THYROID AND CELIAC-DISEASE - CLINICAL, SEROLOGICAL, AND ECHOGRAPHIC STUDY

Objective: We sought to reevaluate the prevalence of thyroid dysfuncti on and thyroid autoimmunity in 37 patient with celiac disease; 91 heal thy subjects were studied as controls. Both patients and controls were from Sardinia, Italy. Methods: Diagnosis of celiac disease was made o n the basis of clinical history, presence of positive antigliadin IgA (AGA-A) and IgG (AGA-G) antibodies, antireticulin antibodies (ARA), an tiendomysium antibodies (EMA), and was confirmed by jejunal biopsy. HL A class II typing for DQB1 and DQA1 alleles was performed in 36/47 cel iac patients. Thyroid was evaluated by palpation and echography; serum free thyroid hormones (FT4, FT3), thyrotropic hormone (TSH), and anti thyroid peroxidase autoantibodies (anti-TPO) were assayed by radioimmu noassays. Results: The prevalence of anti-TPO was higher in celiac pat ients (29.7%) than in healthy controls (9.6%) (p < 0.001) and thyroid echography frequently displayed (32.5%) a hypoechogenic pattern. Five anti-TPO-positive celiac patients were hypothyroid (two overt, three s ubclinical). A higher but not significantly different prevalence of an ti-TPO (3/7 = 32.8 %) was found in celiac patients displaying the DQB1 0502 genotype, when compared with the remaining patients (8/29 = 27.6 %). Conclusions: An elevated prevalence of clinical and subclinical au toimmune thyroid autoimmunity was found in Sardinian celiac patients, especially in those displaying the DQB10502 genotype; this finding co uld be related to a particular genetic background of the Sardinian pop ulation. (Am J Gastroenterol 1998;93:976-979. (C) 1998 by Am. Cell. of Gastroenterology).