ISSN: 1301-2193 E-ISSN: 1308-9846
  • Turkish Journal of
    Endocrinology and Metabolism
ORIGINAL ARTICLE

Thyroid Dysfunction in Alopecia Areata
Alopesi Areatada Tiroid Disfonksiyonu
Doi: 10.25179/tjem.2018-63547 - Makale Dili: EN
Turk J Endocrinol Metab 2019;23:92-96
ABSTRACT
Objective: Alopecia areata is commonly associated with autoimmune disorders such as thyroid dysfunction. This paper aims to evaluate thyroid dysfunction in alopecia areata patients among the Iranian population. Material and Methods: In this case-control study, 80 alopecia areata patients were recruited along with 122 age and sex-matched healthy subjects; serum thyroid stimulating hormone and anti-thyroid peroxidase levels were then compared between the groups. Results: All alopecia areata patients had similar rate of increased thyroid stimulating hormone (10% vs. 8.2%, p=0.66) and anti-tiroid peroksidaz levels (15.6% vs. 23.8%, p=0.14) as compared to the controls. Patients with disease duration >6 months had significantly higher anti-tiroid peroksidaz levels (42.9% vs. 16.9%, p=0.01), with no difference in thyroid stimulating hormone levels (19% vs. 6.8%, p=0.1). Female patients also had higher abnormal anti-tiroid peroksidaz levels (35% vs. 12.5%, p=0.01) compared to the males. Conclusion: Thyroid stimulating hormone and thyroid antibodies are not significantly increased in alopecia areata patients when compared to the normal population. Thyroid antibodies, however, were found to be increased in females and with the progression of disease duration. Therefore, thyroid function and antibodies must be evaluated in alopecia areata patients, especially in females, and along different time periods in individuals having the disease for a long time.
ÖZET
Amaç: Alopesi areata, tiroid disfonksiyonu gibi otoimmün bozukluklarla sıklıkla ilişkilidir. Bu çalışmada, İran populasyonunda alopesi areata hastalarındaki tiroid disfonksiyonunun değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu vaka kontrol çalışmasına 80 alopesi areata hastası ile yaş ve cinsiyet uyumlu 122 sağlıklı birey alındı, daha sonra da gruplar arasında serum tiroid stimüle edici hormon ve anti-tiroid peroksidaz düzeyleri karşılaştırıldı. Bulgular: Kontrol grubu ile karşılaştırıldığında, alopesi areata hastalarının hepsinde tiroid stimüle edici hormon (%10’a karşı %8,2; p=0,66) ve anti-tiroid peroksidaz düzeylerinde (%15,6’ya karşı %23,8; p=0,14) benzer oranda artış mevcuttu. Hastalık süresi >6 ay olan hastalarda antitiroid peroksidaz düzeyleri (%42,9’a karşı %16,9; p=0,01) anlamlı olarak daha yüksekti, tiroid stimüle edici hormon düzeyleri (%19’a karşı %6,8; p=0,1) arasında ise fark bulunmadı. Kadın hastalarda, erkeklere göre daha yüksek anormal anti-tiroid peroksidaz düzeyleri (%35’e karşı %12,5; p=0,01) mevcuttu. Sonuç: Tiroid stimüle edici hormon ve tiroid antikorları, alopesi areata hastalarında normal popülasyona göre anlamlı olarak artmamıştır. Bununla birlikte, tiroid antikorlarının, kadınlarda ve hastalık süresinin ilerlemesi ile arttığı bulunmuştur. Bu nedenle, alopesi areata hastalarında tiroid fonksiyonu ve antikorları, özellikle kadınlarda ve uzun süre hastalığı olan bireylerde farklı zaman periyotlarında değerlendirilmelidir.
KAYNAKLAR
  1. Kasumagić-Halilović E. Thyroid autoimmunity in patients with alopecia areata. Acta Dermatovenerol Croat. 2008;16:123-125.
  2. Baars MP, Greebe RJ, Pop VJ. High prevalence of thyroid peroxidase antibodies in patients with alopecia areata. J Eur Acad Dermatol Venereol. 2013;27:e137-e139. [Crossref] [PubMed]
  3. Rahnama Z, Farajzadeh S, Mohamamdi S, Mqasoudi MA. Prevalence of thyroid disorders in patients with alopecia areata. Journal of Pakistan Association of Dermatology. 2016;24:246-250.
  4. Dilas LT, Icin T, Paro JN, Bajkin I. Autoimmune thyroid disease and other non-endocrine autoimmune diseases. Med Pregl. 2011;64:183-187. [Crossref] [PubMed]
  5. Alkhalifah A, Alsantali A, Wang E, McElwee KJ, Shapiro J. Alopecia areata update: part I. Clinical picture, histopathology, and pathogenesis. J Am Acad Dermatol. 2010;62:177-188. [Crossref] [PubMed]
  6. Guo H, Cheng Y, Shapiro J, McElwee K. The role of lymphocytes in the development and treatment of alopecia areata. Expert Rev Clin Immunol. 2015;11:1335-1351. [Crossref] [PubMed] [PMC]
  7. Gilhar A, Etzioni A, Paus R. Alopecia areata. N Engl J Med. 2012;366:1515-1525. [Crossref] [PubMed]
  8. Huang KP, Mullangi S, Guo Y, Qureshi AA. Autoimmune, atopic, and mental health comorbid conditions associated with alopecia areata in the United States. JAMA Dermatol. 2013;149:789-794. [Crossref] [PubMed]
  9. Dainichi T, Kabashima K. Alopecia areata: what’s new in epidemiology, pathogenesis, diagnosis, and therapeutic options? J Dermatol Sci. 2017;86:3-12. [Crossref] [PubMed]
  10. Seyrafi H, Akhiani M, Abbasi H, Mirpour S, Gholamrezanezhad A. Evaluation of the profile of alopecia areata and the prevalence of thyroid function test abnormalities and serum autoantibodies in Iranian patients. BMC Dermatol. 2005;5:11. [Crossref] [PubMed] [PMC]
  11. Wang H, Gan H, Mei L, Yang G, Fang F. The association between alopecia areata and thyroid autoimmunity in Chinese adult patients: a controlled study. Biomedical Research. 2017;28:3517-3521.
  12. Kaur G, Kuldeep CM, Bhargava P, Mathur DK, Sharda S, Chaturvedi P. Insignificant correlation between thyroid hormone and antithyroid peroxidase antibodies in alopecia areata patients in Northern Rajasthan. Int J Trichology. 2017;9:149-153. [Crossref] [PubMed] [PMC]
  13. Bin Saif GA. Severe subtype of alopecia areata is highly associated with thyroid autoimmunity. Saudi Med J. 2016;37:656-661. [Crossref] [PubMed] [PMC]
  14. Bakry OA, Basha MA, El Shafiee MK, Shehata WA. Thyroid disorders associated with alopecia areata in egyptian patients. Indian J Dermatol. 2014;59:49-55. [Crossref] [PubMed] [PMC]
  15. Park SM, Oh YJ, Lew BL, Sim WY. The association between thyroid dysfunction, thyroid autoimmunity, and clinical features of alopecia areata: a retrospective study. J Am Acad Dermatol. 2018 May 9. Doi: 10.1016/j.jaad.2018.04.051. [Epub ahead of print]. [Crossref]
  16. Lee S, Lee YB, Kim BJ, Lee WS. Screening of thyroid function and autoantibodies in patients with alopecia areata: a systematic review and metaanalysis. J Am Acad Dermatol. 2018;80:14101413.e4. [Crossref] [PubMed]
  17. Lazarus JH, Premawardhana LD. Screening for thyroid disease in pregnancy. J Clin Pathol. 2005;58:449-452. [Crossref] [PubMed] [PMC]
  18. Saylam Kurtipek G, Cihan FG, Erayman Demirbaş Ş, Ataseven A. The frequency of autoimmune thyroid disease in alopecia areata and vitiligo patients. Biomed Res Int. 2015;2015:435947. [Crossref] [PubMed] [PMC]
  19. Gönül M, Gül Ü, Pişkin E, Piskin E, Cakmak SK, Soylu S, Kilic A, Biyikli Z. Alopesi areatali hastaların geriye dönük değerlendirilmesi. Turkish J Dermatol. 2011;5:43-47. [Crossref]