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ORIGINAL CONTRIBUTIONS
Year : 1990  |  Volume : 56  |  Issue : 4  |  Page : 299-300

Triiodothyronine, thyroxine and thyrotropin levels in vitiligo


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Correspondence Address:
Nishi VK Arora


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  Abstract 

Vitiligo and thyroid disease are well known to be associated. Sera from 22 patients of vitiligo without any clinical evidence for thyroid dysfunction were assayed for triiodothyronine, thyroxine and thyrotropin levels. Six cases showed increased levels for triiodothyronine. This appears to be an adaptive change.


Keywords: Thyroid hormones, Vitifigo


How to cite this article:
Arora NV, Shankar V, Chaudhary S D, Nagpal R K. Triiodothyronine, thyroxine and thyrotropin levels in vitiligo. Indian J Dermatol Venereol Leprol 1990;56:299-300

How to cite this URL:
Arora NV, Shankar V, Chaudhary S D, Nagpal R K. Triiodothyronine, thyroxine and thyrotropin levels in vitiligo. Indian J Dermatol Venereol Leprol [serial online] 1990 [cited 2014 Apr 23];56:299-300. Available from: http://www.ijdvl.com/text.asp?1990/56/4/299/3552


Vitiligo is associated with a large variety of diseases like thyroid disorders, pernicious anaemia, diabetes mellitus, alopecia areata, morphoea, lichen sclerosus, lupus erythematosus, halo nevus, malignant melanoma, rheumatoid arthritis, ulcerative colitis etc.[1] The association of vitiligo and thyroid diseases assumes significance as the incidence of thyroid disease in vitiligo is reported to vary from 0.62-12.5%, approaching even 39% in elderly patients.[2] A common pathogenesis for the two conditions is further suggested by the reported effect of decreased cutaneous oxidation in causing depigmentation in rabbits and chickens by injections of thyroid extract and thyroxine; development of diffuse goiter, increased TSH secretion, hepatosplenomegaly and vitiliginous lesions in a group of factory workers exposed to para­tertiary-butylphenol; increased levels of antithyroglobulin antibodies in vitiligo and association of these two with other disorders of auto-immune origin.[2],[3] Keeping this in view, we have assayed sera from 22 clinically euthyroid cases of vitiligo for circulatory levels of triiodothyronine (T3), thyroxine (T4) and thyrotropin (TSH).


  Material and Methods Top


The present study was done on 22 vitiligo patients and 10 healthy controls. The cases of vitiligo included 14 males and 8 females with the mean ages of 27.4 and 23.1 years respectively. Fifteen cases (10 males, 5 females) had generalised lesions, while 7 (4 males, 3 females) had localised disease. A careful history and examination ruled out any other associated disorder and use of any drug(s) which could influence their thyroid state. Blood samples were drawn after an overnight fast. T3, T4 and TSH were assayed in each sample using radio-immune-assay and the results were expressed in terms of ng/dl, µg/dl and micro-units/ml respectively.


  Results Top


Six cases comprising 4 males and 2 females showed higher T3 values. All of them had generalized vitiligo. T4 and TSH levels were normal in all the cases. In the control group, the respective values for T3, T4 and TSH were within the normal ranges of 70 to 220 ng/dl, 4.7 to 11.0 µg/dl and 0-10 units/ ml. The circulatory levels of T3, T4 and TSH in vitiligo patients are given in [Table - 1], while the corresponding values of control group are given in [Table - 2].


  Comments Top


In our series, none of the patients had clinical evidence of thyroid disorder. Still, higher values for T3 were recorded in 6 patients who otherwise had a normal level of thyroxine and thyrotropin. This condition has been termed "T3-toxicosis'[4] and it can occur either due to a mild or early hyperthyroidism, or during treatment of hyperthyroid state. Since none of our patients was on any drug therapy, it must be a mild adaptive changetowards hyperthyroid state. On the other hand, a mild hypothyroid state due to a non-thyroidal illness leads to lowering of T3values although these are within the normal range.[5] Normal levels of T4 in all of our cases indicate that this major secretory product of thyroid gland is not influenced by vitiligo. TSHvalues are considered to be the best indicator of thyroid disease in vitiligo. Since none of our cases showed any derangement of TSH level, it confirms their clinically euthyroid status. Therefore, the changes in other thyroid hormone levels in vitiligo are merely an adaptive response to non-thyroidal illness. However, it is necessary to follow such patients for a longer period to look for the development of overt thyroid dysfunction and also to note whether these adaptive changes are reversed on successful treatment of vitiligo.

 
  References Top

1.Cunliffe WJ, Hall R, Newell DJ et al : Vitiligo, thyroid disease and auto-immunity, Brit J Dermatol, 1968; 80 : 135-139.  Back to cited text no. 1    
2.Mosher IB, Fitzpatrick TB, Ortonne JP et al Disorders of pigmentation in : Dermatology in General Medicine, Third ed, Editors, Fitzpatrick TB, Eisen AZ, Wolff K et al : Mc Graw-Hill Book Company, New York, 1987; 794-876.  Back to cited text no. 2    
3.Brostoff J, Bor S and Feiwel M : Autoantibodies in patients with vitiligo, Lancet, 1969; 11 : 117-178.  Back to cited text no. 3    
4.Kaplan MM : Clinical and laboratory assessment of thyroid abnormalities, Med Clin N Amer, 1985; 69 : 863-880.  Back to cited text no. 4    
5.Bermudez F, Surks MI and Oppenheimer JH High incidence of decreased serum triiodothyronine concentration in patients with nonthyroidal disease, J Clin Endocrinol Metabol, 1975: 41 : 27-40.  Back to cited text no. 5    


    Tables

[Table - 1], [Table - 2]



 

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