Hepato-splenic abnormalities in vitiligo - do they exist? 1 Joanna Bartosińska, 1 Aldona Pietrzak, 2 Ewa Dybiec, 1 Grażyna Chodorowska 1 Department of Dermatology, Venereology and Paediatric Dermatology Medical University of Lublin, Poland
Hepato-splenic abnormalities in vitiligo - do they exist?
Nov 30, 2014
Vitiligo is a skin disease of still unclear, multifactorial aetiology. Numerous autoimmunological disturbances observed in vitiligo may be suggestive of a systemic nature of the disease. Since the research into immunological and metabolic abnormalities gives evidence that they may also be present in vitiligo, it seems essential that any disturbances or abnormalities should also be searched for in the patients affected with the condition. Metabolic changes which take place in both the liver and spleen are also worth the interest.
Aim & Scope: The aim of the study was to assess the liver and spleen function parameters in the children hospitalized in Department of Dermatology Medical University of Lublin.
Material and Methods: The study included 34 vitiligo patients and 35 healthy individuals, aged 7-15 years old. We examined those children who had the active phase of vitiligo, in which exacerbation of skin lesions had a history of 6 months. Liver and spleen ultrasound examination included their size and parenchyma assesment. In order to assess the liver and spleen functioning the following accessory examinations were performed: blood test, transaminases, electrophoresis of proteins, lipid profile, autoantibodies, HCV antibodies.
Results: The values of the liver size were not significantly different between the study and control groups. The ultrasonografic pictures of the spleen did not revealed any abnormalities in the size and structure of the organ. The concentration of HDL-cholesterol was significantly lower whereas the concentration of LDL-cholesterol was significantly higher in vitiligo patient in comparison with the healthy group. The value of the LDL/HDL ratio was significantly higher in vitiligo patients.
Comments:
• Performed investigations are indicative of lipid disturbances in children affected with vitiligo.
• However, the ultrasound examination did not reveal any abnormalities with reference to the size and structure of both the liver and spleen. Neither did biochemical investigations reveal any disfunctions of the liver and spleen.
• Since there were no structural and functional abnormalities in the liver and spleen it seems plausible that lipid disturbances in vitiligo may result from genetic defect or some auto-cytotoxic events taking part in the condition pathogenesis.
• The nature of the conducted research is preliminary and it requires further long-term studies, which would include a wider variety of studied subjects as well as more numerous groups.
- Disclaimer-
This PPT is loaded as student material "as is", from the VRF Vitiligo Master Class Barcelona November 2011; VRF does not endorse or otherwise approve it.
Aim & Scope: The aim of the study was to assess the liver and spleen function parameters in the children hospitalized in Department of Dermatology Medical University of Lublin.
Material and Methods: The study included 34 vitiligo patients and 35 healthy individuals, aged 7-15 years old. We examined those children who had the active phase of vitiligo, in which exacerbation of skin lesions had a history of 6 months. Liver and spleen ultrasound examination included their size and parenchyma assesment. In order to assess the liver and spleen functioning the following accessory examinations were performed: blood test, transaminases, electrophoresis of proteins, lipid profile, autoantibodies, HCV antibodies.
Results: The values of the liver size were not significantly different between the study and control groups. The ultrasonografic pictures of the spleen did not revealed any abnormalities in the size and structure of the organ. The concentration of HDL-cholesterol was significantly lower whereas the concentration of LDL-cholesterol was significantly higher in vitiligo patient in comparison with the healthy group. The value of the LDL/HDL ratio was significantly higher in vitiligo patients.
Comments:
• Performed investigations are indicative of lipid disturbances in children affected with vitiligo.
• However, the ultrasound examination did not reveal any abnormalities with reference to the size and structure of both the liver and spleen. Neither did biochemical investigations reveal any disfunctions of the liver and spleen.
• Since there were no structural and functional abnormalities in the liver and spleen it seems plausible that lipid disturbances in vitiligo may result from genetic defect or some auto-cytotoxic events taking part in the condition pathogenesis.
• The nature of the conducted research is preliminary and it requires further long-term studies, which would include a wider variety of studied subjects as well as more numerous groups.
- Disclaimer-
This PPT is loaded as student material "as is", from the VRF Vitiligo Master Class Barcelona November 2011; VRF does not endorse or otherwise approve it.
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Hepato-splenic abnormalities in vitiligo - do they exist?
1Joanna Bartosińska, 1Aldona Pietrzak, 2Ewa Dybiec, 1Grażyna Chodorowska
1Department of Dermatology, Venereology and Paediatric DermatologyMedical University of Lublin, Poland
2Department of Paediatric Radiology Medical University of Lublin, Poland
Vitiligo
• Stigmatization
• Decreased quality of life
• Obsession and phobia
•Europe about 0.5-2% (in Denmark- 0.38%; in Turkey- 0.15-0.32%)•India 0.005% (in Calcuta- 0.46%; in Surat- 1.13%; in Gujarat- 8.8%)•China 0.093%•The United States 1%
Prevalence of vitiligo
Vitiligo
• A skin disease of still unclear, multifactorial aetiology. • Numerous autoimmunological disturbances observed
in vitiligo may give grounds to conclude that it is a systemic disease.
• Since the research into immunological and metabolic abnormalities gives evidence that they may also be present in vitiligo, it seems essential that any disturbances or abnormalities should also be searched for in the patients affected with vitiligo.
• Metabolic changes which take place in both the liver and spleen are also worth the interest .
Liver
• Detoxication,
• Synthesis of carbohydrates, proteins, lipids
• May be disturbed in vitiligo patients.
Spleen
• Participates in immunological processes,
• Works as a filter for the mature blood cells, i.e. erythrocytes and platalets.
• Among other things, spleenomegaly is also observed in inflammations, metabolic diseases as well as in cancer .
The aim of the study
• The aim of the study was to assess the liver and spleen function parameters in the children hospitalized in Department of Dermatology Medical University of Lublin.
• The study included those children who had the active phase of vitiligo, in which exacerbation of skin lesions had a history of 6 months.
Characteristics of patients
Study group: n=34 vitiligo patients
Control group: n=35 healthy subjects
Parameter Group Min Max M SD p
Age(years)
V 7 15 10.9 2.00.447
C 7 15 10.5 2.3
Height (cm)
V 115 170 141.6 13.40.717
C 110 173 143.0 17.0
Weight(kg)
V 19 50 34.6 8.20.299
C 19 63 37.2 12.5
BMI (kg/m2)
V 13.2 23.6 17.0 2.10.302
C 13.4 25.0 17.6 2.8
• Caucasian children aged 7-15• Duration of vitiligo: from 6 months to 9 years, mean
duration - 2.1 years• Vitiligo type: Vulgaris and Focal• Without mucosal involvement• Family history of vitiligo: 3 patients• Autoimmune thyroid disease: 1 patient;
TSH: within normal limits• No diabetes, glucose intolerance
Total skin involvement
• Liver ultrasound examination included its size and parenchyma assesment.
• In order to determine the liver size, measurements in three vertical lines were performed:-in the right front axillary line;
-in the central line of the right clavicle;-in the central line of the body in the section going through the long axis of the aorta.
• Spleen ultrasound examination included its size and parenchyma assesment .
• In order to determine the size of the spleen, the measurement in two dimensions, longitudinal and transverse were performed.
Liver (differences statistically insignificant)
anterior axillary line medioclavicular line sternal line
12,4 12,412,4 12,4
10,711,1
10,711,1
9,19,5
9,19,5
Vitiligo Control6
7
8
9
10
11
12
13
14
15
16
17
cm
12,4 12,4
10,711,1
9,19,5
Spleen (differences statistically insignificant)
longitudinal section transverse section
9,3 9,49,3 9,4
3,63,5
3,63,5
Vitiligo Control2
4
6
8
10
12
14
cm
9,3 9,4
3,63,5
The following examinations were performed:
• Blood test
• Transaminases
• Electrophoresis of proteins
• Lipid profile
• Autoantibodies: positive ANA in 3 patients
• HCV antibodies: negative
Blood test (differences statistically insignificant)
Transaminases (differences statistically insignificant)
ALT (p=0.423) AST(p=0.143)
19,717,7
19,717,7
Vitiligo Control0
5
10
15
20
25
30
35
40
IU/L
19,717,7 19,0
22,619,0
22,6
Vitiligo Control0
5
10
15
20
25
30
35
40
IU/L 19,0
22,6
Electrophoresis of proteins (differences statistically insignificant)
Total proteins (p=0.296) A/G (p=0.376)
7,07,2
7,07,2
Vitiligo Control5,86,06,26,46,66,87,07,27,47,67,88,0
g/L
7,07,2
1,41,3
1,41,3
Vitiligo Control0,8
0,9
1,0
1,1
1,2
1,3
1,4
1,5
1,6
1,7
1,8
1,9
1,41,3
The structure of albumin and globulins (differences statistically insignificant)
Lipid profile
LDL-cholesterol (p=0.030) LDL/HDL (p=0.000096)
170,8161,6
170,8161,6
Vitiligo Control110
120
130
140
150
160
170
180
190
200
mg
/dL
170,8161,6
49,453,8
49,453,8
Vitiligo Control30
35
40
45
50
55
60
65
70
75
80
mg
/dL
49,453,8
107,2
92,4
107,2
92,4
Vitiligo Control50
60
70
80
90
100
110
120
130
140
mg
/dL
107,2
92,4
2,2
1,7
2,2
1,7
Vitiligo Control0,81,01,21,41,61,82,02,22,42,62,83,03,2
2,2
1,7
Total cholesterol (p=0.055) HDL-cholesterol (p=0.001)
Triglyceride Phospholipids
104,3 101,3104,3 101,3
Vitiligo Control40
60
80
100
120
140
160
mg
/dL 104,3 101,3
174,9 171,9174,9 171,9
Vitiligo Control100
120
140
160
180
200
220
240
mg
/dL 174,9 171,9
HDLF LDLF
81,1 81,781,1 81,774,8 74,074,8 74,0
Vitiligo Control30
40
50
60
70
80
90
100
110
120
mg
/dL 81,1 81,7
74,8 74,0
Vitiligo Control
0,81,0
1,21,4
1,61,8
2,02,2
2,42,6
2,83,0
3,23,4
8
9
10
11
12
13
14
15
16
17
0,81,0
1,21,4
1,61,8
2,02,2
2,42,6
2,83,0
3,23,4
r=-0.001p=0.997
r=0.370p=0.044
0,81,0
1,21,4
1,61,8
2,02,2
2,42,6
2,83,0
3,23,4
6
7
8
9
10
11
12
13
14
15
0,81,0
1,21,4
1,61,8
2,02,2
2,42,6
2,83,0
3,23,4
r=0.221p=0.238
r=0.011p=0.949
0,81,0
1,21,4
1,61,8
2,02,2
2,42,6
2,83,0
3,23,4
6
7
8
9
10
11
12
13
14
0,81,0
1,21,4
1,61,8
2,02,2
2,42,6
2,83,0
3,23,4
r=0.286p=0.126
r=-0.019p=0.913
LDL/HDL
Conclusions
• Performed investigations are indicative of lipid disturbances in children affectedwith vitiligo.
• However, the ultrasound examinationdid not reveal any abnormalities with reference to the size and structure of both the liver and spleen. Neither did biochemical investigations revealany disfunctions of the liver and spleen.
• Since there were no structuraland functional abnormalities in the liver and spleen it seems plausible that lipid disturbances in vitiligo may result from genetic defect or some auto-cytotoxic events taking part in the condition pathogenesis.
• The nature of the conducted researchis preliminary and it requires furtherlong-term studies, which would includea wider variety of studied subjectsas well as more numerous groups.
Thank you for your attention
Related Documents
