The background of the study. Patients with autoimmune thyroid disease, particularly those with chronic autoimmune thyroiditis, may have an increased risk of autoimmune disorders of other organs. The latter may include celiac disease (gluten-sensitive enteropathy), which results in diarrhea when foods containing gluten (wheat) are eaten. This study was undertaken to determine the frequency of celiac disease in patients with chronic autoimmune thyroiditis.
How the study was done. The study subjects were 220 consecutive patients with chronic autoimmune thyroiditis (high serum thyrotropin [TSH] and high serum thyroid microsomal, thyroid peroxidase, or thyroglobulin antibody concentrations), 50 euthyroid patients with one or more thyroid nodules, and 250 normal subjects. Serum IgA tissue transglutaminase antibodies and IgA endomysial antibodies, which are markers of celiac disease, were measured in all study subjects. Subjects with high serum concentrations of the antibodies underwent intestinal biopsy to confirm the diagnosis of celiac disease.
The results of the study. The 220 patients with chronic autoimmune thyroiditis included 196 women and 24 men, of whom 7 (3 percent) had serological and biopsy evidence of celiac disease, as compared with none of the patients with thyroid nodules and 1 (0.4 percent) of the normal subjects.
All seven patients with chronic autoimmune thyroiditis who had high serum concentrations of tissue transglutaminase antibodies had evidence of celiac disease on intestinal biopsy. Two of them had clinical evidence of poor food absorption. The one normal subject with a high serum concentration of tissue transglutaminase antibodies also had biopsy evidence of celiac disease.
The conclusions of the study. Celiac disease is slightly more common among patients with chronic autoimmune thyroiditis as compared with normal subjects or patients with thyroid nodules.
The original article. Volta U, Ravaglia G, Granito A, Forti P, Maioli F, Petrolini N, Zoli M, Bianchi FB. Coeliac disease in patients with autoimmune thyroiditis. Digestion 2001;64:61-5.