title: Thyroid autoimmunity in children with coeliac disease: a prospective survey.
abstract: BACKGROUND
  Thyroid autoimmunity (TA) is often associated with coeliac disease (CD).
  
  
  OBJECTIVE
  To evaluate, in children and adolescents with CD on a gluten-free diet (GFD): (1) the prevalence of TA; (2) the impact of TA on growth and the need for L-thyroxine (L-T4) treatment, during a longitudinal survey.
  
  
  METHODS
  Between January and December 2005, 545 patients with CD, prospectively followed up until December 2007, and 622 controls were screened for TA. Antithyroperoxidase and antithyroglobulin antibodies were assayed and, if positive, serum free tri-iodothyronine, free thyroxine and thyroid-stimulating hormone (TSH) assays and thyroid ultrasound were performed. L-T4 was started if TSH was >5.5 mU/ml at two successive measurements.
  
  
  RESULTS
  There was no significant difference in TA prevalence between patients with CD on a GFD (10%) and controls (8.2%). Duration of GFD differed significantly in coeliac patients with TA in comparison with those without TA (7.9±0.9 and 10.2±0.3 years, p<0.001), but no significant difference was found for weight and height gain (1.8±1.0 vs 3.7±1.5 and 2.1±1.2 kg/year vs 4.0±1.1 cm/year, respectively). At the end of the follow-up an increase of 7% in the prevalence of patients with CD with TA requiring L-T4 was found.
  
  
  CONCLUSIONS
  TA seems no more common in paediatric and adolescent patients with CD on a GFD than in controls; its clinical evolution does not seem to impact on growth. Therefore, a long-term regular screening programme for thyroid disease may not be necessary for all patients with CD on a GFD, but only for those who are suspected of having thyroid diseases.
authors.affiliation: Gastroenterology and Nutrition Unit, Pediatric Hospital 'Bambino Gesù', Piazza S Onofrio 4, 00165 Rome, Italy. diamanti@opbg.net
authors.forename: Antonella
authors.initials: A
authors.lastname: Diamanti
authors.forename: Francesca
authors.initials: F
authors.lastname: Ferretti
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Guglielmi
authors.forename: Fabio
authors.initials: F
authors.lastname: Panetta
authors.forename: Franco
authors.initials: F
authors.lastname: Colistro
authors.forename: Marco
authors.initials: M
authors.lastname: Cappa
authors.forename: Antonella
authors.initials: A
authors.lastname: Daniele
authors.forename: Maria
authors.initials: M
authors.lastname: Sole Basso
authors.forename: Cristian
authors.initials: C
authors.lastname: Noto
authors.forename: Massimo
authors.initials: M
authors.lastname: Crisogianni
authors.forename: Massimo
authors.initials: M
authors.lastname: Castro
mesh_terms: D000293:Adolescent; D001327:Autoimmune Diseases / Q000209:etiology*; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy; D002648:Child; D002675:Child, Preschool; D055050:Diet, Gluten-Free; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000209:etiology; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy / Q000209:etiology; D007223:Infant; D008297:Male; D011446:Prospective Studies; D013959:Thyroid Diseases / Q000209:etiology*; D013974:Thyroxine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D013974:Thyroxine