title: Autoimmune thyroid disease in patients with vitiligo: prevalence study in India.
abstract: OBJECTIVE
  To identify the prevalence of autoimmune thyroid disease (AITD) in Asian Indian patients with vitiligo and to compare the clinical profile between thyroid peroxidase (TPO) antibody-positive and TPO antibody-negative groups.
  
  
  METHODS
  In this cross-sectional, case-controlled study, 50 patients with vitiligo (29 women and 21 men) were included. Patients with previous disorders, irradiation, or surgical procedures involving the thyroid were excluded from the study. All participants underwent a complete physical examination, and a single fasting blood sample was analyzed for thyroid function (triiodothyronine, thyroxine, thyroid-stimulating hormone, and TPO and thyroglobulin antibodies), inflammatory and immunologic markers (erythrocyte sedimentation rate, C-reactive protein, and rheumatoid factor), and serum calcium, phosphorus, and alkaline phosphatase concentrations. All patients underwent thyroid ultrasonography, and the data were analyzed by appropriate statistical methods.
  
  
  RESULTS
  The mean age of the study participants was 42.7 ± 17 years, and 14 of 50 patients (28%) had TPO antibody positivity. A goiter was present in 11 of 50 patients, and the thyroid volume by ultrasonography was similar between the 2 groups. Subclinical hypothyroidism was found in 14 of 50 patients (28%) but more frequently in the TPO antibody-positive group (8 of 14 or 57%) than in the TPO antibody-negative group (6 of 36 or 17%). The prevalence of AITD was 20 of 50 patients (40%) when the TPO antibody-positive group and those with subclinical hypothyroidism were considered collectively. None of the patients had overt hypothyroidism or hyperthyroidism. All other clinical, biochemical, and inflammatory variables did not differ significantly between the TPO antibody-positive and antibody-negative groups.
  
  
  CONCLUSIONS
  Our data showed a 40% prevalence of thyroid disease in patients with vitiligo in India. The risk is exacerbated in patients with thyroid autoimmunity; thus, regular screening of patients with vitiligo for AITD is needed.
authors.affiliation: Department of Endocrinology, Command Hospital, Lucknow Cantt, UP 226002 India. hariendo@rediffmail.com
authors.forename: K V S Hari
authors.initials: KV
authors.lastname: Kumar
authors.forename: Sai
authors.initials: S
authors.lastname: Priya
authors.forename: Ruchita
authors.initials: R
authors.lastname: Sharma
authors.forename: Umesh
authors.initials: U
authors.lastname: Kapoor
authors.forename: Mandeep
authors.initials: M
authors.lastname: Saini
authors.forename: Yudhveer S
authors.initials: YS
authors.lastname: Bisht
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000032:analysis; D001324:Autoantigens; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006042:Goiter / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology; D006801:Humans; D007037:Hypothyroidism / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000503:physiopathology; D007194:India / Q000453:epidemiology; D007453:Iodide Peroxidase / Q000037:antagonists & inhibitors; D033862:Iron-Binding Proteins / Q000037:antagonists & inhibitors; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D013967:Thyroiditis, Autoimmune / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D014463:Ultrasonography; D014820:Vitiligo / Q000208:ethnology / Q000276:immunology / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D015415:Biomarkers; D033862:Iron-Binding Proteins; C006606:anti-thyroglobulin; C056658:TPO protein, human; D007453:Iodide Peroxidase