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    Celiac Disease is Linked to Autoimmune Thyroid Disease


    Scott Adams

    Dig Dis Sci 2000;45:403-406.


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    (Celiac.com 04/10/2000) Italian researcher Dr. Tarcisio Not, of Clinica Pediatrica, I.R.C.C.S., Trieste, and colleagues, have concluded that a relatively high percentage of patients with autoimmune thyroiditis also have celiac disease. They studied 172 patients who had autoimmune thyroid disorders, and two control groups. Their control groups were comprised of 498 patients with other diseases, and 4,000 healthy patients. The method used by the researchers was a blood test that looks for IgA-class endomysium antibodies using immunofluorescence.

    Their results, which were published in the February issue of Digestive Diseases and Sciences, show that the prevalence of celiac disease is 3.4% in patients with autoimmune thyroiditis, compared with 0.6% and 0.25% among the two control groups. They also found a connection between untreated celiac disease, gluten consumption, and autoimmune disorders. The researchers believe that undiagnosed celiac disease can cause other disorders by switching on some as yet unknown immunological mechanism. Untreated celiac patients produce organ-specific autoantibodies. Further, By following these subjects longitudinally, it has been seen that not only do the anti-gliadin antibodies and anti-endomysium antibodies disappear after 3 to 6 months of a gluten-free diet, but so do the organ-specific autoantibodies.

    In conclusion the Italian researchers suggest that patients with autoimmune thyroiditis could benefit from a screening for celiac disease, which could eliminate the symptoms and limit the risk of developing other autoimmune disorders.

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  • About Me

    In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I founded The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

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    Scott Adams
    AUTHORS: Cuoco L; Certo M; Jorizzo RA; De Vitis I; Tursi A; Papa A; De Marinis L; Fedeli P; Fedeli G; Gasbarrini G
    AUTHOR AFFILIATION: Department of Internal Medicine, Catholic University S.C., Rome, Italy.
    SOURCE: Ital J Gastroenterol Hepatol 1999 May;31(4):283-7 [MEDLINE record in process]
    CITATION IDS: PMID: 10425571 UI: 99354303
    ABSTRACT: BACKGROUND AND AIMS - Celiac disease is associated with several autoimmune disorders such as insulin-dependent diabetes, Sjogrens syndrome, Addisons disease and thyroid diseases. The aim of our study was to evaluate the prevalence of celiac disease in patients affected by autoimmune thyroid diseases by means of anti-gliadin and anti-endomysial antibodies. PATIENTS: We studied 92 patients affected by autoimmune thyroid diseases (47 chronic autoimmune thyroiditis, 22 Hashimotos thyroiditis and 23 Graves disease). Ninety patients with non autoimmune thyroid disorders (51 multifollicular goitre, 28 solitary nodule and 11 papillary carcinoma) and 236 blood donors also took part in the study as control groups. METHODS: Total serum IgA were measured in all subjects to exclude selective IgA deficiency; then we measured anti-gliadin antibodies and anti-endomysial antibodies. In patients with anti-gliadin/anti-endomysial antibody positivity and/or with haematinic and laboratory signs of malabsorption we carried out gastrointestinal endoscopy with duodenal histological examination.
    RESULTS: Among the 92 patients with autoimmune thyroid disease, 4 (4.3%) showed anti-gliadin and anti-endomysial positivity and had celiac disease; among the 90 patients with non autoimmune thyroid diseases, 1 (1.1%) had celiac disease; finally, among the blood donors, 1 subject (0.4%) was anti-gliadin-anti-endomysium antibody positive and had celiac disease. Those subjects presenting with only anti-gliadin antibody positivity did not have celiac disease.
    CONCLUSIONS: These results show that the prevalence of celiac disease in patients with autoimmune thyroid diseases is significantly increased when compared with the general population (p = 0.009) but not with patients affected by non autoimmune thyroid disorders (p = 0.18). We suggest a serological screening for celiac disease in all patients with autoimmune thyroid disease measuring anti-endomysial antibodies, considering that early detection and treatment of celiac disease are effective in preventing its complications.

    Jefferson Adams
    Celiac.com 12/08/2008 - Celiac disease is a life-long autoimmune enteropathy that results in damage to the small intestinal mucosa. When people with celiac disease eat the gluten proteins found in wheat, rye and barley, they damage the cells that line the small intestine, which interferes with normal digestion and absorption of nutrients. Recent studies have shown that most people present with a silent, non-diarrheal form of the disease, and show no obvious symptoms. People with celiac disease face rates of autoimmune disease that are10 times higher than the general population.
    People with untreated celiac disease have higher rates of thyroid problems, which generally improve with the adoption of a gluten-free diet. A connection between the span of gluten consumption and autoimmune diseases has been observed in people with celiac disease. Tissue transglutaminase (TGase) is a ubiquitous enzyme and manifests in all tissues, with both intra- and extracellular localization.
    A team of researchers recently set out determine if tissue transglutaminase-2 IgA antibodies (anti-TGase II) present in blood samples from celiac disease patients react with thyroid tissue and possibly contribute to thyroid disease.
    The research team made up of doctors Afzal J. Naiyer, Jayesh Shah, Lincoln Hernandez, Soo-Youl Kim, Edward J. Ciaccio, Jianfeng Cheng, Sanil Manavalan, Govind Bhagat, and Peter H.R.Green. The team took blood samples from 40 people with active celiac disease, but not following a gluten free diet, samples from 46 celiac patients on a gluten-free diet (celiac disease), 40 normal controls (NC), and 25 with Crohn’s disease.
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    Signs of TGase II as the antigen in thyroid tissue were reinforced by elimination of the IIF pattern when sera were depleted of anti-TGase II by pretreatment with human recombinant TGase II. The team saw no such staining of thyroid tissue in blood samples from celiac disease patients who were negative for TGase II antibodies, or samples from the non-celiac control group.
    Thyroid antibodies were found in 43% of celiac disease+ patients, substantially higher than NC and CROHN patients ( p < 0.0001). Moreover, a positive correlation was observed between anti-TGase II and TPO-AB titers (p1/40.0001; r1/40.63).
    The results show that anti-TGase II antibodies bind to TGase II in thyroid follicles and extracellular matrix, and that titers correlate with TPO antibody titers. This indicates that anti-TGase II antibodies might contribute to the development of thyroid disease in people with celiac disease.
    Thyroid Volume 18, Number 11, 2008


    Jefferson Adams
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    The research team included Kristien Boelaert, PhD, Paul R. Newbya, Matthew J. Simmonds, PhD, Roger L. Holderb, Jacqueline D. Carr-Smitha, Joanne M. Heward, PhD, Nilusha Manjia, Amit Allahabadia, MD, Mary Armitage, DM, Krishna V. Chatterjee, PhD, John H. Lazarus, MD, Simon H. Pearce, PhD, Bijay Vaidya, PhD, Stephen C. Gough, PhD, Jayne A. Franklyn, PhD.
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    Patients completed a comprehensive questionnaire detailing personal and parental history of common autoimmune disorders, along with a history of hyperthyroidism or hypothyroidism among parents.
    The frequency of developing another autoimmune disorder was 9.67% in Graves' disease and 14.3% in Hashimoto's thyroiditis index cases (P=.005). Rheumatoid arthritis was the most common coexisting autoimmune disorder, striking 3.15% of those with Graves' disease and 4.24% of those with Hashimoto's thyroiditis.
    Relative risks of almost all other autoimmune diseases in Graves' disease or Hashimoto's thyroiditis were significantly increased (>10 for pernicious anemia, systemic lupus erythematosus, Addison's disease, celiac disease, and vitiligo).
    Results showed relative “clustering” of Graves' disease, and of Hashimoto's thyroiditis, among patients whose parents had hyperthyroidism. Moreover, most other coexisting autoimmune disorders showed markedly increased relative risks for patients with parental history of such disorders.
    This effort to quantify the risk of diagnosis of coexisting autoimmune diseases in more than 3000 index cases with well-characterized Graves' disease or Hashimoto's thyroiditis represents one of the most comprehensive studies yet completed.
    The elevated risks for developing multiple conditions emphasizes the importance of screening for other autoimmune diagnoses in subjects with autoimmune thyroid disease who present new or nonspecific symptoms.
    Source: American Journal of Medicine - Volume 123, Issue 2, Pages 183.e1-183.e9 - February 2010


    Jefferson Adams
    Celiac.com 02/02/2012 - A team of researchers recently conducted a prospective controlled study on a gluten-free diet and autoimmune thyroiditis in patients with celiac disease.
    The research team included S. Metso, H. Hyytiä-Ilmonen, K. Kaukinen, H. Huhtala, P. Jaatinen, J. Salmi, J. Taurio, and P. Collin. They are affiliated with the Department of Internal Medicine at Tampere University Hospital in Tampere, Finland.
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    Overall, celiac patients faced a higher risk of thyroid autoimmune disorders than non-celiac control subjects. Moreover, a gluten-free diet did not seem to stop or reverse the progression of autoimmune disease after one year.
    Source:

    Scand J Gastroenterol. 2012 Jan;47(1):43-8. Epub 2011 Nov 30.

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    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.