[Features of the ontogenetic forms of rheumatoid arthritis associated with autoimmune thyroiditis.]

Ontogenetic debut of diseases can determine clinico-pathogenetic differences in disease variants. The aim of the study was to determine the clinical and laboratory features of the variants of rheumatoid arthritis (RA) associated with autoimmune thyroiditis (AIT) in patients with various ontogenetic debut of the disease. A total of 53 patients with a combination of RA and AIT (mean age 63,92±1,6 years, 92% of patients - women, duration of rheumatoid arthritis - 10,0±1,11 years, disease activity on the DAS28 scale - 5,67±0,14 points). Patients with the debut of joint syndrome in the reproductive period had the highest antibody titer to the cyclic citrullinated peptide (ACCP) and close correlation between the titer of rheumatoid factor (RF) and tobacco smoking experience. Patients with debut joint syndrome in the menopausal period were characterized by geroprotective status, having the largest number of centenarians in the family and a significant negative correlation between the titre of ACCP and this significative, and also the greatest vulnerability to the action of other trigger factors of arthritis, which was confirmed by a close correlation of specific rheumatoid immunological parameters with smoking experience and the presence of an infectious disease in the period preceding the articulate debut of the RA, and also least rate of glomerular filtration. Patients with the debut of the joint syndrome in the early involutionary period were characterized by the presence of a gerontological immunological phenotype, which was manifested by the highest level of RF in the serum, as well as by the faster course of the disease from the joint debut to the unfolded clinical picture.
Conclusions: The ontogenetic analysis of the features of RA associated with AIT showed the presence of ontogenetic clinico-pathogenetic forms of the disease, which may further have implications for clinical practice.