Association of Vitiligo with Other Autoimmune Disorders

Abstract

Objective: To assess the association of Vitiligo with other autoimmune disorders and to see the familial association.Design: Prospective case control study. Material and methods:Hundred cases of vitiligo of all ages and both genders were included in the study. Diagnosis of Vitiligo was done by clinical examination and was confirmed by Wood's lamp examination. Skin biopsy was carried out for standard pathologic examination to help confirm the diagnosis in two cases. The presence of vitiligo in parents and siblings was probed and was recorded. History was taken and physical examination was done to see any evidence of presence of following six autoimmune disorders, alopecia areata, diabetes mellitus, thyroid disorders (both hyper and hypothyroidism), Addison disease, systemic lupus erythematosus and Rheumatoid arthritis. The selected patients were subjected to following tests, blood complete picture, blood glucose levels random and fasting, thyroid function tests (T3, T4 and TSH levels), serum cortisol levels at 0800 hrs. ANA and RA factor in cases of suspected rheumatoid arthritis cases. Fifty cases of chronic eczema reporting in skin outpatient department were taken as control. The control subjects were also studied for the presence of above mentioned autoimmune disorders and the above mentioned laboratory tests were carried out. Results:We analyzed 100 cases of vitiligo, 38 were males and 62 females. The mean age of presentation was 32 ± 17.6 yrs. Positive family history was found in 25 (25%) subjects. Twenty (20%) cases had evidence of presence of other autoimmune disorders. Eight (8%) patients had alopecia areata, 2(2%) patients had insulin dependent diabetes mellitus, 2(2%) patients had RA positive Rheumatoid arthritis, 8(8%) patients had thyroid disorders (5 had hyperthyroidism and 3 had hypothyroidism). In the control group of 50 cases of chronic eczema, 3(6%) cases had the evidence of presence of autoimmune disorders, 2(4%) cases had alopecia areata and 1(2%) case had hyperthyroidism. Conclusion:Vitiligo is strongly associated with other autoimmune disorders and has positive family history. Patients having vitiligo should be looked for other autoimmune disorders especially the thyroid disorders.

Achalasia in a woman presenting with vitiligo: A case report

“…This might explain the increased organ-specific autoimmunity observed in ganglion cell destruction as the mechanism of achalasia, leading to their destruction by T cells. Saleem & Azim (2016) [ 17 ] reported that the frequency of associated autoimmune disorders significantly higher in patients with vitiligo than in the control group study. There are some reports of patients with achalasia responding to immunosuppressive drugs, lending further to the suggestion that this disease has an autoimmune component [ 18 ].…”

Estimate the Serum Level of IL-17A and TGF-?1 1 in Iraqi Generalized Vitiligo Patients

“…Vitiligo is a cutaneous multifactorial disease, affects both sexes equally, higher incidence of females in this study may be result from the greater psychosocial perceived impact of the disease on their life. The presence of positive family history in first degree relative for some patients may indicate a hereditary factor for this disorder (8) .The detection of T-cells infiltration in the perilesional skin of vitiligo macules in previous histopathological studies implicates the cellular immune response in the destruction of melanocytes (9) .Th17 cells play a very important role in the pathogenesis of numerous autoimmune disorders by the production of proinflammatory cytokines includes:IL-17,IL-22 and IL-23, recruit neutrophils, and promote inflammation at the site of infection (10) .In contrast Treg cells inhibit the immune response by the production of anti-inflammatory cytokines include IL-10 and TGF-β which suppress the activity of a variety of immune cells (11) . Several previous studies evaluate the levels of IL-17A and TGF-β1 in the serum of vitiligo patients in alternative countries and reached for the following results: Khan et al (12) reported that the serum level of IL-17A in 45 Indian patients was increased significantly while the serum level of TGF-β1 was decreased significantly as compared with healthy control which came in agreement with the results of this paper.…”

A Study of Association of Diabetes Mellitus and Vitiligo Patients

“…The male: female ratio is 1:1.16. On reviewing various studies conducted on vitiligo by various authors, reported this ratio to be 1:1, 57:76 and 1.19:1 [12][13][14] . Our study is in accordance with other studies.…”

“…After fasting plasma glucose examination, found 16% patients of vitiligo with diabetes mellitus. Previous studies 12,17,18,20 had findings of association of vitiligo and diabetes mellitus. A study 26 showed a significant difference in impaired fasting blood glucose in vitiligo patients.…”