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- Title
Prevalence of Thyroid Disorders in Untreated Adult Celiac Disease Patients and Effect of Gluten Withdrawal: An Italian Multicenter Study.
- Authors
Sategna-Guidetti, C.; Volta, U.; Ciacci, C.; Usai, P.; Carlino, A.; De Franceschi, L.; Camera, A.; Pelli, A.; Brossa, C.
- Abstract
OBJECTIVES: Many afflictions have been associated with celiac disease, but chance associations may exists. The aim of this study was lo establish, by means of a multicenter prospective study, the prevalence of thyroid impairment among adult patients with newly diagnosed celiac disease and to evaluate the effect of a 1-yr gluten withdrawal on thyroid function. METHODS: A total of 241 consecutive untreated patients and 212 controls were enrolled. In 128 subjects a thorough assessment, including intestinal biopsy, was repeated within 1 yr of dietary treatment. Thyroid function was assayed by measuring the levels of TSH, free T3, free T4, thyroperoxidase, and thyroid microsome antibodies. RESULTS: Thyroid disease was 3-fold higher in patients than in controls (<em>p</em> < 0.0005). Hypothyroidism. diagnosed in 31 patients (12.9%) and nine controls (4.2%), was subclinical in 29 patients and of nonautoimmune origin in 21. There was no difference regarding hyperthyroidism. whereas autoimmune thyroid disease with euthyroidism was present in 39 patients (16.2%) and eight controls (3.8%). In most patients who strictly followed a 1-yr gluten withdrawal (as confirmed by intestinal mucosa recovery), there was a normalization of subclinical hypothyroidism. Twenty-five percent of patients with euthyroid autoimmune disease shifted toward either a subclinical hyperthyroidism or subclinical hypothyroidism; in these subjects, dietary compliance was poor. In addition, 5.5% of patients whose thyroid function was normal while untreated developed some degree of thyroid dysfunction 1 yr later. CONCLUSIONS: The greater frequency of thyroid disease among celiac disease patients justifies a thyroid functional assessment. In distinct cases, gluten withdrawal may single-handedly reverse the abnormality.
- Subjects
HYPERTHYROIDISM; THYROID diseases; CELIAC disease; GLUTEN; INTESTINAL biopsy
- Publication
American Journal of Gastroenterology (Springer Nature), 2001, Vol 96, Issue 3, p751
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1111/j.1572-0241.2001.03617.x