Juvenile onset Systemic Lupus Erythematosus thyroid dysfunction: a subgroup with mild disease?

Area of Science:

• Endocrinology
• Rheumatology
• Immunology

Background:

• Juvenile onset Systemic Lupus Erythematosus (JOSLE) is a chronic autoimmune disease with diverse clinical manifestations.
• Thyroid dysfunction and autoantibodies are common comorbidities in autoimmune diseases, but their prevalence in JOSLE requires further investigation.

Purpose of the Study:

• To determine the frequency of thyroid dysfunction and thyroid antibodies in JOSLE patients.
• To explore the association between thyroid dysfunction/antibodies and clinical/immunological features of JOSLE.

Main Methods:

• Seventy-seven JOSLE patients were enrolled, with data collected via chart review and interviews.
• Serum levels of TSH, free T4, anti-thyroglobulin (TgAb), anti-thyroperoxidase (TPOAb), TRAb, and lupus autoantibodies were analyzed.
• Statistical analysis was performed to assess associations between thyroid parameters and JOSLE features.

Main Results:

• A significant prevalence of thyroid dysfunction was observed, with 9 patients diagnosed with hypothyroidism and 4 with hyperthyroidism.
• 28% of JOSLE patients had moderate/high titers of thyroid antibodies (TgAb, TPOAb, TRAb).
• JOSLE patients with positive thyroid antibodies showed a higher frequency of anti-U1RNP antibodies and less renal/neurological/hematological involvement.

Conclusions:

• JOSLE patients exhibit a high prevalence of subclinical hypothyroidism.
• The co-occurrence of anti-thyroid antibodies and anti-U1RNP antibodies in JOSLE may indicate a subgroup with a less severe organ involvement profile.