Endocrine Abstracts

JOINT197

Introduction: Universal alopecia is a rare autoimmune disorder often associated with other autoimmune diseases. This study presents two cases of universal alopecia in patients with hypothyroidism, specifically Hashimoto’s thyroiditis, highlighting the potential relationship between these autoimmune conditions. Case 1 The first patient was a 48-year-old man admitted to the endocrinology department of Hedi Chaker University Hospital in Sfax for the management of profound hypothyroidism. The diagnosis of hypothyroidism had been made seven months prior, at the age of 47, following symptoms including psychomotor slowing, hoarseness, fatigue, and a heterogeneous goiter. During hospitalization, the diagnosis of Hashimoto’s thyroiditis was confirmed, and the patient was started on levothyroxine therapy. The onset of hypothyroidism occurred 24 years after the development of universal alopecia. Case 2 The second patient was a 54-year-old woman also hospitalized for the management of hypothyroidism, diagnosed due to psychomotor slowing and fatigue. She was diagnosed with Hashimoto’s thyroiditis and treated with L-thyroxine, showing good clinical and biological improvement. Her hypothyroidism was preceded by two other autoimmune diseases: universal alopecia and vitiligo. HLA typing was performed, revealing haplotype A2, A white, B50, B white (BW6).

Discussion: Both cases suggest a strong autoimmune association between universal alopecia and thyroid dysfunction, particularly Hashimoto’s thyroiditis. The presence of other autoimmune diseases such as vitiligo in the second case further emphasizes the autoimmune nature of these conditions. The HLA typing results in the second case suggest a potential genetic predisposition.

Conclusion: This report underscores the need for clinicians to consider the association between universal alopecia, autoimmune thyroid disease, and other autoimmune disorders. Further investigation is needed to better understand the genetic and immunological factors involved in these co-occurring conditions.