Hsu Alan Y, Kuo Hou-Ting, Lin Chun-Ju, Wei Chang-Ching, Hsia Ning-Yi, Wei James Cheng-Chung, Wang Yu-Hsun, Li You-Ling, Lai Chun-Ting, Chen Huan-Sheng, Tsai Yi-Yu
Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Department of General Medicine, China Medical University Hospital, Taichung, Taiwan.
Sci Rep. 2024 Dec 30;14(1):31590. doi: 10.1038/s41598-024-79262-w.
To investigate for the risk of uveitis among such patients. A retrospective cohort study utilized the TriNetX database and recruited pediatric autoimmune patients diagnosed between January 1st 2004 and December 31st 2022. The non-autoimmune cohort were randomly selected control patients matched by sex, age, and index year. The main outcome is the incidence of new-onset uveitis. 175,328 pediatric patients with autoimmune diseases (mean age 10.7 +/- 5.1 years; 55.8% female; 66.2% White) and 175,328 pediatric patients without autoimmune diseases (mean age 10.8+/- 5.1 years; 55.7% female; 66% White) were recruited. The autoimmune cohort demonstrated a significantly increased uveitis risk across our 18-year study period (HR 4.42 [95% CI 3.98-4.90]). Iridocyclitis, chorioretinal inflammation, unspecified purulent endophthalmitis, panuveitis, retinal vasculitis, and sympathetic uveitis were uveitis conditions significantly associated with autoimmune diseases. Autoimmune patients who had used immunosuppressant medications had increased uveitis risk compared to those who had never used immunosuppressants. Our subgroup analysis also demonstrated a significantly increased uveitis risk associated with specific autoimmune conditions. Conditions include inflammatory arthritis, systemic autoimmune rheumatic diseases, systemic vasculitis, inflammatory bowel disease, psoriasis, multiple sclerosis, and immune thrombocytopenic purpura. Using hazard ratios HR for comparison, we were able to identify that, out of the previously broadly defined category of autoimmune diseases, only these specific conditions were significantly associated with pediatric uveitis. Uveitis was significantly associated with autoimmune diseases among the pediatric population.
为调查此类患者发生葡萄膜炎的风险。一项回顾性队列研究利用TriNetX数据库,纳入了2004年1月1日至2022年12月31日期间诊断的儿科自身免疫性疾病患者。非自身免疫性队列是通过性别、年龄和索引年份匹配的随机选择的对照患者。主要结局是新发葡萄膜炎的发病率。共纳入了175328例患有自身免疫性疾病的儿科患者(平均年龄10.7±5.1岁;55.8%为女性;66.2%为白人)和175328例无自身免疫性疾病的儿科患者(平均年龄10.8±5.1岁;55.7%为女性;66%为白人)。在我们18年的研究期间,自身免疫性队列的葡萄膜炎风险显著增加(风险比4.42 [95%置信区间3.98 - 4.90])。虹膜睫状体炎、脉络膜视网膜炎、未明确的化脓性眼内炎、全葡萄膜炎、视网膜血管炎和交感性眼炎是与自身免疫性疾病显著相关的葡萄膜炎类型。与从未使用过免疫抑制剂的自身免疫性疾病患者相比,使用过免疫抑制剂的患者发生葡萄膜炎的风险增加。我们的亚组分析还表明,与特定自身免疫性疾病相关的葡萄膜炎风险显著增加。这些疾病包括炎性关节炎(炎性关节病)、系统性自身免疫性风湿性疾病、系统性血管炎、炎性肠病、银屑病、多发性硬化症和免疫性血小板减少性紫癜。通过使用风险比(HR)进行比较,我们能够确定,在先前广泛定义的自身免疫性疾病类别中,只有这些特定疾病与儿科葡萄膜炎显著相关。在儿科人群中,葡萄膜炎与自身免疫性疾病显著相关。