Perfil epidemiológico dos pacientes com vitiligo e sua associação com doenças da tireoide

Abstract

BACKGROUND: Vitiligo is considered the most frequent acquired hypomelanosis. Although its pathogenesis is uncertain, it is believed that autoimmune etiology is the most plausible. This theory is based on the coexistence of vitiligo with autoimmune diseases. Objectives: To describe the epidemiological profile of vitiligo patients and to estimate the prevalence of the association of vitiligo with autoimmune thyroid diseases. Methods: A cross-sectional study was conducted through analysis of the medical records of patients diagnosed with vitiligo in the AME-UNISUL Outpatient Clinic of Dermatology and at HU-UFSC. The clinical and laboratorial characteristics of these patients were assessed. Results: 85 medical records were evaluated; 56 patients were female, with a mean age of 37.14 years and mean onset age of 25.25 years. Vitiligo vulgaris occurred in 70.6%. Autoimmune thyroid diseases were found in 22.4%. Other autoimmune diseases were identified in 5.9%. Patients with positive thyroid autoantibodies showed a probability of extension of vitiligo greater than 25%. There was no statistical difference with regard to the clinical characteristics of vitiligo in patients with or without autoimmune thyroiditis with hormonal change. Conclusion: The findings of this study are similar to those obtained by other authors, showing that autoimmune thyroid diseases are more common in patients with vitiligo. Keywords: Autoimmunity; Thyroid diseases; Vitiligo Resumo: FUNDAMENTO: O vitiligo é considerado a hipomelanose adquirida mais frequente. Apesar de sua etiopatogenia ser incerta, acredita-se que a etiologia autoimune seja a mais plausível, teoria que se fundamenta na concomitância de vitiligo com doenças autoimunes. OBJETIVOS: Traçar o perfil epidemiológico dos pacientes com vitiligo e estimar a prevalência da associação de vitiligo com doenças autoimunes da tireoide. MÉTODOS: Efetuou-se um estudo transversal, analisando-se prontuários dos pacientes com diagnóstico de vitiligo atendidos no Ambulatório de Dermatologia AME-Unisul e do HU-UFSC. Avaliaram-se as características clínicas e laboratoriais desses pacientes. RESULTADOS: Foram avaliados 85 prontuários, sendo 56 do sexo feminino, com idade média de 37,14 anos e idade média de início de 25,25 anos. O vitiligo vulgar ocorreu em 70,6% dos casos. As doenças autoimunes da tireoide foram encontradas em 22,4% dos casos. Outras doenças autoimunes foram identificadas em 5,9% dos casos. Os pacientes com anticorpos antitireoidianos positivos revelaram uma probabilidade elevada de extensão do vitiligo maior que 25%. Não houve diferença estatística quanto às características clínicas do vitiligo em portadores ou não de tireoidite autoimune com alteração hormonal. CONCLUSÃO: Os resultados deste estudo são similares aos de outros autores, mostrando que as doenças autoimunes da tireoide são mais frequentes nos pacientes com vitiligo.

Circulating Autoantibodies and Autoimmune Comorbidities in Vitiligo Patients: A Multicenter Italian Study

“…Results of more recent studies on the association between vitiligo and disorders of the thyroid gland are reported in table 4 [6,7,9,10,12,16,17,18,23,24,28,33,34,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53]. Most surveys involving a control group showed a significant statistical difference in the prevalence of thyroid gland disorders between vitiligo patients and controls.…”

“…These observations are in agreement with the results of our multivariate analysis. Nunes and Esser [41] showed an association between circulating anti-TPO antibodies and late onset of vitiligo. In the multivariate analysis, no association between the presence of circulating anti-TPO antibodies and late onset or clinical subtypes of vitiligo was shown in our sample; this observation is in agreement with the report of Daneshpazhooh et al [39], but not with the data published by Kasumagic-Halilovic et al [42].…”

“…We were not able to detect in the literature any observation regarding a difference between genders concerning anti-TG antibodies. On the contrary, contradictory data exist about the relation between gender and the presence of anti-TPO antibodies in vitiligo patients [7,39,41]. It is well established that anti-TPO antibody (historically referred to as antimicrosomal antibody) is a sensitive tool for the detection of early subclinical autoimmune thyroid disease and for the identification of patients at risk of autoimmune thyroid diseases [56], and it has more correlation with thyroid dysfunction than anti-TG antibody [57]; hence, the detection of anti-TG antibodies in vitiligo patients has probably a limited clinical significance.…”

Comorbidities Associated with Vitiligo: A Ten-Year Retrospective Study

“…The authors attributed this at least in part to higher rates of consanguinity in the Turkish population. The prevalence of thyroid disorders in Brazil, which has a more diverse ethnic population, is lower at 22% [3]. In Asian countries such as Japan [4] and India, the rates of comorbid autoimmune disease are even lower, with several studies from India [5,6,7] showing anywhere from 3% to 11% of vitiligo patients having another autoimmune condition.…”

Autoimmune polyglandular syndromes in the adults: the genetic and immunological diagnostic criteria

“…У пациентов с витилиго, по данным D. Nunes и соавт. [30], повышенный уровень анти-тел к ткани щитовидной железы определяется в 32,8% случаев. Нарушение функции щитовидной железы (клиническое и субклиническое) зареги-стрировано у 22,4% пациентов, из них в 80% -гипо-тиреоз, в 13,3% -тиреотоксикоз, в 6,7% -субкли-нический гипотиреоз.…”