Results from the international Pharmachild registry have proven a family history of autoimmune disease as a significant risk factor for juvenile idiopathic arthritis (JIA), however, it does not have an effect on disease severity. The study findings are published in the recent issue of Pediatric Rheumatology.
Joeri W. van Straalen and co-researchers analyzed the data of 8673 patients including the diseases reported by the first-degree relatives. They also collected patient characteristics including sex, geographic location, ethnicity age of JIA onset, number of active joints, and clinical juvenile arthritis disease activity score at the time of enrollment and at the last follow-up visit. The most common autoimmune diseases reported according to the familial history were psoriasis, autoimmune thyroid disease, rheumatoid arthritis, and ankylosing spondylitis.
The researchers have noted an increased prevalence of several autoimmune diseases in parents of the selected JIA patients than in the general population. However, no significant difference was noted between subjects with (n = 1231) and without a family history of autoimmune diseases (n = 7442) with regard to Clinical Juvenile Arthritis Disease Activity Scores. The study has also reported older age at JIA onset (P < 0.01), Scandinavian residence (P < 0.01), psoriatic arthritis, enthesitis-related arthritis, and undifferentiated arthritis (P < 0.01), HLA-B27 positivity (P < 0.01) and ANA positivity (P = 0.03) as the factors linked to familial autoimmune diseases.
A 2004 study Huang et al. has suggested that common susceptibility genes for different autoimmune phenotypes may serve as risk factors for autoimmunity. The researchers have noted increased incidence of autoimmune disorders among second- and third-degree relatives of SLE or juvenile rheumatoid arthritis (JRA) patients as opposed to first-degree relatives. These data have also shown increased prevalence of autoimmune disorders in the relatives of patients with SLE when compared to those occurring among the relatives of patients with JRA.
The present study is the first of its kind providing a comprehensive overview of the frequency of different autoimmune diseases in parents of JIA patients. Collecting family health history at the diagnosis stage could be useful for pediatric rheumatologists to triage children with probable JIA and take appropriate treatment decisions.
- van Straalen, J.W., de Roock, S., Giancane, G. et al. Prevalence of familial autoimmune diseases in juvenile idiopathic arthritis: results from the international Pharmachild registry. Pediatr Rheumatol 20, 103 (2022).
- Huang CM, Yang YH, Chiang BL. Different familial association patterns of autoimmune diseases between juvenile-onset systemic lupus erythematosus and juvenile rheumatoid arthritis. J Microbiol Immunol Infect. 2004 Apr;37(2):88-94