Thyroid autoimmunity in children and adolescents with alopecia areata.
BACKGROUND
Autoimmune thyroiditis (AT) is often associated with alopecia areata (AA) in children and adolescents.


METHODS
Forty-six children (23 girls and 23 boys), with a mean age of 9.9 +/- 3.38 years (2.24-17.5 years), were included in a study to assess thyroid function and thyroid autoantibody formation in AA. The size and function of the thyroid gland [triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and thyrotropin releasing hormone (TRH) test; fluoroimmunologic assay (FIA), Delfia], antithyroglobulin (TAT) and antimicrosomal (MAT) antibodies (microhemagglutination method), thyroid gland ultrasound, and indices of cellular and humoral immunity were assessed.


RESULTS
Thyromegaly was found in 29 children (63%). Increased basal TSH levels were present in six of the 29 (13.3%) and hypothyroid-type stimulated secretion (TRH test) in two (out of 12). TAT was increased in 17 (39.5%) and MAT in 14 (33.3%) children with AA. Thyroid ultrasound examination was suggestive of AT in 13 (34.2%) and typical of AT in five (13.2%) children.


CONCLUSIONS
We diagnosed AT in 22 of 46 children with AA (47.8%). The immune studies revealed increased activated T lymphocytes. We recommend that thyroid gland size and function and antibody formation be examined at the diagnosis of AA and twice a year thereafter.
Kurtev
Alexander
A
Clinic of Pediatric Endocrinology and Diabetes, University Pediatric Hospital, Sofia, Bulgaria. alkurtev@yahoo.com
Iliev
Emil
E
D000293:Adolescent; D000506:Alopecia Areata / Q000150:complications*; D001323:Autoantibodies / Q000097:blood; D017252:CD3 Complex / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D008297:Male; D013601:T-Lymphocytes / Q000378:metabolism; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D013967:Thyroiditis, Autoimmune / Q000150:complications* / Q000276:immunology*; D013972:Thyrotropin / Q000097:blood; D014463:Ultrasonography
D001323:Autoantibodies; D017252:CD3 Complex; D006684:HLA-DR Antigens; C006606:anti-thyroglobulin; D013972:Thyrotropin