title: Screening of celiac disease in patients with autoimmune thyroid disease from Southern Brazil.
abstract: OBJECTIVE
  The objective of this study was to determine the prevalence of celiac disease (CD) in adults with autoimmune thyroid disease (ATD) from the endocrinology outpatient setting in a university hospital in Southern Brazil.
  
  
  METHODS
  From the years 2007 to 2011, 254 patients with ATD were enrolled consecutively, Grave's disease was diagnosed in 143 (56.3%) and Hashimoto's thyroiditis in 111 (43.7%) of them. All patients answered a questionnaire related to symptoms that could be associated with CD and serum samples to screen for IgA anti-endomysial (EmA-IgA) were collected. EmA-IgA-positive patients were offered upper gastrointestinal endoscopy and biopsy of duodenum.
  
  
  RESULTS
  A total of 254 patients were included; 222 (87.4%) female, mean age 45.4 ± 13.43 years (18 to 79 years). EmA-IgA was positive in seven patients (2.7%) and five done endoscopy with biopsy. Of these, three diagnosis of CD was confirmed (1.2%). All the three patients with CD had higher EmA-IgA titration, were female and had Hashimoto's thyroiditis. Like other patients with ATD, CD patients had nonspecific gastrointestinal symptoms, such as heartburn and gastric distention. In our study, one in each 85 patients confirmed the diagnosis of CD.
  
  
  CONCLUSIONS
  We found a prevalence of 1.2% (1:85) of confirmed CD among Brazilian patients with ATD. Although some IgA-EmA positive patients had Graves' disease and one was male, all three patients with confirmed CD were female and had Hashimoto's thyroiditis.
authors.affiliation: Endocrinology Service, Clinical Hospital, Federal University of Paraná, Curitiba, PR, Brazil.
authors.forename: Laila M
authors.initials: LM
authors.lastname: Teixeira
authors.affiliation: Department of Medicine, University Positivo, Curitiba, PR, Brazil.
authors.forename: Renato
authors.initials: R
authors.lastname: Nisihara
authors.affiliation: Laboratory of Immunopathology, Clinical Hospital, UFPR, Curitiba, PR, Brazil.
authors.forename: Shirley Ramos da Rosa
authors.initials: SR
authors.lastname: Utiyama
authors.affiliation: Gastroenterology and Endoscopy Servic, Clinical Hospital, UFPR, Curitiba, PR, Brazil.
authors.forename: Ricardo S de
authors.initials: RS
authors.lastname: Bem
authors.affiliation: Endocrinology Service, Clinical Hospital, Federal University of Paraná, Curitiba, PR, Brazil.
authors.forename: Cristina
authors.initials: C
authors.lastname: Marcatto
authors.affiliation: Laboratory of Immunopathology, Clinical Hospital, UFPR, Curitiba, PR, Brazil.
authors.forename: Michelli
authors.initials: M
authors.lastname: Bertolazo
authors.affiliation: Endocrinology Service, Clinical Hospital, Federal University of Paraná, Curitiba, PR, Brazil.
authors.forename: Gisah A de
authors.initials: GA
authors.lastname: Carvalho
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004386:Duodenum / Q000473:pathology; D005260:Female; D005455:Fluorescent Antibody Technique; D006111:Graves Disease / Q000150:complications*; D050031:Hashimoto Disease / Q000150:complications*; D006356:Heartburn / Q000175:diagnosis; D006801:Humans; D007070:Immunoglobulin A; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D015995:Prevalence; D013967:Thyroiditis, Autoimmune / Q000150:complications; D055815:Young Adult
chemical_list: D007070:Immunoglobulin A