DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20170803

Prevalence of thyroid dysfunction and anti-thyroid peroxidase antibodies in vitiligo patients

Jishna P., M. P. Binitha, Abdul Latheef E. N., V. P. Anilakumari

Abstract


Background: Vitiligo is associated with various autoimmune diseases, including autoimmune thyroid disease. The objectives of the present study was to determine the prevalence of thyroid dysfunction and anti-thyroid peroxidase antibodies in patients with vitiligo, and to compare the clinical profile of anti-thyroid peroxidase positive and anti-thyroid peroxidase negative patients.

Methods: A cross-sectional comparative study was conducted in 100 patients with vitiligo and 100 controls. After dermatologic and systemic evaluation, serum thyroid hormones and anti-thyroid peroxidase antibody levels were measured in all the subjects.

Results: Thyroid dysfunction was more common in the vitiligo group (27%) than in the controls. Serum thyroid stimulating hormone abnormalities were more common in the vitiligo group (27%) than in the controls (6%). The most common thyroid dysfunction was subclinical hypothyroidism. Anti-thyroid peroxidase antibody positivity was higher in the vitiligo group (36%) when compared to the controls (24%), and the most common type of vitiligo was vitiligo vulgaris (18%) in this group. Thyroid dysfunction and anti-thyroid peroxidase positivity were more common in women (58%) when compared to men (42%). There was a significantly higher prevalence of other autoimmune diseases in the vitiligo group (20%) compared to the controls (6%).

Conclusions: This study shows a significant association between vitiligo and thyroid dysfunction, anti-thyroid peroxidase antibodies and other autoimmune diseases. We recommend that thyroid evaluation and regular follow-up should be done in patients with vitiligo for prompt detection of thyroid dysfunction.


Keywords


Vitiligo, Thyroid dysfunction, Autoimmune thyroid diseases

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References


Gopal KV, Rama Rao GR, Kumar YH, Appa Rao MV, Vasudev P. Vitiligo: a part of a systemic autoimmune process. Indian J Dermatol Venerol Leprol. 2007;73:162-5.

Daneshpazhooh M, Mostofizadeh GM, Bhjati, Akhjani M, Roberto RM. Antithyroid peroxide antibody in vitiligo: a controlled study. BMC Dermatol. 2006;6:3.

Agarwal S, Ojha A, Gupta S. Profile of Vitiligo in Kumaun Region of Uttarakhand, India. Indian J Dermatol. 2014;59:209.

Arycan O, Koç K, Ersoy L. Clinical characteristics in 113 Turkish vitiligo patients. Acta Dermato-venerol Alp Pannonica Adriat. 2008;17:129-32.

Holthausen-NunesH, Esser LMH. Vitiligo epidemiological profile and the association with thyroid disease. An Bras Dermatol. 2011;86:241-8.

Dogra S, Pasard D, Handa S, Kanwar AJ. Late onset vitiligo: A study of 182 patients. Int J Dermatol. 2005;44:193-6.

Mehta NR, Shaha KC, Theodore C, Vyas V, Patel A. Epidemiological study of vitiligo in Surat area, South Gujarat. Indian J Med Res. 1973;61:145–54.

Das SK, Mazumdar PP, Chakraborty R, Majumdar TK, Haldar B. Studies on vitiligo; Epidemiological profile in Calcutta, India. Genet Epidemiol. 1985;2:71–8.

Liu JB, Li M, Yang S, Gui JP, Wang HY, Du WH, et al. Clinical profiles of vitiligo in China: an analysis of 3742 patients. Clin Exp Dermatol. 2005;30:327-31.

Anstey AV. Disorders of skin color. In: Burns T, Breathnach S, Cox N, Griffith C, editors. Rook’s Text Book of Dermatology. 8th edition. England: John Wiley & son Ltd; 2010: 58.46.

Ingordo V, Gentile C, Iannazzone SS, Cusano F, Naldi L. The 'Epilist' Project: a dermo-epidemiologic study on a representative sample of young Italian males. Prevalence of selected pigmentary lesions. J Eur Acad Dermatol Venereol. 2007;21:1091-6.

Dave S, D'Souza M, Thappa DM, Reddy KS, Bobby Z. High frequency of thyroid dysfunction in Indian patients with vitiligo. Indian J Dermatol. 2003;48:68-72.

Silva CMR, Pereira LB, Gontijo B, Ribeiro GB. Childhood vitiligo: clinical and epidemiological characteristics. An Bras Dermatol. 2007;82:47-51.

Birlea SA, Fain PR, Spritz RA. A Romanian population isolate with high frequency of vitiligo and associated autoimmune diseases. Arch Dermatol. 2008;144:310-6.

Laberge G, Mailloux CM, Gowan K, Holland P, Bennett DC, Fain PR, et al. Early disease onset and increased risk of other autoimmune disease in familial generalized vitiligo. Pigment Cell Res. 2005;18:300-5.

Boisseau-Garsaud AM, Garsaud P, Calés-Quist D, Hélénon R, Quénéhervé C, Claire RC. Epidemiology of vitiligo in the French West Indies (Isle of Martinique). Int J Dermatol. 2000;39:18-20.

Dumont JE, Roger PP, Ludgate M. Assays for thyroid growth immunoglobulins and their clinical implications: methods, concepts and mis-conceptions. Endocr Rev. 1987;8:448-52.

Kemp EH. Autoantibodies as diagnostic and predictive markers of vitiligo. Autoimmunity. 2004;37:287-90.

Dumont JE, Roger PP, Ludgate M. Assays for thyroid growth immmunoglobulins and their clinical implications: methods, concepts and implications. Endocr Rev 1987;8:448- 52.

Palit A, Inamadar AC. Childhood vitiligo. Ind J Dermatol Venerol Leprol. 2012;72(1):30- 41.

Zettinig G, Tanew A, Fischer G, Mayr W, Dudczak R, Weissel M. Autoimmune diseases in vitiligo: do anti-nuclear antibodies decrease thyroid volume? Clin Exp Immunol. 2003;131:347-54.

Kakourou T, Kanaka- Gantenbein C, Papadopolou A, Kaloumenou E, Chrousos GP. Increased prevalence of chronic autoimmune (Hashimoto's) thyroiditis in children and adolescents with vitiligo. J Am Acad Dermatol. 2005;53:220-3.

Alkhateeb A, Fain PR, Thody A, Bennett DC, Spritz RA. Epidemiology of vitiligo and associated autoimmune diseases in Caucasian probands and their families. Pigment Cell Res. 2003;16:208-14.

Sedighe M, Gholamhossein G. Thyroid dysfunction and thyroid antibodies in Iranian patients with vitiligo. Indian J Dermatol. 2008;53:9–11.

Tanioka M, Yamamoto Y, Katoh M, Takahashi K, Miyachi Y. Vitiligo vulgaris and autoimmune diseases in Japan: A report from vitiligo clinic in Kyoto University Hospital. Dermatoendocrinol. 2009;1:43–5.

Flores-Rebollar A, Moreno-Castañeda L, Vega-Servín NS, López-Carrasco G, Ruiz-Juvera A. Prevalence of autoimmune thyroiditis and thyroid dysfunction in healthy adult Mexicans with a slightly excessive iodine intake. Nutr Hosp. 2015;32:918-24.

Betterle C, Peserico A, Bersani G. Vitiligo and autoimmune polyendocrine deficiencies with autoantibodies to melanin-producing cells. Arch Dermatol. 1979;115:364

Lacovelli P, Sinagra JL, Vidolin AP, Marenda S, Capitanio B, Leone G, et al. Relevance of thyroiditis and of other autoimmune diseases in children with vitiligo. Dermatol. 2005;210:26-30.

Kumar KV, Priya S, Sharma R, Kapoor U, Saini M, Bisht YS. Autoimmune thyroid disease in patients with vitiligo: prevalence study in India. Endocr Pract. 2012;18:194-9.

Khan FA, Al-Jameil N, Khan MA, Al-Rashid M, Tabassum H. Thyroid dysfunction: an autoimmune aspect. Int J Clin Exp Med. 2015;8:6677-81.

Jin Y. Variant of TYR and auto immunity susceptibility loci in generalized vitiligo. New Engl J Med. 2010;362:1686-97.

Bolaert K, Newby PR, Simmonds MJ, Holder RL, Carr- Smith JD, Heward JM, et al. Prevalence and Relative Risk of Other Autoimmune Diseases in Subjects with Autoimmune Thyroid Disease. Am J Med. 2010;123:183.