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Should Patients with Autoimmune Thyroid Disease Be Screened for Celiac Disease?

Should patients with autoimmune thyroid disease be screened for celiac disease?


Photo: CC--Normalityrelief

Celiac.com 02/13/2017 - Researchers have noted a strong clinical association between autoimmune thyroid disease and adult celiac disease. In part, at least, this appears to be related to common genetically-based determinants as well as a common embryonic origin since the fetal thyroid is derived from the pharyngeal gut.

Dr. Hugh J Freeman of the Department of Medicine, Gastroenterology, at the University of British Columbia in Vancouver, BC, Canada recently set out to review evidence from earlier prevalence studies and recent population-based studies.

Specific phenotypic features have been described if both disorders are defined, including dermatitis herpetiformis, and a greater risk for a malignant complication, including lymphoma, especially if celiac disease is initially diagnosed at a late age. Some phenotypic characteristics of autoimmune thyroid disease, such as orbitopathy, may be an important clue to occult celiac disease.

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Similarly, patients requiring a high thyroxine dose to treat their autoimmune thyroid disease may reflect another aspect of undetected celiac disease.

In some studies, the relationship has also been extended to other phenotypic features, such as dermatitis herpetiformis, and a greater risk of malignant complication, especially if celiac disease is detected in late or elderly age groups. In addition, some phenotypic characteristics of thyroid disease, such as orbitopathy and a high dose requirement for replacement may be added clinical clues to occult or undetected celiac disease.

Dr. Freeman recommends that doctors consider serological screening for adult celiac disease in patients with autoimmune thyroid disease.

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