Coeliac disease associated with Sjögren's syndrome, renal tubular acidosis, primary biliary cirrhosis and autoimmune hyperthyroidism.
Although coeliac disease may occur in patients affected by another immune-mediated disorder, its coexistence with multiple autoimmune diseases is not frequently described. We report here the case of a 45-year-old woman referred to our centre because of diarrhoea and weight loss, who had already received a diagnosis of primary biliary cirrhosis, Sjögren's syndrome and renal tubular acidosis. Following the development of diarrhoea we established the diagnosis of coeliac disease, based on the presence of anti-endomysium antibodies and a compatible duodenal biopsy. Despite gluten withdrawal she went on to develop an autoimmune hyperthyroidism. The patient tested positive for HLA DRB1*03 and DQB1*02. The association is unlikely to be casual and may be explained by autoimmune mechanisms, genetic susceptibility and favouring environmental factors commonly shared by the diseases of our patient.
Fracchia
M
M
Gastroenterology Unit, Mauriziano Umberto I Hospital, Institute for Cancer Research and Treatment--IRCC, 1-10060 Candiolo, Turin, Italy. ggalatola@mauriziano.it
Galatola
G
G
Corradi
F
F
Dall'Omo
A M
AM
Rovera
L
L
Pera
A
A
Vitale
C
C
Bertero
M T
MT
D000141:Acidosis, Renal Tubular / Q000150:complications*; D001327:Autoimmune Diseases / Q000150:complications*; D002446:Celiac Disease / Q000150:complications*; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications*; D008105:Liver Cirrhosis, Biliary / Q000150:complications*; D008875:Middle Aged; D012859:Sjogren's Syndrome / Q000150:complications*