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Immunological Profile of Patients Presenting Down Syndrome and Alopecia Areata

Marcia G Ribeiro, Juliany L Estefan, Kalynka Higino,

Aim: This study was undertaken to contribute to knowledge of the immunological profile of Down syndrome and alopecia areata patients.
Material and Methods: Observational, case series study, with comparison group. The following data were computed: gender, age, karyotype, previous disease and immunological profile: complete blood count, Blood Sedimentation Rate (BSR), cellular and humoral immunity and autoimmunity. Frequency, central trends and dispersion measurements for descriptive analysis. The nonparametric χ2 test and Fisher Exact test for exploratory analyses; significance level for p value < 0.05.
Results: Eighty-three Down Syndrome (DS) patients were evaluated: 21 with Alopecia Areata (AA) and 62 without it. The average age of patients with AA was 13.3 years (SD ± 5.0) and of DS without AA was 12.2 (SD ± 5.3); 94.7% presented free trisomy. The predominant previous illness was hypothyroidism, which occurred only in DS patients with AA (3/21). Hemogram was normal in 40.9% and the most frequent alteration was an increase of hematocrit (22.9%). The BSR was elevated in 71.1%. About cellular immunity, the principal abnormality was the decrease in CD4. Immunoglobulin electrophoresis was normal in 100.0%; DS patients showed normal levels of IgA in 100.0% of cases, of IgM in 98.8% and IgG, in 85.5%. Complement C4 and C3 were decreased in 67.4% and in 9.6% of the patients, respectively. The majority of studied antibodies were non reagent, but the presence of antiperoxidase antibody was significant in DS patients with AA.
Conclusion: There was no significant difference between the groups, related to their immunological profile, except for the presence of antiperoxidase antibody that maybe associated with the presence of hypothyroidism in DS patients with AA. Perhaps some of the findings are justified by the small sample; the authors suggest further studies with a larger sample and with HLA testing in order to understand the mechanism of AA in DS.