Long-term Clinical Significance of Thyroid Autoimmunity in Children with Celiac Disease

Celiac disease and endocrine autoimmune disorders in children: an update

“…Therefore, 93% of patients with TA were still euthyroid for at least 2 years after the original diagnosis. Similar results were reported by Cassio et al [95] who reviewed the medical records of 135 consecutive patients diagnosed with CD at June 1990 and December 2004 (age at diagnosis, 5.7 ± 3.9 years) and followed-up for 8.9 ± 4.0 years (range 3-17 years) on a GFD. At diagnosis, negative antithyroid antibody titers were observed in 119 of 135 patients (88%) and positive antibody titers in 16 of 135 patients (12%).…”

“…Changes in antibody levels observed in this small cohort at the end of the GFD were not significantly different from the fluctuations found in matched historical control subjects, suggesting that the removal of dietary gluten does not modulate the serological markers in the pre-T1D phase. The main clinical studies on the association between CD and T1D are summarized in TABLE 2. Celiac disease & thyroid autoimmunity CD patients, aged <18 years, show a wide variety of TA prevalence without thyroid disease ranging from 12 to 26% [88][89][94][95][96][97][98]. On the contrary, the prevalence of biopsy-proven CD in TA patients seems to reach upto 7% [99].…”

“…There are no current recommendations for TA screening in CD patients. Various screening strategies have been considered advisable in the following clinical conditions: poor growth, weight loss or other signs or symptoms of hypo-or hyperthyroidism [95]; at CD diagnosis and at follow-up evaluation [94]; at CD diagnosis and only in CD who have positive antithyroid antibody titers and at follow-up [95].…”

Principles and Strategies for Monitoring Individuals with Celiac Disease

“…Also, currently there are no means of preventing the development of thyroiditis or other auto-immune disorders such as type-1 diabetes. There is controversy whether a gluten-free diet prevents autoimmune thyroiditis that is established or is in evolution (Meloni et al 2009, Cassio et al, 2010.…”

Gluten-free diet does not influence the occurrence and the Th1/Th17-Th2 nature of immune-mediated diseases in patients with coeliac disease

“…CD is frequently associated to other Th1/Th17-IMD M a n u s c r i p t To date, a gluten free diet (GFD) is considered the only treatment for CD. Numerous papers have investigated the effects of CD therapy on the incidence and prognosis of coexisting or subsequent IMD but thus far they have reported contradictory results [26][27][28][29][30][31][32][33][34][35]. The aims of our study were: 1) to establish the prevalence of IMD at the time and after CD diagnosis in a large sample of adult individuals; 2) to identify any possible changes in immune response after commencement of GFD, in particular with regard to shifts from Th1/Th17-to Th2-immune response or vice versa; and 3) to investigate the potential role of GFD in reducing and/or preventing IMD in adult CD patients.…”