STRATIFYING AUTOIMMUNE RHEUMATIC DISEASES INTO POLYAUTOIMMUNITY-BASED SUBGROUPS: INTRODUCING LATENT AND OVERT POLYAUTOIMMUNITY
- Manuel Rojas, Colombia
Abstract
Background and Aims
The role of polyautoimmunity (PolyA) on clinical manifestations of autoimmune diseases (ADs) is not well defined. We aimed to characterize PolyA and evaluate its influence on clinical features in autoimmune rheumatic diseases (ARDs).
Methods
This was a one-year multicenter cross-sectional study in which 214 consecutive patients with rheumatoid arthritis (RA,n:135), systemic lupus erythematosus (SLE,n:40), and other ARDs (n:39) were included. A total of 33 autoantibodies were measured by ELISA and immunoblot. The coexistence of two or more ADs fulfilling classification criteria was termed “Overt PolyA”, whereas, “Latent PolyA” corresponded to the presence of autoantibodies unrelated to the index AD not fulfilling classification criteria for other ADs. Data was analyzed using Fisher-exact and Kruskall-Wallis tests.
Results
Overt and latent PolyA were present in 30.84% and 31.31% of patients, respectively. The most prevalent AD in both types of PolyA was autoimmune thyroid disease (AITD) (Figure 1A), characterized by a high frequency of anti-TPO positivity (Figure 1B). Age at onset, duration of disease, and medication status based on PolyA were not different. Patients with SLE showed the highest frequency of overt and latent PolyA (p: 0.007).
Conclusions
One in three patients with ARDs disclosed PolyA, with AITD being the most frequent. As a corollary, all patients with ARDs must be routinely evaluated for thyroid autoimmunity. Latent PolyA deserves further evaluation in clinical settings as predictor of overt PolyA.