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Prevalence and Early Diagnosis of Celiac Disease in Autoimmune Thyroid Disorders

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.

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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.

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Kathy Tappe
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