The frequency of celiac disease is increased
slightly in patients with autoimmune thyroiditis
(March 2002)
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.
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