Manuel Rojas, Colombia
Universidad del Rosario Center for Autoimmune Diseases ResearchPresenter of 2 Presentations
PREVALENCE OF LATENT AND OVERT POLYAUTOIMMUNITY IN AUTOIMMUNE THYROID DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Abstract
Background and Aims
Thyroid autoimmunity is the most frequent condition involved into polyautoimmunity (PolyA). However, the frequency of latent and overt PolyA in autoimmune thyroid disease (AITD) as index condition is unknown.
Methods
This study adhered to the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Searches through MEDLINE, EMBASE, and LILACS were performed to include articles in Spanish and English, and published up to August 8, 2018. Relevant vocabulary terms and key terms related to AITD and other autoimmune diseases were used. Fixed and random effects models were used accordingly.
Results
A total of 46 articles fulfilled inclusion criteria, of which 24 were case-controls, 17 were cohorts, and 5 were cross-sectional studies. These studies included a total of 38,921 patients with a mean age of 32.26 years. Female was the predominant gender including 31,251 patients (81.15%, 95% CI: 80.75-81.54). Graves’ disease was the most common type of AITD (64.72%, 95% CI: 63.45-65.98). Overt PolyA was found in 13.09% of patients (95% CI: 12.5-13.71). This type of PolyA was principally represented by type 1 diabetes (4.36%, 95% CI: 3.84-4.95) and autoimmune gastritis (4.24%, 95% CI: 3.63-4.95) (Figure 1A). Latent PolyA was presented in 17.59% of patients (95% CI: 16.64-18.58), in which anti-nuclear antibodies (23.39%, CI: 7.78-52.50), and anti-proinsulin antibodies (18.64%, 95% CI: 13.57-25.07) were the most common (Figure 1B).
Conclusions
Latent and overt PolyA are common in patients with AITD. These results provide insightful information for early diagnosis and management of concurrent ADs in patients with AITD.
STRATIFYING AUTOIMMUNE RHEUMATIC DISEASES INTO POLYAUTOIMMUNITY-BASED SUBGROUPS: INTRODUCING LATENT AND OVERT POLYAUTOIMMUNITY
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.