Celiac disease and the endocrinologist: a diagnostic opportunity.
OBJECTIVE
To review the association of celiac disease and various endocrine disorders and present the related clinical experience of a 3-physician adult endocrinology practice.


METHODS
We provide an overview of the pertinent literature, discuss the clinical manifestations, genetics, and pathogenesis of celiac disease, and describe our clinical experience during a 5-year period.


RESULTS
Celiac disease has been associated with numerous disorders, including several conditions treated by endocrinologists-type 1 diabetes mellitus, autoimmune thyroid disease, Addison disease, osteomalacia, secondary hyperparathyroidism, vitamin D or iron deficiency, fertility problems, hypogonadism in men, and autoimmune hypopituitarism. After our clinical awareness was raised about these potential comorbidities, 18 patients were newly diagnosed with celiac disease in our clinical practice during a 5-year interval. All patients had been referred for endocrine evaluation or were undergoing follow-up for ongoing management of endocrine disorders. When a "celiac-associated" endocrine disorder coexists with other factors associated with celiac disease, we recommend performance of IgA class antibody testing, and either antiendomysial or anti-tissue transglutaminase antibodies provide high specificity and sensitivity for the diagnosis of celiac disease.


CONCLUSIONS
Endocrinologists have an opportunity to diagnose celiac disease, a relatively common disorder with profound clinical implications that can often be associated with various endocrinopathies.
Fisher
Arthur H
AH
Endocrinology and Diabetes Associates of Long Island, Rockville Centre, New York 11570, USA.
Lomasky
Steven J
SJ
Fisher
Matthew J
MJ
Oppenheim
Yael L
YL
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis* / Q000276:immunology; D004700:Endocrine System Diseases / Q000150:complications*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
D015415:Biomarkers; D007070:Immunoglobulin A