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G356 Juvenile idiopathic arthritis and other autoimmune diseases in a nationwide paediatric inflammatory bowel disease cohort
  1. VM Merrick1,
  2. P Henderson1,
  3. H Drummond2,
  4. J Van Limbergen3,
  5. RK Russell4,
  6. J Satsangi2,
  7. DC Wilson1
  1. 1Child Life and Health, University of Edinburgh, Edinburgh, UK
  2. 2Gastrointestinal Unit, Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
  3. 3Department of Paediatrics, Dalhousie University, Halifax, Canada
  4. 4Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Sick Children (Yorkhill), Glasgow, UK

Abstract

Aims Autoimmune diseases (AIDs) affect up to 10% of individuals living in Europe, so are a significant cause of chronic morbidity. High rates of immune-mediated comorbidity and familial clustering suggest that genetic predisposition underlies AI disease susceptibility, yet few clinical studies have defined the prevalence rates of co-morbid AIDs in specific paediatric populations. This study aims to document the occurrence of Juvenile Idiopathic Arthritis (JIA) and other AIDs in a Scotland-wide cohort of paediatric inflammatory bowel disease (PIBD; diagnosed <17 years of age) patients.

Methods The Paediatric-onset IBD Cohort and Treatment Study (PICTS) is a nationwide Scottish study of incident and prevalent PIBD patients, collecting a wide range of data, including rigorous phenotyping, with continuous long-term follow-up. The PICTS database was interrogated to identify patients enrolled up to 30/06/12 (follow-up to 30/06/14) with a diagnosis of at least one associated AID by last follow-up. Cases believed to be related to use of anti-TNFα treatment were excluded.

Results Of 809 patients in the PICTS cohort, 43 had one or more associated AID, an overall co-morbid immune disease rate of 5.3%; 49% (21/43) male. There were 44 AIDs in 43 patients; one patient had dual AIDs (psoriasis [PSOR] and spondyloarthropathy [SPA]) co-existing with IBD. Otherwise, there were 7 cases of JIA, 3 cases of SPA and 9 cases of PSOR. Additionally there were 4 cases of coeliac disease, 2 of thyroiditis and 2 cases of type 1 diabetes. No cases of Systemic Lupus Erythematosus (SLE) were identified. There were 15 cases of autoimmune liver disease (Primary Sclerosing Cholangitis [PSC], Auto-Immune Hepatitis [AIH] and Autoimmune Sclerosing Cholangitis [ASC]) in this cohort, accounting for 35% of all PIBD-associated AID.

Conclusion Over 5% of PIBD patients in this large cohort study have associated AIDs. Autoimmune liver disease is the commonest AID in this cohort of PIBD patients, followed by PSOR accounting for 23%; JIA accounted for 16% of PIBD-associated AID.

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