Association between thyroid autoimmunity and recurrent angioedema in children

Area of Science:

• Pediatric Allergy and Immunology
• Endocrinology
• Autoimmune Diseases

Background:

• The relationship between thyroid autoimmunity (TA) and idiopathic isolated angioedema (angioedema without urticaria) lacks evaluation in pediatric populations.
• Recurrent idiopathic angioedema is a condition that warrants investigation into potential underlying autoimmune associations.

Purpose of the Study:

• To investigate the prevalence of underlying or concomitant TA and/or autoimmune thyroid disease in children diagnosed with recurrent idiopathic angioedema.
• To assess the association between TA and autoimmune thyroid disease in pediatric patients with recurrent idiopathic histaminergic acquired angioedema (IH-AAE).

Main Methods:

• A prospective, case-control study enrolled 80 children with recurrent IH-AAE and 80 healthy controls.
• Thyroid autoantibodies and thyroid function tests were measured in all participants.
• Patients with recurrent IH-AAE received a standard diagnostic and therapeutic algorithm, including antihistamine prophylaxis when necessary.

Main Results:

• Children with recurrent IH-AAE showed a significantly higher prevalence of TA (13.7%) compared to healthy controls (2.5%; p = 0.009).
• No significant difference was observed in the prevalence of autoimmune thyroid disease between the groups (3.7% vs. 0%; p = 0.2).
• The presence of TA did not influence the need for or duration of antihistamine prophylaxis in IH-AAE patients.

Conclusions:

• Recurrent IH-AAE in children may be associated with TA and/or autoimmune thyroid diseases.
• Further investigation and longer follow-up studies are required to determine if this association represents a causal link or an epiphenomenon.