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Rheumatology Advance Access published online on February 3, 2005
Rheumatology, doi:10.1093/rheumatology/keh531
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British Society for Rheumatology; all rights reserved
Received November 3, 2004
Accepted November 26, 2004

Original Papers

Thyroid function, autoimmune thyroiditis and coeliac disease in juvenile idiopathic arthritis

S. Stagi 1, T. Giani 1, G. Simonini 1, and F. Falcini 1*

1 Department of Paediatrics, Paediatric Rheumatology Unit, University of Florence, Italy

* To whom correspondence should be addressed.
F. Falcini, E-mail: falcini{at}unifi.it


  Abstract

Objectives. Autoimmune diseases have been associated with some organ non-specific rheumatological disorders such as rheumatoid arthritis and systemic lupus erythematosus; however, few studies have been performed in an extensive cohort of children with juvenile idiopathic arthritis (JIA). Our objective was to evaluate the thyroid function and the prevalence of antithyroid antibodies, autoimmune thyroiditis and coeliac disease in children with JIA.

Methods. One hundred and fifty-one children (120 female, 31 male, median age 8.3 yr, range 2.4-16.9 yr) with JIA were evaluated. All patients underwent thyroid function tests (u-TSH, free T4 and free T3), antithyroglobulin (TgA) and antiperoxidase (TPOA) antibodies, antigliadin, anti-endomysium and antitransglutaminase antibodies. All patients with raised thyroid stimulating hormone levels, low thyroid hormone levels or positive TPOA and/or TgA values had a thyroid high-resolution sonography examination. Coeliac disease was confirmed by jejunal biopsy if the specific antibodies profile was positive. One hundred and fifty-eight age- and sex-matched Caucasian children from the same geographical area acted as controls.

Results. Fourteen (9.3%) patients showed subclinical hypothyroidism, 17 (11.9%) patients showed autoimmune thyroiditis with nine patients also showing a non-homogeneous thyroid parenchyma at ultrasound evaluation. Coeliac disease was demonstrated in 10 (6.6%) patients. Compared with controls, JIA patients had higher prevalence of subclinical hypothyroidism (P<0.01), autoimmune thyroiditis (P<0.0001) and coeliac disease (P<0.005).

Conclusions. JIA children have an increased prevalence of autoimmune thyroiditis, subclinical hypothyroidism and coeliac disease. These data seem to suggest careful monitoring of thyroid function, thyroid autoantibodies and coeliac disease in JIA children.

Keywords: Thyroid function; Thyroid autoantibodies; Autoimmune thyroiditis; Coeliac disease; Juvenile idiopathic arthritis.
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