Determining the Pattern of Autoimmune Disorders in Children with Polyautoimmunity

Background: Autoimmune diseases (ADs) are chronic conditions characterized by the loss of immunological tolerance to self-antigens. ADs are not rare and show variable patterns in different countries. In this study, we aim to investigate the prevalence of autoimmune disorders and pattern of polyautoimmunity among Iranian children with endocrinopathy. Methods: Overall 45 patients with early-onset multiple autoimmune disorders were enrolled in the study and data was collected via a questionnaire. All statistical analyses were performed using SPSS software (v. 26.0, Chicago, IL). The statistical significance level was set at P < 0/05. Results: Forty-five patients (15 [33/3%] male and 30 [66/7%] female) with early-onset polyautoimmunity were included in the study. The most prevalent ethnic groups were Persians (51/2%) and Azeris (39/0%). The median age at the time of evaluation and the onset of autoimmune symptoms were 12.0 and 6.0 years, respectively. Most patients (58/5%) were born to non-consanguineous parents. In 23 (54/8%) patients a positive family history of autoimmune disorder was reported. The autoimmune disorders mostly included insulin-dependent diabetes mellitus (IDDM) in 39 (86/7%) patients, celiac disease in 29 (64/4%) patients, and autoimmune thyroiditis in 20 (44/4%) patients. The most frequent overlap in autoimmune disorders was present between IDDM and celiac (n=25, 55/6%) and then IDDM and autoimmune thyroiditis (n=15, 33/3%). Conclusion:In the current study, the most common autoimmune disorder was IDDM, which was mostly in overlap with celiac disease. This finding further highlights the importance of precise follow up of IDDM patients for celiac disease which can lead to earlier diagnosis and positively impact the evolution of complications.