Celiac disease and autoimmune endocrinologic disorders

Patients with insulin-dependent diabetes mellitus, autoimmune thyroid disea se, Addison's disease, and alopecia areata are at increased risk of celiac disease, We investigated whether patients with more than one autoimmune end ocrinologic disorder are even more susceptible to celiac disease or have ce liac-type mucosal inflammation. All 62 patients found to have such multiple diseases in 1994-1996 were investigated. Small bowel biopsy was performed on all voluntary nonceliac subjects. The villous structure and density of i ntraepithelial lymphocytes were examined, and HLA-DQ alleles were determine d, Seven (11%) patients had celiac disease: six cases were detected earlier and there was one new case: in addition, two had minor villous deteriorati on and five an increased density of mucosal intraepithelial gamma delta(+) T-cells, HLA-DQ2 or DQ8 alleles were found in all subjects with mucosal cha nges. Patients with multiple autoimmune disorders clearly run an increased risk of developing celiac disease, and some of them have minor mucosal chan ges compatible with the early signs of the disease.