Vitiligo is a chronic disease characterized by the dysfunction or destruction of melanocytes with secondary depigmentation. The aim of the present study was to determine the prevalence of vitiligo associated with autoimmune rheumatic diseases. The clinical records from a 10-year database of patients with rheumatic diseases and associated vitiligo was analysed, with one group of patients having autoimmune rheumatic disease and another non-autoimmune rheumatic disease. Available serum samples were used to assess the anti-melanocyte antibodies. A total of 5,251 individual clinical files were archived in the last 10 years, and these patients underwent multiple rheumatology consultations, with 0.3% of the group presenting with vitiligo. The prevalence of vitiligo in the autoimmune rheumatic disease group was 0.672%, which was mainly associated with lupus and arthritis. However, patients with more than one autoimmune disease had an increased relative risk to develop vitiligo, and anti-melanocyte antibodies were positive in 92% of these patients. By contrast, the prevalence was 0.082% in the group that lacked autoimmune rheumatic disease and had negative autoantibodies. In conclusion, the association between vitiligo and autoimmune rheumatic diseases was relatively low. However, the relative risk increased when there were other autoimmune comorbidities, such as thyroiditis or celiac disease. Therefore, the presence of multiple autoimmune syndromes should be suspected.

In 1972, Sharp et al described the mixed connective tissue disease; such a description corresponded to an apparently distinct rheumatic disease syndrome associated to U1RNP, which is an extractable nuclear antigen or ENA (1). After this clever description, different overlap syndromes that did not meet the EMTC criteria were described. Conceptually Alarcón-Segovia coined the term of “shared autoimmunity”, which was defined by the presence of two or more data compatible with autoimmune disease; such category of disease describes signs or symptoms of certain autoimmune connective diseases, for instance Rupus corresponds to lupus erythematosus associated..

Background: The autoimmunity associated with environmental pollutants such as heavy metals is a phenomenon that has been described previously. The aim of the present study investigated the relationship between autoimmunity and lead pollutants in a cohort of children who lived in a mining settlement. Methods: Children were studied clinically and serologically. The serum lead concentration was measured by atomic absorption spectrometry, and antinuclear antibodies were analysed by immunofluorescence, ELISA and Western blot. Results: None of the studied children displayed any autoimmune disease. The lead concentration in the control group was negligible, at 0.10 ± 011 µg. L -1 . In contrast, the study group had values of 12.72 ± 0.5 µg. L -1 . The differences between the groups were significant (p< 0.0001). In addition, control sera were negative for antinuclear antibodies (ANA), while the sera of children living near the mining settlement showed ANA-positive titres (p< 0.001). These autoantibodies mainly recognized antigens associated with dividing cells, such as the mitotic apparatus and centrioles. Conclusion: The present results show how metallic pollutants induce environmentally associated autoimmunity and are reflected by antinuclear antibodies. This research should prompt us to take greater caution and implement permanent monitoring to ensure a healthy environment.

No abstract

No abstract