中国东部白癜风患儿：基于甲状腺功能测试和免疫学结果的145例异常情况
Pediatric Patients with Vitiligo in Eastern China: Abnormalities in 145 Cases Based on Thyroid Function Tests and Immunological Findings.
作者信息
Xianfeng Cheng, Yuegen Jiang, Zhiyu Yin, Yan Yang, Xuesi Zeng, Fenglai Wang, Ansheng Li, Wei Wang
机构信息
Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union, Nanjing, Jiangsu, China (mainland).
Department of Anaesthesia, Xuzhou Medical College, Xuzhou, Jiangsu, China (mainland).
出版信息
Med Sci Monit. 2015 Oct 23;21:3216-21. doi: 10.12659/msm.894981.
BACKGROUND
The aim of this study was to evaluate abnormalities in thyroid function according to tests and the humoral immune systems of patients from Eastern China with pediatric vitiligo.
MATERIAL AND METHODS
A total of 145 pediatric patients with vitiligo were investigated in this study, along with 59 children without autoimmune diseases as controls. Laboratory tests of thyroid function were conducted, and these tests examined free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), thyroglobulin antibody (TG-Ab), thyroid peroxidase antibody (TPO-Ab), antinuclear antibodies (ANAs), immunoglobulins (IgA, IgM, and IgG), and complements (C3 and C4).
RESULTS
A total of 63 patients (43.4%), including 39 boys (44.3%) and 24 girls (42.1%), displayed abnormalities in thyroid function according to the tests. This finding indicated that patients with vitiligo differed significantly from those in the control group (P<0.001), particularly in terms of FT3 and TSH abnormalities (P<0.05). However, these groups did not deviate significantly with respect to FT4, Tg-Ab, and TPO-Ab abnormalities (P>0.05). Thirteen patients (8.9%) and 1 (1.7%) control were positive for ANA. All 12 specific antibodies were detected in 8 patients. Anti-SSA/Ro-60 and anti-SSA/Ro-52 were the most prevalent antibodies, followed by anti-dsDNA and then by anti-SmD1 and CENB-P. The serum levels of IgA and IgG decreased more significantly in the vitiligo group than in the control group (P<0.001). However, no significant difference was observed in terms of IgM levels (P>0.05). C4 serum levels also decreased more significantly in the vitiligo group than in the control group (P=0.035).
CONCLUSIONS
Results suggest that the incidence of abnormalities in the thyroid functions of children and adolescents is significantly higher in those with vitiligo than that in those in the control group. In addition, immunological dysfunction is common in the vitiligo group.
背景
本研究旨在根据检测结果及体液免疫系统评估中国东部地区儿童白癜风患者的甲状腺功能异常情况。
材料与方法
本研究共调查了145例儿童白癜风患者，并选取59例无自身免疫性疾病的儿童作为对照。进行了甲状腺功能的实验室检测，检测项目包括游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）、甲状腺球蛋白抗体（TG-Ab）、甲状腺过氧化物酶抗体（TPO-Ab）、抗核抗体（ANA）、免疫球蛋白（IgA、IgM和IgG）以及补体（C3和C4）。
结果
根据检测结果，共有63例患者（43.4%）甲状腺功能异常，其中男孩39例（44.3%），女孩24例（42.1%）。这一结果表明，白癜风患者与对照组患者存在显著差异（P<0.001），尤其是在FT3和TSH异常方面（P<0.05）。然而，在FT4、Tg-Ab和TPO-Ab异常方面，两组之间无显著差异（P>0.05）。13例患者（8.�%）ANA检测呈阳性，对照组有1例（1.7%）呈阳性。8例患者检测出了所有12种特异性抗体。抗SSA/Ro-60和抗SSA/Ro-52是最常见的抗体，其次是抗双链DNA抗体，然后是抗SmD1和着丝粒蛋白B抗体。白癜风组的IgA和IgG血清水平下降比对照组更显著（P<0.001）。然而，IgM水平方面未观察到显著差异（P>0.05）。白癜风组的C4血清水平下降也比对照组更显著（P=0.035）。
结论
结果表明，白癜风儿童和青少年甲状腺功能异常的发生率显著高于对照组。此外，白癜风组存在免疫功能障碍较为常见。
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