Celiac.com 12/22/2025 - Do teenagers who already live with an autoimmune condition face a higher chance of developing type one diabetes later in life? While doctors have long noticed that autoimmune disorders tend to cluster together, most earlier research focused only on people who already had type one diabetes. A recent study reverses that perspective by looking at teenagers who began with conditions such as thyroid disease or celiac disease and then following them into adulthood to see who later developed type one diabetes.

Because type one diabetes is a lifelong condition that often begins unexpectedly, learning more about early risk factors can help improve monitoring, early detection, and long-term care. The researchers used a uniquely large group of Israeli teenagers who went through a medical screening process required before military service, which gave them access to detailed health information.

How the Study Was Conducted

The study examined more than one million four hundred thousand teenagers between the ages of sixteen and nineteen. None of them had any signs of abnormal blood sugar at the beginning. The researchers separated them into two groups. The first group included those who had no autoimmune disease. The second group consisted of individuals who already lived with at least one autoimmune condition. These included autoimmune thyroid disease and celiac disease, which were the two most common, but also other diagnosed immune-related conditions.

After placing the teenagers into these two groups, the researchers followed their medical records for up to twenty years. They relied on national diabetes registry data to determine who later developed type one diabetes as adults. Because this registry tracks new, confirmed diagnoses, including tests that show the presence of diabetes-related antibodies, it allowed the researchers to identify true new cases.

The methods used in the study allowed the researchers to adjust for important background factors such as birth year, sex, and socioeconomic indicators. This means the results better reflect the true influence of autoimmune diseases rather than unrelated lifestyle or demographic differences.

What the Study Found

Out of the entire group, a little under three percent had an autoimmune condition at the start. This included more than ten thousand with autoimmune thyroid disease and more than nine thousand with celiac disease. Over the combined follow-up period, which totaled more than fifteen million person-years, several hundred people developed type one diabetes.

People who began the study with an autoimmune disorder were far more likely to develop type one diabetes in adulthood. Their rate of developing the condition was roughly double that of their peers who had no autoimmune disease. When statistical adjustments were made to account for differences between the groups, the increased risk still remained strong.

The greatest increase in risk occurred among those with autoimmune thyroid disease. This group had nearly four times the likelihood of developing type one diabetes compared to teens without autoimmune disease. Those with celiac disease also had an elevated risk, nearly triple that of those with no autoimmune condition.

Importantly, the pattern held even when the definition of type one diabetes required confirmation by antibody testing, meaning the cases were genuine immune-driven diabetes. This strengthens the reliability of the findings.

Why These Findings Matter

Autoimmune disorders occur when the body's defense system mistakenly attacks its own tissues. Once a person has one autoimmune condition, it becomes more likely for the immune system to become misdirected toward another part of the body. This study shows that this pattern is not only theoretical—it has real implications for long-term health.

For thyroid disease and celiac disease, the results suggest that these conditions may act as early indicators of a heightened immune vulnerability that could eventually manifest as type one diabetes. Doctors caring for teens with these conditions may consider closer monitoring for symptoms related to abnormal blood sugar as these individuals approach adulthood.

Early identification of diabetes is important because it can prevent life-threatening complications at diagnosis and can allow earlier interventions that might preserve remaining insulin-producing cells.

What This Means for People with Celiac Disease

For individuals living with celiac disease—and for parents of children with celiac disease—this study carries meaningful insights. The findings show that celiac disease is not only a digestive condition but part of a broader immune pattern that may raise the likelihood of other related conditions later in life.

Although the increased risk does not mean that every person with celiac disease will develop type one diabetes, it does highlight the importance of regular checkups, awareness of symptoms such as unusual thirst or unexplained weight loss, and ongoing communication with healthcare providers.

The study also reinforces the value of proper management of celiac disease. Staying on a strict gluten-free diet helps reduce ongoing immune activity in the body. While this study does not directly evaluate whether diet lowers future diabetes risk, reducing chronic inflammation may be helpful in overall health.

Conclusion

This large and long-running study provides strong evidence that teenagers with autoimmune thyroid disease, celiac disease, or other immune disorders are more likely to develop type one diabetes as adults compared with their peers who do not have autoimmune conditions. The research highlights how interconnected autoimmune diseases can be, and why early recognition of one may prompt careful observation for others.

For people with celiac disease, the findings can help guide informed discussions with doctors about long-term health. Understanding that celiac disease may indicate a higher susceptibility to type one diabetes empowers individuals and families to seek appropriate monitoring, respond early to possible symptoms, and maintain consistent follow-up care. Ultimately, awareness is a powerful tool that can support better outcomes and long-term well-being.

Read more at: diabetesjournals.org

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Celiac.com 07/17/2025 - People living with autoimmune conditions often face higher risks for developing other autoimmune diseases. One such concern is type 1 diabetes, a serious and lifelong condition where the immune system destroys insulin-producing cells in the pancreas. This new observational study explored whether people with celiac disease or thyroid disorders—two common autoimmune conditions—are at a higher risk of developing type 1 diabetes compared to those without these conditions. The findings offer valuable insights that may influence how patients are monitored and cared for after being diagnosed with one autoimmune disease.

How the Study Was Designed

This was a large-scale, retrospective observational study using health insurance claims data from millions of people in the United States. The researchers compared individuals diagnosed with celiac disease, hyperthyroidism (such as Graves' disease), or hypothyroidism (such as Hashimoto's disease) to similar individuals who had none of these conditions. The goal was to see how many in each group went on to develop type 1 diabetes.

To ensure fairness in comparison, each person with a condition of interest was matched to a control person based on age, sex, and other health characteristics. This approach helped reduce bias and made the results more reliable.

Participants were followed for at least one month and up to several years, with most people being followed for about two years. The researchers looked for new diagnoses of type 1 diabetes in both the disease groups and the control groups during this time.

Key Findings: Celiac and Thyroid Disease Raise the Risk

The results clearly showed that people with any of the three autoimmune conditions had a significantly higher risk of developing type 1 diabetes compared to those without these conditions:

• Celiac disease: 0.14% of individuals developed type 1 diabetes, compared to only 0.06% of the matched controls. This means the risk was more than twice as high.
• Hyperthyroidism: 0.17% developed type 1 diabetes vs. 0.06% of controls—nearly a threefold increase in risk.
• Hypothyroidism: 0.18% developed the disease, compared to 0.08% of controls, more than doubling the risk.

In particular, children and teenagers (under age 18) were at even greater risk. For young people with hyperthyroidism, the risk of developing type 1 diabetes was more than eight times higher than in peers without the condition. Similarly, those under 18 with hypothyroidism had over three times the risk, and those with celiac disease had about triple the risk.

Time to Diabetes: Faster Onset in Autoimmune Groups

Not only were people with these autoimmune conditions more likely to develop type 1 diabetes, but they also developed it faster. For example, people newly diagnosed with celiac disease developed type 1 diabetes in just over a year, on average. This rapid progression raises concern because type 1 diabetes often presents suddenly and can result in serious complications like diabetic ketoacidosis if not caught early.

Why These Results Are Reliable

The researchers performed multiple tests to ensure their findings were solid. They analyzed not only people newly diagnosed with autoimmune conditions but also ran a secondary test that required evidence of both a diabetes diagnosis and insulin use—confirming the need for insulin therapy. These extra layers of analysis supported the original findings and showed that the results were consistent across age groups and not dependent on family history of type 1 diabetes.

Even people without a relative with type 1 diabetes still had a significantly higher risk if they had celiac or thyroid disease. This challenges the assumption that only people with a family history should be closely monitored.

What This Means for Celiac Disease Patients

For individuals with celiac disease, this study is particularly meaningful. While it's known that celiac disease and type 1 diabetes often occur together—especially in children—this study quantifies the risk in a large population of both children and adults. It also highlights how quickly type 1 diabetes can develop in this group. Importantly, the findings suggest that people with celiac disease—even without a family history of diabetes—should be considered for early screening to detect signs of type 1 diabetes before symptoms appear.

The Role of Screening and Early Detection

One of the key takeaways from this study is the importance of screening. Type 1 diabetes does not appear overnight. It develops gradually, beginning with the appearance of certain autoantibodies in the blood. These early warning signs can be found long before blood sugar levels rise or symptoms show up. By identifying people in the early stages, doctors may be able to delay or even prevent the full onset of the disease using new therapies now in clinical trials.

Yet, current guidelines often do not recommend routine diabetes screening for people with other autoimmune diseases unless they have a close relative with type 1 diabetes. This study provides strong evidence that such guidelines may need updating.

Limitations to Consider

As with any research, there are some limitations. This study used insurance claim data, which depends on accurate diagnosis codes. Errors in medical coding or differences in how diseases are diagnosed could influence results. Also, since the study used U.S.-based insurance data, the findings might not apply directly to people in other countries with different healthcare systems.

Another challenge is that the exact autoimmune cause of thyroid disease wasn’t always clear in the data. Graves' disease and Hashimoto’s disease were likely included but not specifically separated from other types of thyroid dysfunction. Still, the large number of participants makes the findings significant.

Conclusion: Why This Study Matters for People with Celiac Disease

This study shows that people with celiac disease are more than twice as likely to develop type 1 diabetes as those without it—and that risk may be even higher in children. The same is true for individuals with thyroid disorders. These findings provide a strong argument for routine screening for early signs of type 1 diabetes in people with these conditions, regardless of family history.

For those living with celiac disease, this means being aware of possible symptoms of diabetes, such as increased thirst, frequent urination, or unexplained weight loss, and discussing screening options with their healthcare provider. With earlier detection, there is a greater opportunity to avoid severe complications and possibly benefit from therapies that slow disease progression.

Ultimately, this research may help shape future guidelines to better protect individuals at risk—and ensure those living with one autoimmune disease do not face the surprise of another.

Read more at: dom-pubs.pericles-prod.literatumonline.com

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Celiac.com 07/29/2024 - Hashimoto's thyroiditis (HT) is an autoimmune thyroid disorder characterized by inflammation and impaired function of the thyroid gland, leading to hypothyroidism. The disease involves a complex interplay of genetic, environmental, and epigenetic factors, particularly affecting the regulation of T regulatory (Treg) cells, including CD4+ foxp3+ T cells. The FoxP3 transcription factor is crucial for the development and differentiation of Treg cells, which are essential for maintaining immune tolerance. Disruptions in this regulation can lead to immune dysregulation and proinflammatory responses.

This study investigates the impact of dietary patterns, specifically the elimination of gluten and casein proteins, on the epigenetic changes in the FoxP3 gene in patients with HT. The primary aim is to evaluate how such dietary changes might influence the methylation levels of the FoxP3 gene, considering the potential link between these dietary components and the triggering of autoimmune diseases.

Methods

The study involved analyzing the methylation levels of the FoxP3 gene in two groups: patients with Hashimoto's thyroiditis following a strict casein-free and gluten-free diet, and a control group following a regular diet. The analysis was done before and after the dietary intervention to see if eliminating these proteins had any effect on the methylation levels of the FoxP3 gene.

Results

The results showed a significant reduction in the methylation levels of the FoxP3 gene in patients with Hashimoto's thyroiditis who adhered to the casein-free and gluten-free diet. This reduction was not observed in the control group, which continued with their regular diet. This suggests that the dietary intervention specifically influenced the epigenetic regulation of the FoxP3 gene in the patients with Hashimoto's thyroiditis.

Discussion

The reduction in methylation levels of the FoxP3 gene could potentially enhance its expression. Increased expression of FoxP3 would improve the function of regulatory T cells, which are vital for maintaining immune tolerance. This improvement could help prevent the immune system from attacking the body's own tissues, thereby reducing the autoimmune response in patients with Hashimoto's thyroiditis.

The findings highlight the significant role of environmental factors, such as diet, in influencing epigenetic changes that regulate immune function. The study supports the idea that dietary interventions could be a viable strategy for managing autoimmune diseases through epigenetic mechanisms.

Conclusion

This study underscores the potential benefits of a casein-free and gluten-free diet in managing Hashimoto's thyroiditis through epigenetic changes. By reducing the methylation levels of the FoxP3 gene, such a diet may enhance the function of regulatory T cells, improving immune regulation and reducing autoimmune responses. These findings are particularly meaningful for individuals with celiac disease, as they highlight the broader implications of dietary changes on autoimmune health. Further research with larger and more diverse groups is needed to validate these findings and develop personalized dietary interventions for managing autoimmune diseases.

Read more at: cureus.com

Celiac.com 08/29/2022 - Rotavirus infection is a potential trigger for autoimmune diseases, and some studies have shown associations between rotavirus vaccination and autoimmune conditions, such as type 1 diabetes.

There have also been a number of studies that show an association between celiac disease and childhood or infant rotavirus infection. But is there any association between the rotavirus vaccine and rates of celiac disease? 

A team of researchers recently set out to examine the association between rotavirus vaccination and celiac disease and autoimmune thyroiditis, both of which are associated with type 1 diabetes.

The research team included Catherine Kim, Zhe Yin, Neil Kamdar & Grace J. Lee. They are variously affiliated with the Departments of Medicine, Obstetrics & Gynecology and Epidemiology, University of Michigan, Ann Arbor, MI, USA; the Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, MI; and the Department of Pediatrics at the University of Michigan, Ann Arbor, MI.

The team's retrospective cohort study used de-identified claims data to include more than 2.1 million eligible infants who were born between 2001 and 2018, and continuously enrolled from birth for at least 365 days.

Nearly thirty percent of infants were born prior to the introduction of rotavirus vaccine in 2006; thirty-two percent were eligible for the vaccine, but were not vaccinated; nearly ten percent received partial vaccination;  while nearly thirty percent received full vaccination. 

The team found 1,000 cases of autoimmune thyroiditis, and nearly 1,400 cases of celiac disease. 

Compared to unvaccinated children born after 2006, children who were born prior to the introduction of rotavirus vaccine in 2006 had lower risk of celiac disease. However, the risk for children who were partially vaccinated or fully vaccinated was similar to the unvaccinated children. Risk of autoimmune thyroiditis also corresponded to vaccination status. 

Based on the data, the team concludes that rotavirus vaccination has no effect on risk for celiac disease or autoimmune thyroiditis.

Hopefully, this will alleviate any concerns about celiac disease or autoimmune thyroiditis and the rotavirus vaccine, and help parents to make informed decisions about vaccinating infants against rotavirus.

Read more in Scientific Reports volume 12, Article number: 12941 (2022).

Celiac.com 08/10/2022 - Celiac disease is a common inflammatory disease of the small intestine. Hashimoto's thyroiditis and Graves' disease make up most cases of autoimmune thyroid disease, and are marked by lymphocytic infiltration of the thyroid parenchyma. Both Hashimoto's thyroiditis and Graves' disease are often seen together with celiac disease. 

Meanwhile, patients with monoglandular and polyglandular autoimmunity have a higher rates of celiac disease. Rising rates of celiac disease among autoimmune thyroid disease patients has prompted researchers to investigate the link between the two.  A team of researchers recently set out to review the medical literature to more clearly illuminate the connections between celiac disease and thyroid autoimmunity. 

The team's goal was to study the shared genetic background, the incidence of celiac disease in autoimmune thyroid disease, the effect of a gluten-free diet on autoimmune thyroid disease, and the need for routine screening of celiac disease in autoimmune thyroid disease patients.

The research team included Tejaswini Ashok, Nassar Patni, Mahejabeen Fatima, Aselah Lamis, and Shiza W. Siddiqui. They are variously affiliated with the Research at Dubai Medical College in Dubai, ARE; Research, Dubai Medical College for Girls in Dubai, ARE; and Internal Medicine, Deccan College of Medical Sciences in Hyderabad, India.

Researchers think that shared genetic background is likely the main reason for the connection, as there seems to be a substantial overlap in genetic variables between celiac disease and autoimmune thyroid disease. 

Because of the subclinical aspects of the celiac disease, doctors often miss the diagnosis or make it coincidentally during screening. 

The rising rates of celiac disease in autoimmune thyroid disease patients is well documented. Moreover, most studies on the effects of a gluten-free diet in autoimmune thyroid disease patients with celiac disease have shown beneficial effects for the management of both diseases. 

To create a clinical therapy regimen to manage these two concurrent disorders, the team calls for more study on autoimmune thyroid disease patients for genes related to celiac disease, and to subclinical and clinical celiac disease rates.

They note that the multi-system nature of celiac disease warrants a multidisciplinary research and treatment approach that meshes with the diagnostic algorithm of autoimmune thyroid diseases to give patients with both autoimmune thyroid disease and celiac disease the best possible treatment. 

Read more at Cureus.com

Celiac.com 08/01/2022 - There have been only a few studies to address the use of a gluten-free diet in patients with Hashimoto's disease. To date, no study has confirmed positive changes resulting from a gluten-free diet in patients with Hashimoto's disease. 

At the same time, rates of other comorbid autoimmune diseases in patients with Hashimoto's disease are on the rise. This may have important implications for the interpretation of test results, and the need for a gluten-free diet in some patients. 

A team of researchers recently set out to analyze the current medical literature for data supporting a gluten-free diet for the standard management of Hashimoto patients. The research team included Małgorzata Szczuko, Anhelli Syrenicz, Katarzyna Szymkowiak, Aleksandra Przybylska, Urszula Szczuko, Jakub Pobłocki, and Danuta Kulpa.

They are variously affiliated with the Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, Poland; the Department of Endocrinology, Metabolic Diseases and Internal Diseases, Pomeranian Medical University in Szczecin, Poland; the Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences in Poznań, Poland; and the Department of Genetics, Plant Breeding and Biotechnology, Faculty of Environmental Management and Agriculture, West Pomeranian University of Technology in Szczecin, Poland.

For their study, the team reviewed the PubMed database for links between a gluten-free diet, Hashimoto’s disease, and autoimmune diseases. Their analysis of the available literature found no support for using a gluten-free diet to treat patients with Hashimoto's disease. 

The team instead recommended an anti-inflammatory diet that restores deficient levels of vitamin D, iodine, and selenium, which are found in plant products rich in polyphenols, antioxidants, and omega-3 fatty acids.

This is an interesting finding that seems to resolve the question of whether a gluten-free diet is beneficial for patients with Hashimoto's disease. The team found that the literature shows no benefit to using a gluten-free diet to treat Hashimoto's disease, but recommends an anti-inflammatory diet to restore levels of certain vitamins and minerals.

Stay tuned for more on this and related stories.

Read more in Nutrients 2022, 14(9), 1727

Celiac.com 09/08/2020 - Women with a type of hair loss called frontal fibrosing alopecia (FFA) have higher rates of autoimmune disease, estrogen deficiency, and thyroid hormone issues, compared with the general population.

The study included 711 female UK residents of Eurasian ancestry, and diagnosed with FFA. Women in the study group had scalp hair loss for an average of 7 years, and nearly 75% of those had frontotemporal hairline recession following menopause. More than 77% showed perifollicular erythema, more than 25% showed hyperkeratosis, while 26.0% also showed occipital recession. 

More than 90% of the women suffered eyebrow loss, while nearly 45% suffered eyelash loss. Hair loss on the limbs was also common, with nearly 78% of the cohort had limb hair loss, usually to the arms and legs, and nearly 70% had concomitant loss of axillary and/or pubic hair.

Nearly half of the study participants were taking prescription drugs to treat FFA. Of those, nearly 25% were taking hydroxychloroquine. Nearly twenty percent were taking topical corticosteroids, while ten percent were taking oral tetracycline antibiotics, or a range of other drugs, including topical calcineurin inhibitors (3.8%), intralesional steroids (1.7%), and oral corticosteroids (1.3%).

More than twenty percent of participants reported at least 1 comorbid autoimmune disease. Nearly 13% reported autoimmune thyroid disease, while 1.5% reported celiac disease, and 1.2% reported pernicious anemia.

In addition, 5.6% of women had a history of estrogen deficiency secondary to oophorectomy or primary ovarian insufficiency, and more than 70% of the women used an oral contraceptive pill for more than 6 months.

Though the study was limited by cross-sectional design, lack of a control group, and missing data for some clinical features, the findings "...accord with other epidemiological studies and the results of our genetic investigation, which implicated causal genetic variation related to antigen presentation and hormone/xenobiotic metabolism in FFA pathogenesis,” stated the investigators.

The research team is calling for further study to determine the extent of the connection, and the potential implications for diagnosis and treatment.

Read more in the Br J Dermatol. doi: 10.1111/BJD.19399

06/08/2020 - Many doctors and celiac patients have found that a gluten-free diet seems to improve some autoimmune diseases associated with celiac disease. A team of researchers recently set out to determine the effect of a gluten-free diet on autoimmune pituitary impairment in patients with celiac disease and potential/subclinical lymphocytic hypophysitis (LYH) by conducting a five-year longitudinal observational study.

The research team included Giuseppe Bellastella, Maria Ida Maiorino, Paolo Cirillo, Miriam Longo, Vlenia Pernice, Angela Costantino, Carmen Annunziata, Antonio Bellastella, Katherine Esposito, and Annamaria De Bellis.

They are variously affiliated with University of Campania “Luigi Vanvitelli,” in Naples, Italy; the Unit of Endocrinology and Metabolic Diseases, University of Campania “Luigi Vanvitelli,” in Naples, Italy; the Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy; and the Unit of Diabetes, University of Campania “Luigi Vanvitelli,” Naples, Italy.

The study took place in the tertiary referral center for immunoendocrinology at the University of Campania “Luigi Vanvitelli.”

In all, from 2000 to 2013, the team assessed ninety-three newly diagnosed LYH patients, with high titer of antipituitary antibodies [APA], and a second group with normal or subclinically impaired pituitary function. The first group included 43 patients with LYH and celiac disease. The second group included 50 patients with just isolated LYH. Patients diagnosed with celiac disease initiated a gluten-free diet. 

The team assessed APA titers and pituitary function in both groups at the start of the study, and then every year for 5 years. The team did not follow-up on patients who developed clinically overt LYH.

Nearly 35% of patients in group 1 experienced remission of LYH (defined as the disappearance of APA and recovery of pituitary function in patients with previous subclinical hypopituitarism). Just a single patient (2% of total) in group 2 experienced remission. 

Two patients in group 1 and 25 in group 2 developed clinically overt hypopituitarism, and left the study to receive appropriate therapy. The big takeaway here is that the presence of celiac disease was the only independent predictor of pituitary function recovery.

A gluten-free diet helps a significant number of patients with LYH and celiac disease to achieve remission of subclinical LYH, or prevent disease progression to more severe stages.

Stay tuned for more on this and related stories.

Read more at the Journal of Clinical Endocrinology & Metabolism, Volume 105, Issue 7, July 2020

Celiac.com 12/20/2018 - Patients with monoglandular and/or polyglandular autoimmunity, and their relatives, have higher rates of celiac disease than those without such autoimmunity. Somewhere between 10 and 30% of patients with celiac disease test positive for thyroid and/or type 1 diabetes antibodies, while around 5 to 7% of patients with autoimmune thyroid disease and/or type 1 diabetes test positive for IgA anti-tissue transglutaminase antibodies. 

A team of researchers recently set out to examine the relationship between celiac disease and endocrine autoimmunity. The research team included George J. Kahalya, Lara Frommera, and Detlef Schuppan. They are variously affiliated with the Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany, the Institute for Translational Immunology and Research Center for Immunotherapy (FZI), Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany, and the Division of Gastroenterology and the Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.

Celiac disease and endocrine autoimmunity do share a common genetic background, which definitely explains some of the relationship. The main common denominators are HLA antigens DQ2 (DQA1*0501-DQB1*0201) and/or DQ8 (DQA1*0301-DQB1*0302), that are tightly linked to DR3 and DR4, respectively. 

Researchers have identified functional single nucleotide polymorphisms of various genes involved in immune regulation as susceptibility genes for both celiac disease and monoglandular or polyglandular autoimmunity. This is a promising hypothesis, but exactly how the effects of a gluten-free diet might prevent or ameliorate glandular autoimmunity remains unclear. 

Based on their results, the research team does recommend that all patients with celiac disease be tested for type 1 diabetes and/or autoimmune thyroid disease. They also recommend that patients with the above autoimmune endocrine disorders be checked for celiac disease.

Read more at:

• Sciencedirect.com
• https://doi.org/10.1016/j.autrev.2018.05.013

Celiac.com 11/06/2018 - Autoimmune pancreatitis is a rare disorder whose association with celiac disease (celiac disease) has never been investigated, although celiac patients show high rates of both endocrine and exocrine pancreatic affections. To address this lack of information, a team of researchers recently set out to evaluate the frequency of celiac disease in patients with autoimmune pancreatitis and in further medical pancreatic disorders.

The research team included G De Marchi, G Zanoni, MC Conti Bellocchi, E Betti, M Brentegani, P Capelli, V Zuliani, L Frulloni, C Klersy, and R Ciccocioppo. They are variously affiliated with the Department of Medicine, the Department of Pathology and Diagnostics, the Gastroenterology Unit, the Immunology Unit, and the Pathology Unit of the Department of Pathology and Diagnostics; and the Gastroenterology Unit of the Department of Medicine, AOUI Policlinico G.B. Rossi, University of Verona in Verona, Italy; the Clinica Medica I, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation in Pavia, Italy; and the Clinical Epidemiology & Biometry Unit, IRCCS Fondazione Policlinico San Matteo; Pavia, Italy. 

They screened for celiac disease by looking for tissue transglutaminase (tTG) autoantibodies in the blood of patients retrospectively enrolled and divided in four groups: autoimmune pancreatitis, chronic pancreatitis, chronic asymptomatic pancreatic hyperenzymemia (CAPH), and control subjects with functional dyspepsia. 

In patients with borderline or positive anti-tTG values, the team also looked at anti-endomysium autoantibodies. They offered duodenal biopsy to all patients with positive results. 

They found just one patient out of 72 (1.4%) with autoimmune pancreatitis who had already been diagnosed with celiac and was following a gluten-free diet, while one case out of 71 (1.4%) with chronic pancreatitis and one out of 92 (1.1%) controls were found to have celiac disease.  They found no celiac disease in the CAPH group. By contrast, a high prevalence of cases with ulcerative colitis was found in the AIP group (13.8%). 

Despite an alleged connection between celiac disease and several autoimmune disorders, the data in this study do not support celiac screening for autoimmune pancreatitis patients. 

Celiac screening may be useful in other pancreatic disorders, but further study is needed to make a determination.

Source:

• Nutrients. 2018 Aug 24;10(9). pii: E1157. doi: 10.3390/nu10091157.

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.

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.

Source:

• International Journal of Celiac Disease. Vol. 4, No. 4, 2016, pp 121-123. doi: 10.12691/ijcd-4-4-6

Celiac.com 02/06/2017 - People with celiac disease have higher rates of autoimmune thyroiditis, and vice versa. Both of these common autoimmune diseases share multiple aspects lodging at the two ends of the gut-thyroid axis where the cross-talks' pathways are still unrivaled.

A team of researchers recently set out to better understand the parameters for effectively screening patients with either disease for the presence of the other. The research team included Aaron Lerner, and Torsten Matthias of the Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel, and with AESKU.KIPP Institute, Wendelsheim, Germany.

Many clinicians recommend screening patients with thyroid autoimmunity for celiac disease associated antibodies. However, the wisdom of routinely screening of celiac patients for anti-thyroid antibodies is less certain.

Despite the fact that the latter screening fulfills most of the criteria for screening a disease, the timing and cost-effectiveness remains undetermined.

For now, in face of celiac disease, the researchers are recommending that clinicians and practitioners keep in mind the higher rates of autoimmune thyroid disease in the interests of making timely and accurate diagnosis.

Read their full report.

Source:

• International Journal of Celiac Disease. Vol. 4, No. 4, 2016, pp 124-126. doi: 10.12691/ijcd-4-4-10