title: Celiac autoimmunity in autoimmune thyroid disease is highly prevalent with a questionable impact.
abstract: BACKGROUND
  The prevalence of autoimmune thyroid disease (AITD) is 10-12% in the general population worldwide. Among various disorders co-existing with AITD, the concomitance of celiac disease (CD) with AITD results in poor absorption of thyroid medications and results in higher doses of the same. Institution of gluten-free diet (GFD) in this cohort helps reduce medication doses.
  
  
  OBJECTIVE
  To screen patients with AITD for the presence of celiac autoimmunity (CA).
  
  
  METHODS
  A total of 280 consecutive patients with AITD attending the thyroid Out-patient Department of a tertiary care hospital were screened for the presence of tissue transglutaminase antibodies (immunoglobulin A tissue transglutaminase). Those with a positive titer (but < 10 times the upper limit of normal) underwent upper gastrointestinal endoscopy and duodenal mucosal biopsy for the diagnosis of CD, followed by institution of GFD in confirmed cases.
  
  
  RESULTS
  Of a total of 280 (182 females and 98 males) patients with AITD screened, 24 (8.6%) turned out to be positive for CA. Of 24 (8.6%), 15 (8.24%) females and 9 (9.18%) males were positive for CA. There was no statistically significant difference in the thyroxine doses required for normalization of thyroid function and the weight of the patients in CA positive and CA negative patients.
  
  
  CONCLUSIONS
  The prevalence of CD in patients with AITD is much greater than in the general population. This forms the basis for screening patients with AITD for presence of CD.
authors.affiliation: Department of Endocrinology, BYL Nair Charitable Hospital and Topiwala National Medical College, Mumbai, Maharashtra, India.
authors.forename: Bharat Rakeshkumar
authors.initials: BR
authors.lastname: Sharma
authors.affiliation: Department of Endocrinology, BYL Nair Charitable Hospital and Topiwala National Medical College, Mumbai, Maharashtra, India.
authors.forename: Ameya S
authors.initials: AS
authors.lastname: Joshi
authors.affiliation: Department of Endocrinology, BYL Nair Charitable Hospital and Topiwala National Medical College, Mumbai, Maharashtra, India.
authors.forename: Premlata K
authors.initials: PK
authors.lastname: Varthakavi
authors.affiliation: Department of Endocrinology, BYL Nair Charitable Hospital and Topiwala National Medical College, Mumbai, Maharashtra, India.
authors.forename: Manoj D
authors.initials: MD
authors.lastname: Chadha
authors.affiliation: Department of Endocrinology, BYL Nair Charitable Hospital and Topiwala National Medical College, Mumbai, Maharashtra, India.
authors.forename: Nikhil M
authors.initials: NM
authors.lastname: Bhagwat
authors.affiliation: Department of Endocrinology, BYL Nair Charitable Hospital and Topiwala National Medical College, Mumbai, Maharashtra, India.
authors.forename: Pratibha S
authors.initials: PS
authors.lastname: Pawal
keywords: Autoimmunity; celiac disease; thyroid disease