Increased prevalence of familial autoimmunity in simplex and multiplex families with juvenile rheumatoid arthritis.
OBJECTIVE
To determine if the prevalence of autoimmunity among relatives of patients with juvenile rheumatoid arthritis (JRA) is greater than that among relatives of healthy volunteer control subjects.


METHODS
Interviews were used to obtain histories of the following disorders among living first- and second-degree relatives of 110 patients and 45 controls: alopecia areata, ankylosing spondylitis, dermatomyositis, Graves' disease, Hashimoto thyroiditis, insulin-dependent diabetes mellitus, inflammatory bowel disease, iritis, JRA, multiple sclerosis, psoriasis, RA, systemic lupus erythematosus, and vitiligo. Chi-squares, odds ratios (ORs), and 95% confidence intervals (95% CIs) were calculated. Families of 23 JRA affected sibpairs were interviewed subsequently.


RESULTS
There were no significant differences between patients and controls with regard to age, sex, ethnicity, or family size. Patients had 1,228 relatives and controls had 496 relatives. Of all the relatives of the patients, 155 had at least 1 autoimmune disorder, compared with 20 relatives of the controls (12.6% versus 4.0%; OR 3.4 [95% CI 2.1-5.7], P < 0.000001). The prevalence of autoimmunity was increased in first-degree and in second-degree relatives of patients (16.1% and 10.6%, respectively). The prevalence of Hashimoto thyroiditis was significantly higher in the relatives of patients (OR 3.5 [95% CI 1.6-7.9], P = 0.0008). The prevalences of other disorders were not significantly different. JRA affected sibpair families had an increased prevalence of autoimmunity (15.0%). A history of arthritis was found significantly more frequently in the JRA affected sibpair families, but not in the simplex families.


CONCLUSIONS
These data demonstrate that the prevalence of autoimmunity is significantly higher among first- and second-degree relatives of JRA patients. This suggests that clinically different autoimmune phenotypes may share common susceptibility genes, which may act as risk factors for autoimmunity.
Prahalad
Sampath
S
Department of Pediatrics, University of Utah School of Medicine, Salt Lake City 84132, USA. sampath.prahad@hsc.utah.edu
Shear
Edith S
ES
Thompson
Susan D
SD
Giannini
Edward H
EH
Glass
David N
DN
D000506:Alopecia Areata / Q000235:genetics; D001171:Arthritis, Juvenile / Q000453:epidemiology / Q000235:genetics*; D001172:Arthritis, Rheumatoid / Q000235:genetics; D001327:Autoimmune Diseases / Q000235:genetics*; D015551:Autoimmunity / Q000235:genetics; D003882:Dermatomyositis / Q000235:genetics; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics; D006111:Graves Disease / Q000235:genetics; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000235:genetics; D007500:Iritis / Q000235:genetics; D008180:Lupus Erythematosus, Systemic / Q000235:genetics; D009103:Multiple Sclerosis / Q000235:genetics; D015995:Prevalence; D011565:Psoriasis / Q000235:genetics; D013167:Spondylitis, Ankylosing / Q000235:genetics; D013967:Thyroiditis, Autoimmune / Q000235:genetics; D014820:Vitiligo / Q000235:genetics