TOPLINE

Thyroid disease was more common among children and adolescents with vitiligo than among those without vitiligo in the general population, a meta-analysis showed. The prevalence was higher in patients with nonsegmental vitiligo (NSV) than in those with segmental vitiligo (SV), and the most frequently observed abnormalities were antithyroid antibody positivity and elevated thyroid-stimulating hormone (TSH) levels.

METHODOLOGY

• A systematic review included 27 studies conducted across 15 countries, involving 6291 children and adolescents with vitiligo aged 19 years or younger; 19.4% of the patients had SV, and 80.6% of the patients had NSV or mixed or unclassified vitiligo.
• The studies were identified from the PubMed and Cochrane databases. Data on thyroid disease prevalence, testing methods, and clinical characteristics were extracted.
• The review included 22 cross-sectional or observational studies (11 retrospective and 11 prospective), three cohort studies, and two case-control studies.
• The definition of thyroid disease included hypothyroidism, hyperthyroidism, subclinical hypothyroidism, autoimmune thyroid disease, isolated laboratory abnormalities (involving triiodothyronine [T3], thyroxine [T4], free T3, free T4, TSH, antithyroid peroxidase [anti-TPO] antibodies, antithyroglobulin [anti-TG] antibodies, or thyrotropin-releasing hormone), thyroid ultrasound abnormalities, or a personal history of thyroid disease.
• A random-effects meta-analysis was conducted, including 17 studies reporting the prevalence of thyroid disease.

TAKEAWAY

• The mean age at vitiligo onset was 7 years (16 studies), and the mean disease duration was 1.9 years (14 studies).
• Among the included patients with vitiligo, 571 had thyroid dysfunction; per-study prevalence rates vitiligo with concomitant thyroid disease varied from 0% to 55.3%. The pooled prevalence estimate of thyroid disease was 10.8% (95% CI, 7.4%-15.5%), with high heterogeneity across the included 17 studies. A higher proportion of girls with vitiligo had concomitant thyroid disease than boys with vitiligo (ratio, 1.43:1; eight studies).
• Thyroid disease was more common in patients with NSV than in those with SV (15.9% vs 0.8%; 11 studies). Thyroid disease was not associated with age, sex, disease duration or activity, or a family history of thyroid disease or vitiligo.
• Among the tested patients with vitiligo (n = 2860), the most common abnormality was antithyroid antibody positivity, reported in 13.5% of these patients; anti-TG antibody positivity and anti-TPO antibody positivity were reported in 3.7% and 6.1% of these patients, respectively. TSH levels were elevated in 6.3% of these patients.

IN PRACTICE

"Baseline and periodic thyroid testing for children with NSV is recommended, including TSH, anti-TPO, and TG antibodies," the authors wrote.

SOURCE

The study was led by Minu Jose Chiramel, Icahn School of Medicine at Mount Sinai, New York City. It was published online on September 14 in Pediatric Dermatology.

LIMITATIONS

The study was limited by heterogeneity of ages in the included studies, absence of inclusion criteria in a few studies, and inconsistent specification of diagnostic parameters for thyroid disease. Additionally, the course of thyroid disease in adults who had childhood-onset vitiligo was not examined in most studies.

DISCLOSURES

The study did not receive any specific funding. One author reported advisory or investigator relationships with Lilly, Loreal, Pelthos, Pfizer, Regeneron, Sanofi, and Verrica, outside this work. The other authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.