Family Case Finding in Children with Family History of Autoimmune Disease.
Here is another reason for case finding.
Thyroid Case Finding Advised for Some Kids with Alopecia Areata AA
Those with atopy, Down syndrome, and familial history may be at increased risk
1. 298 individuals with AA (all ≤21 years) 20% (59) had abnormal findings on thyroid testing, with hypothyroidism as the most common form (49% or 29) as a result of Hashimoto thyroiditis (41% or 24).
2. Other thyroid abnormalities reported in the cohort included hyperthyroidism due to Grave disease (20%, 12), as well as subclinical thyroid dysfunction (12%, 7), according to Deepa Patel, BS, of The Children’s Hospital of Philadelphia, and colleagues.
3. A family history of thyroid disease (P=0.001) was also significantly associated with thyroid dysfunction in the AA population, as well as atopy (P=0.009).
4.Based on these findings, the authors recommend that those with Down syndrome, atopy, or a familial history of thyroid disease should undergo a thyroid screening with TSH and free T4 at the initial signs of AA.
Comment: I would include thyroid antibodies at the first visit not later.