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Increased Prevalence of Antithyroid Antibodies and Subclinical Hypothyroidism in Children with Juvenile Idiopathic Arthritis
LIORA HAREL, DARIO PRAIS, YOSEF UZIEL, MASZA MUKAMEL, PHILIP HASHKES, GIDEON HAREL, JACOB AMIR, YEHUDIT MONSELISE, and JOSEPH PRESS
ABSTRACT. Methods. The occurrence of ATA, including antithyroglobulin (anti-TG) and antithyroid peroxidase (anti-TPO) antibodies, was evaluated by quantitative immunometric ELISA in children with JIA and in a healthy matched control group. Thyroid function was assessed in both groups. Results. The study group included 66 patients with JIA (50 girls, 16 boys) of mean age 11.7 ± 4.4 years (range 2–23). The control group included 89 children (71 girls, 18 boys) of mean age 10.8 ± 4.2 years (range 2–18). Mean age at onset of joint disease was 7.3 ± 3.6 years (range 1–15). Anti-TG antibodies were found in 7 of 62 patients (11.3%) in the JIA group and 2 of 89 controls (2.2%) (p = 0.03); anti-TPO antibodies were found in 5 of 65 patients (7.9%) and one of 89 controls (1.1%) (p = 0.08). All patients with ATA had oligoarticular type JIA (p = 0.01). Mean thyroid stimulating hormone (TSH) levels were higher in the study group than in controls (2.6 ± 2.3 vs 1.9 ± 1.0 mIU/l; p = 0.01); levels were above normal range (0.4–4 mIU/l) in 8 study patients (12%) and 3 controls (3.4%) (p = 0.055). Overall, ATA were found in 9 of the 150 study participants, 4 (44%) of whom had TSH levels above 4 mIU/l (p = 0.001). Conclusion. Children with JIA have a higher than normal incidence of ATA and subclinical hypothyroidism and should be routinely screened for these variables. (J Rheumatol 2006;33:164-6) Key Indexing Terms:
JUVENILE IDIOPATHIC ARTHRITIS
From the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv; the Department of Pediatrics C and the Rheumatology Unit, Schneider Children's Medical Center of Israel; the Endocrinology Unit, Rabin Medical Center, Golda Campus; the Laboratory of Clinical Immunology, Rabin Medical Center, Beilinson Campus, Petah Tiqva; the Emergency Department, Soroka Medical Center, Beer Sheva; and the Department of Pediatrics, Sapir Medical Center, Kfar Saba, Israel; and the Department of Rheumatic Diseases, Cleveland Clinic Foundation, Cleveland, Ohio, USA. L. Harel, MD; D. Prais, MD, Sackler Faculty of Medicine, Tel Aviv University and Department of Pediatrics C, Schneider Children's Medical Center; Y. Uziel, MD, MSc, Faculty of Medicine, Tel Aviv University and Department of Pediatrics, Sapir Medical Center; M. Mukamel, MD, Faculty of Medicine, Tel Aviv University and Rheumatology Unit, Schneider Children's Medical Center; P. Hashkes, MD, MSc, Department of Rheumatic Diseases, Cleveland Clinic Foundation; G. Harel, MD, Faculty of Medicine, Tel Aviv University and Endocrinology Unit, Rabin Medical Center; J. Amir, MD, Faculty of Medicine, Tel Aviv University and Department of Pediatrics C, Schneider Children's Medical Center; Y. Monselise, PhD, Faculty of Medicine, Tel Aviv University and Laboratory of Clinical Immunology, Rabin Medical Center; J. Press, MD, Emergency Department, Soroka Medical Center. Address reprint requests to Dr. L. Harel, Department of Pediatrics C, Schneider Children's Medical Center of Israel, 14 Kaplan Street, Petah Tiqva 49202, Israel. E-mail: xxxx Accepted for publication August 15, 2005. |
