary general hospital in Thessaloniki, Greece. All patients were diagnosed and sorted according to the classification criteria of the International League of Associations for Rheumatology. The presence of thyroid autoantibodies was considered for determining autoimmune thyroiditis. Basic demographic, clinical, and laboratory data were collected from patients' records. Results: The analyzed sample comprised 130 patients with JIA (mean age 12.22 years; 69.2% female). Most patients (70%) had a family history of at least one autoimmune disease and 30.8% of Hashimoto's thyroiditis. More than half (53.8%) had enthesitis-related arthritis (ERA), 22.3% had oligoarthritis, and 15.4% had psoriatic arthritis. Thyroid autoantibodies were detected in 22/130 patients (16.9%) suggesting autoimmune thyroiditis; most of these patients were euthyroid, whereas 3/22 (13.6%) had overt hypothyroidism determined by elevated levels of thyroid-stimulating hormone, decreased levels of free thyroxine, and typical ultrasound findings for Hashimoto's thyroiditis. The prevalence of clinical cases of Hashimoto's disease was 2.3%.
The prevalence of autoimmune thyroiditis in our JIA cohort is higher compared to the general population and consistent with the previously reported range. Hence, investigation for thyroid autoimmunity should be included in the workup of patients with JIA.
自身免疫性甲状腺疾病在幼年特发性关节炎（JIA）患儿中的发生率似乎高于普通儿科人群。我们调查了希腊JIA年轻患者中自身免疫性甲状腺炎（桥本甲状腺炎）的患病率，此前尚未对此进行评估。
这项描述性研究纳入了在希腊塞萨洛尼基一家三级综合医院儿科第二科室的儿科风湿病科随访的JIA患者。所有患者均根据国际风湿病联盟的分类标准进行诊断和分类。通过检测甲状腺自身抗体来确定自身免疫性甲状腺炎。从患者记录中收集基本人口统计学、临床和实验室数据。结果：分析样本包括130例JIA患者（平均年龄12.22岁；69.2%为女性）。大多数患者（70%）有至少一种自身免疫性疾病的家族史，桥本甲状腺炎的患病率为30.8%。超过一半（53.8%）的患者患有附着点炎相关关节炎（ERA），22.3%患有少关节炎，15.4%患有银屑病关节炎。130例患者中有22例（16.9%）检测到甲状腺自身抗体，提示存在自身免疫性甲状腺炎；这些患者大多数甲状腺功能正常，而22例中有3例（13.6%）因促甲状腺激素水平升高、游离甲状腺素水平降低以及桥本甲状腺炎的典型超声表现而被诊断为明显的甲状腺功能减退。桥本氏病的临床病例患病率为2.3%。
我们的JIA队列中自身免疫性甲状腺炎的患病率高于普通人群，与先前报道的范围一致。因此，对JIA患者的检查应包括甲状腺自身免疫的调查。
