Clinico immunological profile of immune-mediated disorders in South Indian children- A prospective observational...

Immune-mediated diseases can affect any part of the body of genetically susceptible individuals. Few diseases predominantly affect a single organ, while others present with multisystemic manifestations.

We collected data on the clinical, demographic, and immunological details of children with immune-mediated diseases presenting over a period of three years from January 2020 to December 2022 retrospectively from the children enrolled in Pediatric immunology clinic of a tertiary care hospital in South India.

The prevalence of immune-mediated diseases among children visiting the hospital for various illnesses was 5 per 1000 children, and the percentage of positive autoantibodies in children with connective tissue disorders and single-organ autoimmune disorders was 41.3% and 40.7%, respectively. The most common connective tissue disorder in our study was juvenile idiopathic arthritis (21 patients), among which 9 / 21 (42.8%) were autoantibody positive. ANA was the most common antibody in both groups (47.5%). Only 3.4% had rheumatoid factor positivity in the connective tissue group. The most common single-organ autoimmune disorders in children are autoimmune thyroid disorders (25), followed by autoimmune hematological disorders (18), while autoantibodies were more common in patients with thyroid disorders (18 / 25) and autoimmune hepatitis (7 / 8).

Early clinical suspicion and prompt diagnosis in children with prolonged illness or atypical presentation is essential to ensure remission and prevent complications, morbidity and mortality. Further research is needed to identify early biomarkers in immune-mediated pediatric disorders that will help to confirm the diagnosis and guide physicians to start immunosuppressive therapy at the right time.