Thyroid and celiac disease: clinical, serological, and echographic study.
OBJECTIVE
We sought to reevaluate the prevalence of thyroid dysfunction and thyroid autoimmunity in 47 patients with celiac disease; 91 healthy subjects were studied as controls. Both patients and controls were from Sardinia, Italy.


METHODS
Diagnosis of celiac disease was made on the basis of clinical history, presence of positive antigliadin IgA (AGA-A) and IgG (AGA-G) antibodies, antireticulin antibodies (ARA), antiendomysium antibodies (EMA), and was confirmed by jejunal biopsy. HLA class II typing for DQB1 and DQA1 alleles was performed in 36/47 celiac patients. Thyroid was evaluated by palpation and echography; serum free thyroid hormones (FT4, FT3), thyrotropic hormone (TSH), and antithyroid peroxidase autoantibodies (anti-TPO) were assayed by radioimmunoassays.


RESULTS
The prevalence of anti-TPO was higher in celiac patients (29.7%) than in healthy controls (9.6%) (p < 0.001) and thyroid echography frequently displayed (42.5%) a hypoechogenic pattern. Five anti-TPO-positive celiac patients were hypothyroid (two overt, three subclinical). A higher but not significantly different prevalence of anti-TPO (3/7 = 42.8%) was found in celiac patients displaying the DQB1*0502 genotype, when compared with the remaining patients (8/29 = 27.6%).


CONCLUSIONS
An elevated prevalence of clinical and subclinical autoimmune thyroid autoimmunity was found in Sardinian celiac patients, especially in those displaying the DQB1*0502 genotype; this finding could be related to a particular genetic background of the Sardinian population.
Velluzzi
F
F
Department of Endocrinology, Institute of Internal Medicine, University of Cagliari, Italy.
Caradonna
A
A
Boy
M F
MF
Pinna
M A
MA
Cabula
R
R
Lai
M A
MA
Piras
E
E
Corda
G
G
Mossa
P
P
Atzeni
F
F
Loviselli
A
A
Usai
P
P
Mariotti
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000032:analysis; D002446:Celiac Disease / Q000150:complications* / Q000235:genetics / Q000276:immunology; D005260:Female; D005838:Genotype; D005903:Gliadin / Q000276:immunology; D006683:HLA-DQ Antigens / Q000032:analysis; D059848:HLA-DQ alpha-Chains; D059866:HLA-DQ beta-Chains; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007453:Iodide Peroxidase / Q000276:immunology; D007558:Italy; D008297:Male; D008875:Middle Aged; D012155:Reticulin / Q000276:immunology; D013959:Thyroid Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000276:immunology; D013963:Thyroid Hormones / Q000097:blood; D013972:Thyrotropin / Q000097:blood; D014463:Ultrasonography
D001323:Autoantibodies; D006683:HLA-DQ Antigens; D059848:HLA-DQ alpha-Chains; D059866:HLA-DQ beta-Chains; C069050:HLA-DQA1 antigen; C069051:HLA-DQB1 antigen; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D012155:Reticulin; D013963:Thyroid Hormones; D013972:Thyrotropin; D005903:Gliadin; D007453:Iodide Peroxidase