Thyroid disease common in vitiligo patients

Results from a systematic review and meta analysis suggest that thyroid disease is a common comorbidity in people with vitiligo.

Writing in the British Journal of Dermatology, Charlotte Vrijman (University of Amsterdam, the Netherlands) and colleagues explain that whilst "thyroid disease has been suggested to be associated with vitiligo… the outcomes of prevalence studies on thyroid disease in vitiligo vary widely."

To investigate further, they carried out a literature search and selected 48 studies, including over 24,000 vitiligo patients, published between 1968 and 2011 to include in further analysis. To be included the studies had to include at least 10 segmental or non-segmental vitiligo patients and had to assess the prevalence of any kind of thyroid disease in the study cohort. Some studies had control groups without vitiligo, but not all.

Overall, 33 studies reported the prevalence of thyroid diseases, 19 reported autoimmune thyroid disease, and 28 reported levels of thyroid antibodies. Regarding methodologic quality of the studies, 12% were of good quality, 50% were of fair quality, and 38% were of poor quality.

In the overall pooled cohort, 15.1% of the vitiligo patients had thyroid disease, 14.3% had autoimmune thyroid disease, and 20.8% tested positive for thyroid-specific autoantibodies

Patients with vitiligo were 1.9 times more likely to have thyroid disease, 2.5 times more likely to have autoimmune thyroid disease, and 5.2 times more likely to test positive for thyroid specific antibodies than individuals without vitiligo. The team also noted that risk for thyroid disease seemed to increase with age in vitiligo patients.

"Clinicians should be aware of the increased risk of thyroid disease in vitiligo patients and should be attentive [to] symptoms of thyroid disease," write Vrijman et al.

However, "to recommend… screening of autoimmune thyroid disease in euthyroid vitiligo patients more research on prevalence, cost-effectiveness and burden of the patient is needed," they emphasize.

"Hence, future research of good methodological quality, with differentiation of vitiligo types and the use of standardized outcome measures is recommended."

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