Markers of potential coeliac disease in patients with Hashimoto's thyroiditis

Valentino, Rossella; Savastano, Silvia; Maglio, Maria; Paparo, Francesco; Ferrara, Francesco; Dorato, M.; Lombardi, Gaetano; Troncone, Riccardo

doi:10.1530/eje.0.1460479

Cited by 36 publications

(22 citation statements)

References 24 publications

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“…Also, the epithelial compartment shows signs of increased infiltration by CD3 ϩ and ␥␦ ϩ cells. Similar findings have been observed in the intestinal mucosa of patients with Hashimoto's thyroiditis (17) and could be a general feature of autoimmune disorders (18). More intriguing is the enhanced mucosal immune response to gliadin observed in biopsies from type 1 diabetic patients.…”

Section: Discussionsupporting

confidence: 82%

In Vitro–Deranged Intestinal Immune Response to Gliadin in Type 1 Diabetes

Auricchio¹,

Paparo²,

Maglio³

et al. 2004

Diabetes

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Dietary gluten has been associated with an increased risk of type 1 diabetes. We have evaluated inflammation and the mucosal immune response to gliadin in the jejunum of patients with type 1 diabetes. Small intestinal biopsies from 17 children with type 1 diabetes without serological markers of celiac disease and from 50 age-matched control subjects were examined by immunohistochemistry. In addition, biopsies from 12 type 1 diabetic patients and 8 control subjects were cultured with gliadin or ovalbumin peptic-tryptic digest and examined for epithelial infiltration and lamina propria T-cell activation. The density of intraepithelial CD3 ؉ and ␥␦ ؉ cells and of lamina propria CD25 ؉ mononuclear cells was higher in jejunal biopsies from type 1 diabetic patients versus control subjects. In the patients' biopsies cultured with peptic-tryptic gliadin, there was epithelial infiltration by CD3 ؉ cells, a significant increase in lamina propria CD25 ؉ and CD80 ؉ cells and enhanced expression of lamina propria CD54 and crypt HLA-DR. No such phenomena were observed in control subjects, even those with celiac disease-associated HLA haplotypes. In conclusion, signs of mucosal inflammation were present in jejunal biopsies from type 1 diabetic patients, and organ culture studies indicate a deranged mucosal immune response to gliadin.

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Section: Discussionsupporting

confidence: 82%

In Vitro–Deranged Intestinal Immune Response to Gliadin in Type 1 Diabetes

Auricchio¹,

Paparo²,

Maglio³

et al. 2004

Diabetes

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“…However, there are a limited number of studies examining the prevalence of CD in children and adolescents with autoimmune thyroid disease. In studies conducted with adults, the prevalence of CD has been reported to be 10.8-3.3% in subjects with autoimmune thyroid disease (28)(29)(30). In studies conducted with children, the prevalence of CD has been reported to be 0.3-1.2% in healthy children and 1,3-6,5% in children and adolescents with a diagnosis of autoimmune thyroiditis (31,32).…”

Section: Discussionmentioning

confidence: 99%

Celiac disease in children and adolescents with Hashimoto Thyroiditis

et al. 2016

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Aim: The aim of this study was to evaluate clinical and laboratory findings and determine the prevalence of celiac disease (CD) in children with Hashimoto thyroiditis (HT). Material and Methods:The data of a total of 80 patients with positive anti-thyroid antibodies who were aged between 6 and 17.9 years were retrospectively studied. Age, gender, complaints at the time of presentation, family history of thyroid disorders, clinical and laboratory findings were recorded. The levels of thyrotropin, free thyroxin, thyroid autoantibodies (thyroid peroxidase and thyroglobulin antibodies), immunoglobulin A (IgA), anti-tissue transglutaminase antibodies (IgA-tTG), and thyroid ultrasonography findings were enrolled.Results: Eighty patients (65 females (81.2%) and 15 males (18,8%)) were included in the study. Family history of thyroid disease was present in 38 (47.5%) patients. The most common complaints at the time of presentation were goiter (%30) and weight gain (%25). Forty three (53.8%), 23 (28.7%), and 14 (17.5%) patients presented with euthyroidism, subclinical hypothyroidism and obvious hypothyroidism. Thirty seven (46.2%) patients had goiter. IgA-tTG was found to be positive after a diagnosis of HT was made in only one patient (1.25%) and the diagnosis of CD was confirmed when intestinal biopsy of this patient revealed villus atrophy, crypt hyperplasia and increase in the intraepithelial lymphocyte count. Conclusions:In our study, it was found that the most common complaints at presentation in patients with a diagnosis of hashimoto thyroiditis included goiter, weakness and weight gain and the prevalence of celiac diseases was found to be 1.25% (1/80). This study shows that the prevalence of CD in patients with a diagnosis of HT is higher compared to the prevalence in the healthy pediatric population.

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“…Six of these 14 patients showed an increased density of γδ + T-cell receptor-bearing intra-epithelial lymphocytes and signs of mucosal T-cell activation, both typical of CD. 94 Also among 4 of these 6 patients, HLA genotypes associated with CD (three with DRB1*04, DQB1*03 and one with DQA1*0501, DQB1*02) were described.…”

Section: Pathogenesis Of Co-existent Autoimmune Thyroid Disease and CDmentioning

confidence: 99%

Celiac Disease and Autoimmune Thyroid Disease

Ch’ng¹,

Jones²,

Kingham³

2007

Clinical Medicine & Research

152

101

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Cel iac disease (CD) or gluten sensitive enteropathy is a permanent intolerance of dietary gluten leading to mucosal damage in the proximal small bowel in genetically susceptible individuals, characterized by inflammation, crypt hyperplasia and villous atrophy which regress on withdrawal of gluten from the diet. Recent population screening studies have shown the prevalence of CD in Western countries approaches 1% 1-3 but the condition is greatly under-diagnosed, partly because many cases are subclinical, but also because of its previously perceived rarity.CD should be considered in many clinical settings and detected early to prevent complications in later life. In a 6-year prospective study, Corrao et al 4 followed 1,072 consecutive CD patients and found a standard mortality ratio of 0.5 in those who complied with a strict gluten-free diet but a standard mortality ratio of 6.0 in the poor compliers. Using the general practice research database, West et al 5 identified 4,732 CD patients and found a modest increase in overall risks of malignancy and mortality compared to matched controls. 184Celiac disease (CD) or gluten sensitive enteropathy is relatively common in western populations with prevalence around 1%. With the recent availability of sensitive and specific serological testing, many patients who are either asymptomatic or have subtle symptoms can be shown to have CD. Patients with CD have modest increases in risks of malignancy and mortality compared to controls. The mortality among CD patients who comply poorly with a gluten-free diet is greater than in compliant patients.The pattern of presentation of CD has altered over the past three decades. Many cases are now detected in adulthood during investigation of problems as diverse as anemia, osteoporosis, autoimmune disorders, unexplained neurological syndromes, infertility and chronic hypertransaminasemia of uncertain cause.Among autoimmune disorders, increased prevalence of CD has been found in patients with autoimmune thyroid disease, type 1 diabetes mellitus, autoimmune liver diseases and inflammatory bowel disease. Prevalence of CD was noted to be 1% to 19% in patients with type 1 diabetes mellitus, 2% to 5% in autoimmune thyroid disorders and 3% to 7% in primary biliary cirrhosis in prospective studies. Conversely, there is also an increased prevalence of immune based disorders among patients with CD.The pathogenesis of co-existent autoimmune thyroid disease and CD is not known, but these conditions share similar HLA haplotypes and are associated with the gene encoding cytotoxic T-lymphocyte-associated antigen-4.Screening high risk patients for CD, such as those with autoimmune diseases, is a reasonable strategy given the increased prevalence.Treatment of CD with a gluten-free diet should reduce the recognized complications of this disease and provide benefits in both general health and perhaps life expectancy. It also improves glycemic control in patients with type 1 diabetes mellitus and enhances the absorption of medications for associated hypoth...

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Markers of potential coeliac disease in patients with Hashimoto's thyroiditis

Cited by 36 publications

References 24 publications

In Vitro–Deranged Intestinal Immune Response to Gliadin in Type 1 Diabetes

In Vitro–Deranged Intestinal Immune Response to Gliadin in Type 1 Diabetes

Celiac disease in children and adolescents with Hashimoto Thyroiditis

Celiac Disease and Autoimmune Thyroid Disease

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