Cortisol and parathormone levels in juvenile rheumatoid arthritis: relation to interleukin-1 beta and interleukin-6

This study was designed to define the levels of cortisol and parathormone in children with juvenile rheumatoid arthritis [JRA] in relation to disease activity as well as to the levels of the proinflammatory cytokines interleukin-1 beta [IL-l, beta] and interleukin-6 [IL-6]. Thirty six patients [26 females and 10 males; aged 6-12 years; mean 7.3 +/- 1.6 yr] as well as 18 apparently healthy controls were recruited into the study. Patients and controls were subjected to clinical examination and a comprehensive battery of investigations including a complete blood picture, ESR, CRP, serum levels of calcium. phosphorus, alkaline phosphatase, IL-I beta, IL-6 as well as cortisol and parathyroid hormone [PTH]. Serum levels of IL-I, beta and IL-6 were significantly higher in JRA patients than those of the controls [p<0.001]. This rise was more evident in patients with an active disease. On the other hand, serum levels of both cortisol and FTH were significantly lower in patients compared to the controls [p<0.001]. Moreover, there were significant negative correlations between serum levels of both cortisol and PTH with IL-i, 6 and IL-6 as well as other parameters of disease activity [ESR and CRP] [p<0.05 and p<0.001, respectively]. There was also a significant negative correlation between FTH only and serum calcium p<0.05]. Decreased serum values of both cortisol and FTH were demonstrated in the children suffering from JRA, especially those with a high disease activity. This hormonal status may indicate a disturbed homeostasis contributing to a more active disease