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Long-term Clinical Significance of Thyroid Autoimmunity in Children with Celiac Disease

Celiac.com 03/03/2010 - A team of researchers set out to assess long-term outcomes of thyroid function and autoimmunity in a large population of children with celiac disease.

The research team included Alessandra Cassio, MD, Giampaolo Ricci, MD, Federico Baronio, MD, Angela Miniaci, MD, Milva Bal, MD, Barbara Bigucci, MD, Veronica Conti, MD, and Alessandro Cicognani, MD.

To accomplish this, they conducted a longitudinal, retrospective study at the Pediatric Department, University of Bologna, Italy (duration of follow-up, 8.9 +- 4.0 years).

In all, the team examined one hundred thirty-five consecutive patients diagnosed between June 1990 and December 2004 and followed on a gluten-free diet.

To be included, researchers required study subjects to maintain good dietary compliance and duration of follow-up for at least 3 years. A total of 101 patients showed no positive antithyroid titers during the follow-up, while 86 remained euthyroid; 15 showed high thyroid-stimulating hormone values at diagnosis that normalized in 11 cases after 12 to 18 months of gluten withdrawal. A total of 31 patients showed persistently positive antibody titers, with 23 of those (74%) remained consistently euthyroid during the follow-up and 8 (26%) had a subclinical hypothyroidism.

Children with growth retardation or gastroenterological symptoms at diagnosis and different lengths of gluten exposure showed similar rates of positive antibodies.

In children with celiac disease, antithyroid antibodies have a low clinical value for predicting the development of thyroid hypo-function during the indicated surveillance period. They encourage a more comprehensive follow-up.

Source:
J Pediatr. Volume 156, Issue 2, Page A2; February 2010

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