Addison's Disease

[georgie]

Design: The aim was to define the prevalence of celiac disease and of IgA deficiency in a group of Italian patients with AAD.

Methods: One hundred and nine patients with AAD were enrolled and examined for tissue transglutaminase autoantibodies of the IgA class, circulating levels of IgA and adrenal cortex antibodies.

Results: Two (1.8%) of the patients were affected by already diagnosed celiac disease and were already on a gluten-free diet. Out of the remaining 107 patients, four (3.7%) were found to be positive for IgA antibodies to human tissue transglutaminase. Three of the four patients who were positive for tissue transglutaminase autoantibodies agreed to undergo endoscopy and duodenal biopsies and, in one, a latent form of celiac disease was identified. The clinical, silent or latent form of celiac disease was present in six out of 109 (5.4%). This prevalence was significantly higher (P = 0.0001) than that reported for the Northern Italian population which was equal to 0.063%. Specifically, celiac disease was present in 12.5% of the autoimmune polyglandular syndrome (APS) type 1 cases, in four out of 60 (6.7%) of the APS type 2 cases and in one out of 40 (2.5%) of the isolated AAD cases. IgA deficiency was present in two out of 109 patients (1.8%), all of whom had normal IgG anti-gliadin. Autoantibodies to the adrenal cortex were detected in 81 out of 109 patients (74.3%).

Conclusions: In patients with AAD there is a high prevalence of both celiac disease and IgA deficiency. Consequently, it is important to screen for celiac disease with tissue transglutaminase autoantibodies of the IgA class and for IgA levels.

Open Original Shared Link