Coeliac Disease in Patients with Autoimmune Thyroiditis

Abstract

Background and Aims: The close association between coeliac disease and autoimmunity prompted us to perform an antibody screening for gluten-sensitive enteropathy in patients with autoimmune thyroid dysfunction. Methods: Sera from 220 patients with autoimmune thyroiditis, 50 euthyroid subjects with thyroid nodules and 250 blood donors were tested for IgA anti-tissue transglutaminase (anti-tTG) and antiendomysial antibodies (EmA). Results: IgA anti-tTG was positive in 7 patients with autoimmune thyroiditis, whereas IgA EmA was found only in 6 of them. Duodenal biopsy confirmed coeliac disease diagnosis disclosing marked and mild villous atrophy in 6 and 1 of them, respectively. All but 2 of the 7 coeliacs did not show any sign of malabsorption. All euthyroid controls were negative for IgA antibodies, whereas 1 blood donor, positive for both IgA anti-tTG and EmA, was found to be coeliac. The prevalence of coeliac disease in patients with autoimmune thyroiditis (3.2%) was significantly higher than that found in blood donors (0.4%) (p = 0.022, Fisher’s exact test). Conclusions: Antibody screening for coeliac disease should be included in the work-up of patients with autoimmune thyroiditis. Either IgA anti-tTG or EmA may be used, even though the former seems to be slightly more sensitive than the latter.

Prevalence of coeliac disease in patients with autoimmune thyroiditis in a Turkish population

“…Additionally, in our study, the prevalence rate of CD in patients with AT was higher than in the previous studies (mean value 3.7%) [11][12][13][14] . This might be associated with the higher prevalence rate of CD in Turkish population.…”

“…An increased prevalence of coeliac disease has been found in patients with AT and Graves' disease [11][12][13][14] . Moreover, it has been demonstrated that many coeliacs are prone to autoimmune thyroid dysfunction [18,19] .…”

“…I t i s k n ow n t h a t C D i s a s s o c i a t e d w i t h s o m e autoimmune disorders, especially type-Ⅰdiabetes mellitus, autoimmune thyroid diseases, collagen disorders, Addison' s disease, pernicious anaemia, alopecia and autoimmune hepatitis [8][9][10] . Among adult patients with autoimmune thyroiditis, the prevalence of CD has been reported to be 3.3-4.8 times more than in the general population [11][12][13][14] . In contrast, a study reported a CD prevalence of 0% in patients with autoimmune thyroiditis [15] .…”

Clustering of additional autoimmunity behaves differently in Hashimoto's patients compared with Graves' patients

“…This is somewhat lower than recent (smaller) studies which reported percentages between 2.7 and 4.8 (20)(21)(22)(23). We ruled out IgA-deficiency since Em and TTG test are an IgA-class test.…”

Associação entre marcadores sorológicos de doença celíaca e das doenças autoimunes da tireóide

“…Estes autores recomendam a triagem de DC rotineira nos pacientes com DAT. O grupo controle deste estudo, que é de indivíduos supostamente sadios (doadores de sangue), difere do nosso, que teve base laboratorial (28).…”