045 - Autoimmune diseases among children and adolescents: from symptoms to laboratory diagnosis

Autor(s): R. Tozzoli, R. Perini

Issue: RIMeL - IJLaM, Vol. 3, N. 1, 2007 (MAF Servizi srl ed.)

Page(s): 45-50

Autoimmune diseases are increasing worldwide and nowadays show a prevalence of about 3% in childhood and adolescence; autoimmune thyroid diseases (AITD), celiac disease (CD) and juvenile idiopathic arthritides (JIA) are the commonest pathologies, constituting about 75% of all autoimmune diseases of these ages. Hashimoto’s thyroiditis (HT), the most frequent form of AITD, affects up to 3% of the pediatric population, with reported 10-fold frequency in females. Juvenile TH is diagnosed by thyroid ultrasonography and measurement of thyroid peroxidase antibodies, always found at moderate-high concentration in sera of affected children. Celiac disease is a chronic disorder caused by an inflammatory T-cell response to gluten and frequently unrecognized, with an estimated prevalence of 1% in pediatric age. Measurements of IgA tissue transglutaminase antibody levels, together with total IgA concentrations, represent the first-line serological tests, according to a shared diagnostic algorithm, related to the patient’s age. Divided into seven subtypes, JIA is the most widespread rheumatic disease of childhood. The diagnosis depends primarily on clinical manifestations of the disease, but antinuclear antibodies, rheumatoid factors and recently anti-citrullinated proteins antibodies are useful serological tests, which select for a specific polyarticular subtype, considered the pediatric form of adult rheumatoid arthritis. The growing evidence of the predictive role of autoantibodies and the recent introduction of updated multiplex technologies might give the chance of serological screening of pediatric population, with the goal to diagnose in preclinical phase and make early therapies, in order to modify the ongoing of autoimmune diseases.

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