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Increased prevalence of chronic autoimmune (Hashimoto's) thyroiditis in children and adolescents with vitiligo

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Background

An increased prevalence of autoimmune (Hashimoto's) thyroiditis in adult patients with vitiligo has been described. This association has scarcely been studied in children.

Objective

We sought to assess children and adolescents with vitiligo for autoimmune thyroid disorder and to identify any predisposing factors of this association.

Methods

In all, 54 children and adolescents (23 boys, 31 girls; mean age 11.4 years) with known vitiligo were studied by physical examination and laboratory studies.

Results

Four patients with vitiligo were already known to have Hashimoto's thyroiditis. In 9 of the remaining 50 patients, autoimmune thyroiditis was revealed at the time of the investigation. Of the 54 patients with vitiligo, 13 (24.1%) had autoimmune thyroiditis as compared with 9.6% of school-aged children from an iodine-replete area of Greece (P = .002). There was no association between thyroiditis and clinical type of vitiligo, age at onset, mean duration of vitiligo, or sex.

Conclusions

Hashimoto's thyroiditis is 2.5 times more frequent among children and adolescents with vitiligo than in a healthy age- and sex-matched population. It usually follows the onset of vitiligo. We propose that children and adolescents with vitiligo should be screened annually for thyroid dysfunction, particularly autoimmune thyroiditis.

Section snippets

Methods

The study was approved by our institutional review board and informal consent was obtained.

In all, 54 children and adolescents (23 boys, 31 girls; mean age 11.4 ± 4.89 years) with vitiligo, who had visited the skin clinic at least once during the last 5 years and lived in the municipality of Athens, Greece, were recalled and re-examined. A detailed personal and family history of thyroid disorder, autoimmune disease, or both was obtained; the age at onset, duration, location, and distribution of

Results

The mean age at onset of vitiligo was 7.7 ± 3.8 years, whereas the duration of the disease before the time of study was 3.7 ± 3.6 years (0.16-15.75). Most of the patients had the vitiligo vulgaris type (30 of 54, 55.6%) followed by the focal (16 of 54, 29.6%) and segmental (8 of 54, 14.8%) types.

Two patients had alopecia areata and celiac disease, respectively, whereas 28 patients had at least one family member, up to second degree, with thyroid disorder, autoimmune disease, or both, including

Discussion

Chronic autoimmune (Hashimoto's) thyroiditis is the most common cause of hypothyroidism in iodine-replete areas of the world. It is, by strict criteria, a histologic diagnosis, characterized by diffuse lymphocytic infiltration with occasional germinal centers, thyroid follicles of reduced size containing sparse colloid, and fibrosis.15 However, in clinical practice, the diagnosis of the disease is based on positive serum thyroid autoantibodies and the characteristic echographic pattern of

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Funding sources: None.

Conflicts of interest: None identified.

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