REVIEW: Autoimmune thyroid disease in Coeliac patients

Thyroid disorders and other health conditionsA 2018 research study recruited 341 coeliac [celiac] disease patients and found that 91 of them (26.6%) had at least one autoimmune disease.

Among those 91 patients, 44 patients (48.4%) also had a diagnosis of autoimmune thyroid disease. These coeliac patients with autoimmune thyroid disease constituted 12.9% of the total sample of 341 coeliac patients.

Among the 17 patients with more than one autoimmune disease, autoimmune thyroiditis was the most frequent (64.7%).

Risk factors and odds ratios (OR)

Factors linked to the association of Autoimmune Disease and Coeliac Disease were

  • a positive 1st-degree family history of AD (OR 3.7, 95% CI 1.93 to 7),
  • a body mass index ≥ 25 kg/m2 (OR 2.0, 95% CI 1.1 to 3.8),
  • and long standing presentation signs/symptoms before CD diagnosis (>10 years) (OR 2.1, 95% CI 1.1 to 3.7)

Delayed diagnosis of coeliac disease

The diagnosis of autoimmune disease was known before the diagnosis of coeliac disease in 90% of the cases.

Among the 91 coeliac “cases” with one or more autoimmune disease and 250 coeliac “controls” with without an autoimmune disease,

  • 55.7% of them had “nonclassical presentation” of coeliac disease (61.5 % of cases vs. 53.6% of controls),
  • 33.7% had classical presentation (28.6% of cases, 35.6% of controls)
  • 12% had subclinical presentation (12% of cases, 12% of controls).

Source

Conti, L., Lahner, E., Galli, G., Esposito, G., Carabotti, M., & Annibale, B. (2018). Risk Factors Associated with the Occurrence of Autoimmune Diseases in Adult Coeliac Patients. Gastroenterology Research and Practice, 2018.
LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157138/

More info: Celiac disease symptoms

According to the Celiac Disease Foundation (USA)’s web page on Celiac Disease Symptoms,

  • “In classical celiac disease, patients have signs and symptoms of malabsorption, including
    • diarrhea,
    • steatorrhea (pale, foul-smelling, fatty stools), and
    • weight loss
    • or growth failure in children.”
  • “In non-classical celiac disease, patients may have mild gastrointestinal symptoms without clear signs of malabsorption or may have seemingly unrelated symptoms. They may suffer from
    • abdominal distension and pain, and/or other symptoms such as:
    • iron-deficiency anemia,
    • chronic fatigue,
    • chronic migraine,
    • peripheral neuropathy (tingling, numbness or pain in hands or feet),
    • unexplained chronic hypertransaminasemia (elevated liver enzymes),
    • reduced bone mass and bone fractures, and
    • vitamin deficiency (folic acid and B12),
    • late menarche/early menopause and unexplained infertility,
    • dental enamel defects,
    • depression and anxiety,
    • dermatitis herpetiformis (itchy skin rash), etc.”
  • “Silent celiac disease is also known as asymptomatic celiac disease. Patients do not complain of any symptoms, but still experience villous atrophy damage to their small intestine. Studies show that even though patients thought they had no symptoms, after going on a strict gluten-free diet they report better health and a reduction in acid relux, abdominal bloating and distention and flatulence.
  • “First-degree relatives (parents, siblings, children) , whether or not experiencing symptoms, should always be screened, since there is a 1 in 10 risk of developing celiac disease.”
  • “Currently it is estimated that 80% of the celiac disease population remains undiagnosed.”

 

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