Diabetes Case Reports

Abstract

Association of Vitiligo with Other Autoimmune Disorders

Khawer Saleem and Waqar Azim

Objective: To assess the association of Vitiligo with other autoimmune disorders and to see the familial association. Design: Prospective case control study. Duration and place of study: Jan 2005 to Jan 2007. Skin department PNS Shifa Hospital Karachi. 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.