Incidence and Significance of Organ-Specific Autoimmune Disorders (Clinical, Latent or only Autoantibodies) in Patients with Vitiligo

Abstract

The frequency of autoimmune disorders was determined in 373 vitiligo patients and in controls matched for sex, age and race. Vitiligo patients had an increased frequency of clinical autoimmune diseases of thyroid (7.5%), stomach (0.8%), parathyroid (1%), adrenal gland (1.3%). Vitiligo patients, without clinical signs of overt autoimmune diseases, also had a statistically significant increase in the frequency of gastric parietal cell (p < 0.001), thyroid microsomal (p < 0.05) and adrenal autoantibodies (p < 0.05). This increased incidence of autoimmune manifestations was correlated with the duration of vitiligo. Furthermore in 94% of the patients with parietal cell autoantibodies a gastric biopsy showed atrophic gastritis. In addition, in 48% of the patients with thyroid microsomal autoantibodies and in 2 out of 6 patients with adrenal autoantibodies without overt diseases at the beginning of the study, the functional investigation of the target organs during the follow-up allowed the detection of the presence or that of the subsequent development of clinical or subclinical dysfunction.

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

“…From our review of the literature, the presence of different circulating autoantibodies in vitiligo patients varied from 2 to 70% [7,9,10,20,21]; these data are also roughly in agreement with our observations.…”

“…Nevertheless the analysis of existing data is difficult, owing to the heterogeneity of examined samples of patients and the diversity of searched autoantibodies. From our review of the literature, the prevalence of reported autoimmune diseases, according to history and/or clinical and instrumental findings, ranged from 2.7 to 55% [2,6,7,8,9,10,11,12,13,14,15,16,17,18]. The rates of autoimmune comorbidities in vitiligo patients appear to differ based on the population under study, according to ethnic differences [18].…”

Childhood vitiligo: Clinical epidemiological profile

“…In addition, two studies have reported an increased prevalence of various autoantibodies in patients with vitiligo [12,13]. A recent article has reported the presence of thyromegaly, antithyroid antibodies and thyroid dysfunction in significant numbers of children and adolescents with vitiligo [14,15].…”

The Transcription Factors SOX9 and SOX10 Are Vitiligo Autoantigens in Autoimmune Polyendocrine Syndrome Type I

“…In the majority of patients studied with vitiligo and APS I, complement-fixing antibodies directed against melanin-producing cells were identified (27,28). This immunoreactivity was not demonstrated in patients with isolated vitiligo or vitiligo associated with other autoimmune disorders (28) and can be found in patients with APS I many years before the development of vitiligo (29).Sera from patients with APS I are known to contain high titer autoantibodies, which makes APS I a suitable disease model for the identification of autoantigens. We recently demonstrated the presence of immunoreactivity against melanocyte nuclei in both hair follicles and epidermis in APS I patients (30).…”

“…The etiology is largely unknown, but autoimmune mechanisms are thought to be involved. It is associated with various autoimmune disorders (16) such as insulin-dependent diabetes mellitus (17), thyroid disease (18,19), and pernicious anemia (20,21) and is often a component in autoimmune polyendocrinopathies (4) including APS I (1,5). Autoantibodies against melanocytes have been reported in patients with vitiligo unrelated to APS I (22,23), but the major autoantigens in vitiligo are yet to be identified.…”