ESPE Abstracts

Background: Multiple causes of hyperprolactinemia can be identified in some patients with rheumatic diseases. Prolactin maintains cartilage maintenance, osteogenesis, growth, proliferation and apoptosis as well as the release of proinflammatory mediators by immune cells – events that can both induce and prevent rheumatic diseases. The aim of this study is to analyze the serum prolactin level in patients with juvenile idiopathic arthritis (JIA), and their association with demographic and disease indices.

Methods and materials: The study included 100 children with juvenile idiopathic arthritis. We assessed basal serum prolactin levels in correlation with the JIA duration and activity indices. The JIA diagnosis was established based on the ILAR / ACR criteria.

Results and Discussion: The demographic indexes of subjects in the study revealed: mean age 9.38 years, mean age at onset - 6.4 years, mean disease duration - 5.35 years, gender distribution 1: 1.47. The oligoarticular form was found to be in 43%, the seronegative polyarticular form in 27.6% and the systemic form 24.8%. The JADAS-71 score averaged 23.35 points. Paraclinical findings revealed hyperprolactinemia in 6 of 50 patients (12% of cases; girls: boys = 4: 2). Clinical manifestations of specific conditions with hyperprolactinemia (galactorrhea, disturbance of visual field, pituitary tumor syndrome) have not been identified. In 2 out of 6 patients, periodic headache was noted. Serum prolactin abnormalities correlate with disease activity (JADAS score> 25 points in all cases with hyperprolactinemia) and low onset age (1.5-2.5 years).

According to literature data, prolactin along with estrogen is pro-inflammatory hormones, and high levels in women explain the high proportion of women: men. The correlation of hyperprolactinemia with the indices of the activity of many rheumatologic conditions are still contradictory. Both hypo- and hyperprolactinemia induce immunocompromised conditions. TNFα and IL-6 have the potential to stimulate prolactin secretion, which is another cause of hyperprolactinemia in patients with rheumatic diseases.

Conclusions: In conclusion, elevated serum levels of prolactin in cases of idiopathic juvenile arthritis may possibly suggest its role in autoimmune response. Identification of endocrine comorbidities in juvenile idiopathic arthritis, aims to prevent and limit the impact of disease on child development.