AUTOIMMUNE THYROID-DISORDERS AND CELIAC-DISEASE

Eighty-three patients with autoimmune thyroid disorders were screened for coeliac disease. The screening was performed with IgA-class reticu lin and endomysium antibody, IgA- and IgG-class gliadin antibody tests , and various biochemical tests for malabsorption. None of the tested subjects had selective IgA deficiency, which excludes the possibility of not detecting positives by an IgA-class test. Of the 83 patients, t hree asymptomatic coeliac patients were found, and one patient with co eliac disease previously diagnosed, an overall frequency of 4.8%. In a ddition, 25 patients with a solitary nodule of the thyroid gland were examined and one of them (4%) was found to have coeliac disease. By co ntrast, one (0.4%) out of 249 age- and sex-matched blood donors was fo und to have coeliac disease. All newly detected coeliac patients had I gA-class gliadin, reticulin and endomysium antibodies, but none of the patients had any gastrointestinal symptoms or abnormal biochemical fi ndings suggesting coeliac disease. Treatment of thyroid disorders and coeliac disease was successful in these patients. The present results confirm that the frequency of subclinical coeliac disease is increased among patients with autoimmune thyroid disorders. IgA-class reticulin , endomysium or gliadin antibody tests are suitable screening methods for detecting these patients, as far as selective IgA-deficiency is ex cluded.