Dr. Amal Hussein Ahmed, Dr. Hesham Ahmed Nada, Dr. Fadia Mustafa Ateya, Rana Mohammed Al Alfy*


Background: Vitiligo is an idiopathic disorder characterized by depigmented patches in skin because of loss of melanocytes. Death of the pigment cells may be caused by factors from inside and/or outside the cell and there are many potential systems that could be involved. However, the exact cause of destruction of epidermal melanocytes is complex and not yet fully understood. Vitiligo is a relatively common dermatologic finding observed since ancient times. It presents as an idiopathic acquired skin disease, characterized by pearly-white macules of different shapes and sizes, with a tendency to increase in size centrifugally. For this reason, diagnosis is mainly clinically established. Vitiligo often precedes the clinical manifestations of thyroid gland dysfunction. Thus, screening of vitiligo patients to identify at-risk cases for autoimmune thyroid diseases and for early detection of subclinical autoimmune thyroid diseases becomes relevant and necessary. Objectives: 1. To assess the level of thyroid auto-antibodies (anti-TPO) in serum of vitiligo patients as a sensitive marker of autoimmune thyroid disease. 2. To assess the correlation between the level of anti TPO with the severity of vitiligo. Materials & Methods: This study is a case control study was conducted in Dermatology clinic of Suez Canal University Hospital at Ismailia city Egypt from March 2016 to march 2017. Case group include 40 patients with vitiligo and control group include 40 healthy volunteers who are matched with vitiligo patients for age and gender without vitiligo or family history of vitiligoand informed consent was obtained from every participant in this study. Result: the mean and SD of age in the all study population was 38.40 ± 12.86 with a non-statistically significant difference in between the two groups. Genders distribution among the study population was (case group 60% females &40% males while in control group 62.5% females & 37.5% males) with a statistically significant difference in between both groups. Regarding disease severity; the mean (VASI score) was 51.25 ±22.03 in cases with high anti-TPO and 25.10± 19.17 in cases with normal anti-TPO levels with a statistically significant difference in between the two groups and there is a significant correlation between disease severity and other variables in the study including TSH, FT3, and FT4 anti-TPO levels. In our study anti-TPO level was high (+ve) in 7 cases (17.5%) with vitiligo. The mean and SD of anti- TPO was 16.22 ± 39.84 in case group and 0.48± 0.18 in control group, the difference was statistically significant (p value = (0.015). Anti-TPO was significantly correlated with the following variables: FT3, TSH, Disease duration and Disease severity. Conclusion: This study confirmed that the commonest thyroid disorder related to vitiligo is autoimmune subclinical hypothyroidism that is shown by the significant increase in positivity of both anti TPO and increase in TSH level in vitiligo patients than in normal controls.

Keywords: Vitiligo, Thyroid, anti TPO, Free T3, TSH, VASI score, Free T4.

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