Published online Aug 8, 2016. doi: 10.5409/wjcp.v5.i3.288
Peer-review started: January 26, 2016
First decision: March 23, 2016
Revised: April 8, 2016
Accepted: May 7, 2016
Article in press: May 9, 2016
Published online: August 8, 2016
AIM: To verify the prevalence of thyroid autoimmunity (TA) and the possible association between atopy and TA in children affected by skin disease.
METHODS: Three hundred and twenty-four children consecutively referred due to skin disease symptoms to our Pediatric Department were enrolled. One hundred and eighty-seven were diagnosed with atopic dermatitis (AD), 95 with acute urticaria, 40 with chronic urticaria (CU), and 2 with alopecia areata (AA). According to the work-up for atopy, the children were divided into two groups: Atopics and non-atopics. TA was diagnosed by serum thyroid peroxidase autoantibodies and/or thyroglobulin autoantibodies levels more than twice normal values over a period of two months by immunoassay.
RESULTS: In all children with skin disease, a significant prevalence of TA in atopics compared with non-atopics (13.67% vs 2.67%, P = 0.0016) and a significant association between TA and atopy (OR = 5.76, 95%CI: 1.71-19.35) were observed. These findings were confirmed as significant in children with AD: TA in atopics was 11.5%, while TA in non-atopics was 2.7% (P = 0.03, OR = 4.68, 95%CI: 1.02-21.38). In addition, atopics with CU showed a significantly higher prevalence of TA (26.9%), but none of the non-atopics showed CU (P = 0.0326). On the other hand, atopics with AA showed a 100% (2 out of 2) prevalence of TA, compared with none of the non-atopics.
CONCLUSION: In children with skin disease, atopy seems to be associated with an increased risk of TA.
Core tip: We observed a significant association between atopy and thyroid autoimmunity (TA) in atopic children with skin disease. This association was confirmed in atopic children affected by atopic dermatitis. The key message from our study for pediatricians is that clinicians should always evaluate thyroid peroxidase and thyroglobulin autoantibodies in atopic children with skin disease, as these children could also have TA.