Question 4. I have vitiligo: will my children have vitiligo too?
- Be optimistic! If you have vitiligo, most probably your children will not have vitiligo.
- The genetic component in vitiligo is weak and quite inconsistent.
- If I have vitiligo, it is possible that all my relatives may have increased probability of developing vitiligo.
- Identical twins have only 23% concordance of developing vitiligo: this means that the pure genetic component of the disease is not really dominant.
- Most cases of vitiligo are sporadic, thus it is not necessary that children of parents with vitiligo will also develop vitiligo.
- In less than 20% of vitiligo patients are close relatives affected.
Although most cases of vitiligo are sporadic, familial clustering is not uncommon, and up to 20% of patients report to having affected relatives. In Caucasians, the lifetime frequency of vitiligo among patients’ siblings is 6.1%, an 18-fold increase over the studied population. The frequency of vitiligo among first degree relatives in Caucasian, Indo - Pakistani, and Hispanic populations is 7.1%, 6.1%, and 4.8%, respectively, compared to an estimated worldwide frequency of 0.14% to 2%.
Epidemiological studies indicate that vitiligo is inherited in a multi-factorial pattern. Identical twins with identical DNA have only a 23% concordance in developing vitiligo, suggesting a significant non-genetic component in the disease.
Familial clustering of generalized vitiligo with other autoimmune diseases is compelling evidence for an autoimmune predisposition, a common underlying genetic susceptibility to an immunological aberrancy Among vitiligo patients, 20% report thyroid disease (an 8-fold increase over the general population), particularly hypothyroidism. Similarly, there is an increased frequency in other forms of autoimmune diseases and autoimmune disorders of the endocrine system (see later on).
Author: Prof. Torello Lotti, MD
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