Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Polyautoimmunity and Autoimmune Aggregation in Rheumatoid Arthritis.

Rojas-Villarraga1,  Adriana, Cifuentes3,  Ricardo A., Botello-Corzo3,  Diana, Iglesias-Gamarra4,  Antonio, Mantilla5,  Ruben D., Anaya2,  Juan-Manuel

Center for Autoimmune Diseases Research (CREA), Universidad del Rosario
CREA, Universidad del Rosario, Bogota, Colombia
CREA, Universidad del Rosario
Rheumatology Unit, Universidad Nacional
Riesgo de Fractura-CAYRE IPS

Objectives:

Characterization of the extent to which particular combinations of autoimmune diseases occur in excess of what could be expected as a result of chance may offer new insights into possible common pathophysiological mechanisms. The goal of this study was to investigate the spectrum of polyautoimmunity [i.e. autoimmune diseases (Ads) co-occurring within patients], familial autoimmunity (i.e. diverse Ads co-occurring within families) and aggregation in patients with rheumatoid arthritis (RA).

Methods:

This was a cross-sectional study in which 304 consecutive patients with RA (ACR criteria) and their nuclear families were included. The history of 23 Ads was investigated. A multivariate logistic regression analysis was performed in a search for risk factors that were significantly associated with the presence of polyautoimmunity. Aggregation (lR) was obtained by the ratio between the prevalence of Ads in relatives and the current prevalence of Ads in the general population.

Results:

There were 98 (32.3%) patients presenting with at least one other AD. A total of 116 Ads were observed in patients of which the most frequent were autoimmune thyroid disease (AITD), Sjögren's syndrome (SS) and antiphospholipid syndrome (APS), registered in 64 (21.1%), 36 (11.8%) and 8 (2.6%) cases respectively. Of the patients with polyautoimmunity, 16 (16.3%) presented with multiple autoimmune syndrome (i.e., two or more Ads in addition to RA). Female gender (AOR: 2.8, 95%CI:1.22–6.31), cardiovascular disease (AOR: 2.2, 95%CI: 1.17–3.94) and the presence of antinuclear antibodies (AOR: 2.0, 95%CI: 1.08–3.84) were risk factors for polyautoimmunity. Seventy-three families (24%) had at least one first degree relative (FDR) with an AD. Of the 571 FDR in these 73 families, 145 (25%) had one or more AD. The most frequent Ads registered in FDR were AITD (9.5%), RA (4%) and systemic lupus erythematosus (1.4%), with a lR of 3.5, 8 and 7 respectively.

Conclusion:

Polyautoimmunity and familial autoimmunity are frequent in RA and influenced by clinical and immunological features. These findings support the hypothesis that clinically different autoimmune phenotypes might share common susceptibility variants.

To cite this abstract, please use the following information:
Rojas-Villarraga, Adriana, Cifuentes, Ricardo A., Botello-Corzo, Diana, Iglesias-Gamarra, Antonio, Mantilla, Ruben D., Anaya, Juan-Manuel; Polyautoimmunity and Autoimmune Aggregation in Rheumatoid Arthritis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1048
DOI: 10.1002/art.28815

Abstract Supplement

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