Coeliac disease in Dutch patients with Hashimoto's thyroiditis and vice versa.
OBJECTIVE
To define the association between Hashimoto's thyroiditis and coeliac disease in Dutch patients.


METHODS
A total of 104 consecutive patients with Hashimoto's thyroiditis underwent coeliac serological tests (antigliadins, transglutaminase and endomysium antibodies) and HLA-DQ typing. Small intestinal biopsy was performed when any of coeliac serological tests was positive. On the other hand, 184 patients with coeliac disease were subjected to thyroid biochemical (thyroid stimulating hormone and free thyroxine) and thyroid serological tests (thyroglobulin and thyroid peroxidase antibodies).


RESULTS
Of 104 patients with Hashimoto's thyroiditis, sixteen (15%) were positive for coeliac serology and five patients with documented villous atrophy were diagnosed with coeliac disease (4.8%; 95% CI 0.7-8.9). HLA-DQ2 (and/or -DQ8) was present in all the five and 53 patients with Hashimoto's thyroiditis (50%; 95% CI 43-62). Of 184 patients with coeliac disease, 39 (21%) were positive for thyroid serology. Based on thyroid biochemistry, the 39 patients were subclassified into euthyroidism in ten (5%; 95% CI 2-9), subclinical hypothyroidism in seven (3.8%; 95% CI 1.8-7.6), and overt hypothyroidism (Hashimoto's thyroiditis) in 22 (12%; 95% CI 8-16). Moreover, four patients with coeliac disease had Graves' disease (2%; 95% CI 0.8-5) and one patient had post-partum thyroiditis.


CONCLUSIONS
The data from a Dutch population confirm the association between Hashimoto's thyroiditis and coeliac disease. Screening patients with Hashimoto's thyroiditis for coeliac disease and vice versa is recommended.
Hadithi
Muhammed
M
Department of Gastroenterology, Rijnstate Hospital, The Netherlands. muhammed.hadithi@ghz.nl
de Boer
Hans
H
Meijer
Jos W R
JW
Willekens
Frans
F
Kerckhaert
Jo A
JA
Heijmans
Roel
R
Peña
Amado Salvador
AS
Stehouwer
Coen D A
CD
Mulder
Chris J J
CJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002446:Celiac Disease / Q000097:blood / Q000150:complications* / Q000208:ethnology; D005260:Female; D006683:HLA-DQ Antigens / Q000097:blood; D050031:Hashimoto Disease / Q000097:blood / Q000150:complications* / Q000208:ethnology; D006801:Humans; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009426:Netherlands; D013954:Thyroglobulin / Q000097:blood; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood
D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; C109756:HLA-DQ8 antigen; D013972:Thyrotropin; D013954:Thyroglobulin; D013974:Thyroxine