Thyroid dysfunction in Mexican pediatric patients with vitiligo and its association with clinical characteristics and...

Vitiligo is an autoimmune, polygenic, and multifactorial disorder and the leading cause of acquired depigmentation worldwide. More than 50% of cases begin before 18 years of age, significantly impacting quality of life. It has been associated with other autoimmune diseases, particularly thyroid dysfunction; however, studies in the pediatric population are limited. This study analyzed the frequency of thyroid abnormalities and their relationship with clinical characteristics in Mexican pediatric patients with vitiligo.

A retrospective, cross-sectional, analytic study was conducted in patients <18 years of age with vitiligo treated at the National Institute of Pediatrics (2007-2017). Clinical and demographic data, as well as thyroid function tests and thyroid autoantibodies, were collected. Differences between groups were analyzed using the Chi-square test or Fisher's exact test.

A total of 141 patients were included (49% female), with a mean age at onset of 6.3 ± 3.7 years. Most patients (120, 85%) had non-segmental vitiligo, and 95 (48%) had disseminated disease. Of the 88 patients (62%) who underwent thyroid testing, 30 (34%) had abnormalities, predominantly subclinical hypothyroidism in 18 (20.4%). Thyroid autoantibodies were assessed in 66 patients (46.8%) and were positive in 18 cases (27.3%). Good response (> 50% repigmentation) was achieved in 96 (68%) patients. We found a significant association between non-segmental vitiligo with disseminated disease (p < 0.001), with family history of autoimmunity (p = 0.01), and with thyroid autoantibody positivity (p < 0.001).

This study demonstrated a higher frequency than reported of thyroid dysfunction and positive thyroid autoantibodies in pediatric patients with vitiligo. Although this could represent bias, thyroid and autoantibody screening is recommended at diagnosis in these patients, along with periodic follow-up, to detect early dysfunction and optimize management.