The relationship between autoimmune disease and respiratory diseases in a pediatric population

To investigate the association between autoimmune disease (AD) and inflammatory respiratory conditions (IRCs) in pediatric patients. The study also explores whether ADs confer greater risk for chronic IRCs such as chronic rhinosinusitis (CRS), compared to acute IRCs such as acute rhinosinusitis (ARS).

This retrospective study utilized the TriNetX United States Collaborative Network database to analyze a pediatric population aged 2-17 years with outpatient visits. The cohort included children with various ADs such as rheumatoid arthritis, Crohn's disease, and systemic lupus erythematosus, matched 1:1 with non-AD controls by age, race, and ethnicity. Primary outcomes included the prevalence of CRS, ARS, upper respiratory infections, and asthma. In a reverse analysis, we assessed the odds of AD presence in patients with each IRC, controlling for demographic factors.

After propensity matching, the AD cohort demonstrated significantly higher odds of developing IRC. CRS (OR = 2.09, p < 0.001), ARS (OR = 1.75, p < 0.001), chronic rhinitis (OR = 1.86, p < 0.001), and asthma (OR = 1.86, p < 0.001) were more common among patients with AD. Reverse analysis further revealed elevated odds of ADs in patients with CRS and ARS, particularly for necrotizing vasculopathies (OR = 3.93, p < 0.001) and systemic lupus erythematosus (OR = 3.28, p < 0.001).

This national analysis highlights an increased risk of IRCs in pediatric patients with AD, suggesting a need for enhanced clinical vigilance. These findings underscore the importance of further research to understand the underlying mechanisms and potential for early intervention in managing IRCs among children with AD.