Thyroid autoimmunity in children and adolescents with alopecia areata

Background  Autoimmune thyroiditis (AT) is often associated with alopecia areata (AA) in children and adolescents. Methods  Forty‐six children (23 girls and 23 boys), with a mean age of 9.9 ± 3.38 years (2.24–17.5 years), were included in a study to assess thyroid function and thyroid autoantibody formation in AA. The size and function of the thyroid gland [triiodothyronine (T3), thyroxine (T4), thyroid‐stimulating hormone (TSH), and thyrotropin releasing hormone (TRH) test; fluoroimmunologic assay (FIA), Delfia], antithyroglobulin (TAT) and antimicrosomal (MAT) antibodies (microhemagglutination method), thyroid gland ultrasound, and indices of cellular and humoral immunity were assessed. Results  Thyromegaly was found in 29 children (63%). Increased basal TSH levels were present in six of the 29 (13.3%) and hypothyroid‐type stimulated secretion (TRH test) in two (out of 12). TAT was increased in 17 (39.5%) and MAT in 14 (33.3%) children with AA. Thyroid ultrasound examination was suggestive of AT in 13 (34.2%) and typical of AT in five (13.2%) children. Conclusions  We diagnosed AT in 22 of 46 children with AA (47.8%). The immune studies revealed increased activated T lymphocytes. We recommend that thyroid gland size and function and antibody formation be examined at the diagnosis of AA and twice a year thereafter.