Skip to main content
Top
Published in: Italian Journal of Pediatrics 1/2024

Open Access 01-12-2024 | Autoimmune Hepatitis | Research

Prevalence of autoimmune thyroiditis among children with autoimmune hepatitis

Authors: Engy Adel Mogahed, Hend M. Soliman, Dalia Saber Morgan, Hoda Mohammed Abd Elaal, Rasha Abd El Razek Mahmoud Khattab, Ragaey A. Eid, Mahmoud Hodeib

Published in: Italian Journal of Pediatrics | Issue 1/2024

Login to get access

Abstract

Background

Autoimmune hepatitis (AIH) is an organ specific autoimmune disease, which can manifest at any age of life. there is a high prevalence of extrahepatic autoimmune diseases in patients with AIH. Autoimmune thyroid diseases (ATDs) are the most frequent extrahepatic autoimmune disorders among patients with AIH. Aim of work is to detect the frequency of ATDs among Egyptian children with AIH.

Methods

This research is a cross-sectional study conducted on 58 children with AIH aged ≤ 18 years. All patients were tested for free triiodothyronine (FT3), free tetraiodothyronine (FT4), thyroid stimulating hormone (TSH), anti-thyroid peroxidase (anti-TPO) and antithyroglobulin (anti-TG). Thyroid ultrasound (US) and thyroid scan were performed for patients with abnormal thyroid profile, borderline values, positive anti-TPO or anti-TG.

Results

The mean ± standard deviation (SD) for the age of the patients was 11.3 ± 4.5 years. Out of 58 patients of AIH, 28 patients (48.3%) had associated other autoimmune diseases. Autoimmune thyroiditis was the most common associated autoimmune disease being present in 10 patients (17.2%). The thyroid status of AIT patients showed that 6 patients (60%) were euthyroid, 3 patients (30%) had subclinical hypothyroidism and only one patient (10%) was hyperthyroid.

Conclusion

Autoimmune hepatitis in Egyptian children is commonly associated with other autoimmune diseases. Autoimmune thyroiditis is the most common to be associated with AIH in pediatric patients. As it is not usually clinically manifesting, regular screening for AIT in children with AIH is mandatory.
Literature
1.
go back to reference Afaa TJ, et al. Clinical characteristics of paediatric autoimmune hepatitis at a referral hospital in Sub Saharan Africa. Plos one. 2020;15(12):e0239964.CrossRefPubMedPubMedCentral Afaa TJ, et al. Clinical characteristics of paediatric autoimmune hepatitis at a referral hospital in Sub Saharan Africa. Plos one. 2020;15(12):e0239964.CrossRefPubMedPubMedCentral
2.
go back to reference Vierling JM. Autoimmune hepatitis and overlap syndromes: diagnosis and management. Clin Gastroenterol Hepatol. 2015;13(12):2088–108.CrossRefPubMed Vierling JM. Autoimmune hepatitis and overlap syndromes: diagnosis and management. Clin Gastroenterol Hepatol. 2015;13(12):2088–108.CrossRefPubMed
3.
go back to reference Khoury T, et al. Thyroid dysfunction is prevalent in autoimmune hepatitis: a case control study. Isr Med Assoc J. 2020;22(2):100–3.PubMed Khoury T, et al. Thyroid dysfunction is prevalent in autoimmune hepatitis: a case control study. Isr Med Assoc J. 2020;22(2):100–3.PubMed
4.
go back to reference Muratori L, Longhi MS. The interplay between regulatory and effector T cells in autoimmune hepatitis: Implications for innovative treatment strategies. J Autoimmun. 2013;46:74–80.CrossRefPubMed Muratori L, Longhi MS. The interplay between regulatory and effector T cells in autoimmune hepatitis: Implications for innovative treatment strategies. J Autoimmun. 2013;46:74–80.CrossRefPubMed
5.
go back to reference Jain V, et al. Concurrent extrahepatic autoimmune disorders: unexplored dimension of autoimmune liver disease in children. Eur J Gastroenterol Hepatol. 2018;30(8):910–7.CrossRefPubMed Jain V, et al. Concurrent extrahepatic autoimmune disorders: unexplored dimension of autoimmune liver disease in children. Eur J Gastroenterol Hepatol. 2018;30(8):910–7.CrossRefPubMed
6.
go back to reference Muratori P, et al. Autoimmune liver disease and concomitant extrahepatic autoimmune disease. Eur J Gastroenterol Hepatol. 2015;27(10):1175–9.CrossRefPubMed Muratori P, et al. Autoimmune liver disease and concomitant extrahepatic autoimmune disease. Eur J Gastroenterol Hepatol. 2015;27(10):1175–9.CrossRefPubMed
7.
go back to reference Betterle C, Zanchetta R. Update on autoimmune polyendocrine syndromes (APS). Acta Biomed. 2003;74(1):9–33.PubMed Betterle C, Zanchetta R. Update on autoimmune polyendocrine syndromes (APS). Acta Biomed. 2003;74(1):9–33.PubMed
8.
go back to reference Fogel R, et al. Extrahepatic autoimmune diseases are prevalent in autoimmune hepatitis patients and their first-degree relatives: survey study. Interact J Med Res. 2018;7(2):e9625.CrossRef Fogel R, et al. Extrahepatic autoimmune diseases are prevalent in autoimmune hepatitis patients and their first-degree relatives: survey study. Interact J Med Res. 2018;7(2):e9625.CrossRef
9.
go back to reference Floreani A, et al. Extrahepatic autoimmunity in autoimmune liver disease. Eur J Intern Med. 2019;59:1–7.CrossRefPubMed Floreani A, et al. Extrahepatic autoimmunity in autoimmune liver disease. Eur J Intern Med. 2019;59:1–7.CrossRefPubMed
12.
go back to reference Foley TP, et al. Hypothyroidism caused by chronic autoimmune thyroiditis in very young infants. N Engl J Med. 1994;330(7):466–8.CrossRefPubMed Foley TP, et al. Hypothyroidism caused by chronic autoimmune thyroiditis in very young infants. N Engl J Med. 1994;330(7):466–8.CrossRefPubMed
13.
go back to reference Skarpa V, et al. Epidemiological characteristics of children with autoimmune thyroid disease. Hormones. 2011;10(3):207–14.CrossRefPubMed Skarpa V, et al. Epidemiological characteristics of children with autoimmune thyroid disease. Hormones. 2011;10(3):207–14.CrossRefPubMed
14.
go back to reference Admoni O, et al. Long-term follow-up and outcomes of autoimmune thyroiditis in childhood. Front Endocrinol. 2020;11:309.CrossRef Admoni O, et al. Long-term follow-up and outcomes of autoimmune thyroiditis in childhood. Front Endocrinol. 2020;11:309.CrossRef
17.
go back to reference Porta G, et al. Autoimmune hepatitis in 828 Brazilian children and adolescents: clinical and laboratory findings, histological profile, treatments, and outcomes. J Pediatr. 2019;95:419–27.CrossRef Porta G, et al. Autoimmune hepatitis in 828 Brazilian children and adolescents: clinical and laboratory findings, histological profile, treatments, and outcomes. J Pediatr. 2019;95:419–27.CrossRef
18.
go back to reference Teufel A, et al. Concurrent autoimmune diseases in patients with autoimmune hepatitis. J Clin Gastroenterol. 2010;44(3):208–13.CrossRefPubMed Teufel A, et al. Concurrent autoimmune diseases in patients with autoimmune hepatitis. J Clin Gastroenterol. 2010;44(3):208–13.CrossRefPubMed
19.
go back to reference Efe C, et al. Autoimmune hepatitis/primary biliary cirrhosis overlap syndrome and associated extrahepatic autoimmune diseases. Eur J Gastroenterol Hepatol. 2012;24(5):531–4.CrossRefPubMed Efe C, et al. Autoimmune hepatitis/primary biliary cirrhosis overlap syndrome and associated extrahepatic autoimmune diseases. Eur J Gastroenterol Hepatol. 2012;24(5):531–4.CrossRefPubMed
20.
go back to reference Wong GW, et al. Concurrent extrahepatic autoimmunity in autoimmune hepatitis: implications for diagnosis, clinical course and long-term outcomes. Liver Int. 2017;37(3):449–57.CrossRefPubMed Wong GW, et al. Concurrent extrahepatic autoimmunity in autoimmune hepatitis: implications for diagnosis, clinical course and long-term outcomes. Liver Int. 2017;37(3):449–57.CrossRefPubMed
21.
go back to reference Kyle UG, Shekerdemian LS, Coss-Bu JA. Growth failure and nutrition considerations in chronic childhood wasting diseases. Nutr Clin Pract. 2015;30(2):227–38.CrossRefPubMed Kyle UG, Shekerdemian LS, Coss-Bu JA. Growth failure and nutrition considerations in chronic childhood wasting diseases. Nutr Clin Pract. 2015;30(2):227–38.CrossRefPubMed
22.
go back to reference Ahmet A, Kim H, Spier S. Adrenal suppression: a practical guide to the screening and management of this under-recognized complication of inhaled corticosteroid therapy. Allergy Asthma Clin Immunol. 2011;7(1):1–12.CrossRef Ahmet A, Kim H, Spier S. Adrenal suppression: a practical guide to the screening and management of this under-recognized complication of inhaled corticosteroid therapy. Allergy Asthma Clin Immunol. 2011;7(1):1–12.CrossRef
23.
go back to reference Guo L, et al. Extrahepatic autoimmune diseases in patients with autoimmune liver diseases: a phenomenon neglected by gastroenterologists. Gastroenterol Res Pract. 2017;2017:2376231.CrossRefPubMedPubMedCentral Guo L, et al. Extrahepatic autoimmune diseases in patients with autoimmune liver diseases: a phenomenon neglected by gastroenterologists. Gastroenterol Res Pract. 2017;2017:2376231.CrossRefPubMedPubMedCentral
26.
go back to reference Wasniewska M, et al. Thyroid function patterns at Hashimoto’s thyroiditis presentation in childhood and adolescence are mainly conditioned by patients’ age. Horm Res Paediatr. 2012;78(4):232–6.CrossRefPubMed Wasniewska M, et al. Thyroid function patterns at Hashimoto’s thyroiditis presentation in childhood and adolescence are mainly conditioned by patients’ age. Horm Res Paediatr. 2012;78(4):232–6.CrossRefPubMed
27.
go back to reference De Vries L, Bulvik S, Phillip M. Chronic autoimmune thyroiditis in children and adolescents: at presentation and during long-term follow-up. Arch Dis Child. 2009;94(1):33–7.CrossRefPubMed De Vries L, Bulvik S, Phillip M. Chronic autoimmune thyroiditis in children and adolescents: at presentation and during long-term follow-up. Arch Dis Child. 2009;94(1):33–7.CrossRefPubMed
28.
go back to reference Aversa T, et al. Phenotypic expression of autoimmunity in children with autoimmune thyroid disorders. Front Endocrinol. 2019;10:476.CrossRef Aversa T, et al. Phenotypic expression of autoimmunity in children with autoimmune thyroid disorders. Front Endocrinol. 2019;10:476.CrossRef
29.
go back to reference Salerno M, Improda N, Capalbo D. Management of endocrine disease subclinical hypothyroidism in children. Eur J Endocrinol. 2020;183(2):R13–28.CrossRefPubMed Salerno M, Improda N, Capalbo D. Management of endocrine disease subclinical hypothyroidism in children. Eur J Endocrinol. 2020;183(2):R13–28.CrossRefPubMed
30.
go back to reference Malik R, Hodgson H. The relationship between the thyroid gland and the liver. QJM. 2002;95(9):559–69.CrossRefPubMed Malik R, Hodgson H. The relationship between the thyroid gland and the liver. QJM. 2002;95(9):559–69.CrossRefPubMed
31.
go back to reference Huang MJ, Liaw YF. Clinical associations between thyroid and liver diseases. J Gastroenterol Hepatol. 1995;10(3):344–50.CrossRefPubMed Huang MJ, Liaw YF. Clinical associations between thyroid and liver diseases. J Gastroenterol Hepatol. 1995;10(3):344–50.CrossRefPubMed
Metadata
Title
Prevalence of autoimmune thyroiditis among children with autoimmune hepatitis
Authors
Engy Adel Mogahed
Hend M. Soliman
Dalia Saber Morgan
Hoda Mohammed Abd Elaal
Rasha Abd El Razek Mahmoud Khattab
Ragaey A. Eid
Mahmoud Hodeib
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Italian Journal of Pediatrics / Issue 1/2024
Electronic ISSN: 1824-7288
DOI
https://doi.org/10.1186/s13052-024-01639-4

Other articles of this Issue 1/2024

Italian Journal of Pediatrics 1/2024 Go to the issue