Patients with autoimmune thyroid diseases (AITDs) are likely to develop celiac disease (CD) among other autoimmune disorders. The prevalence of CD in general population is about 11.5% and the frequency of AITDs-CD association is about 1.24.8%. CD can be asymptomatic in adults. Our objectives were to determine the prevalence of CD in adult patients with AITDs and the presence of other endocrine and non-endocrine autoimmune diseases in a single center in Buenos Aires. We evaluated the presence of CD antibodies in our patients with AITDs. In those with positive antibdies, CD was confirmed by endoscopy and duodenal biopsies. A total of 757 patients with AITDs were consecutively included in the study. The following antibodies were screened: Tiroperoxidase by MEIA, TSH receptor by Radioreceptor assay, IgA Endomisium by IFI, IgA and IgG transglutaminase by ELISA. We registered the presence of other autoimmune diseases. In 757 patients with AITDs: 86.7% had Hashimotos thyroiditis (HT), 12.6% had Graves disease (GD) and 0.7% Hashi-Graves; 84% were female, mean age: 52±17 years; 35 patients (4.7%) had AITDs-CD. Five were previously affected with CD and 30 patients were newly diagnosed. Astenia, alopecia, osteoporosis, infertility, vitamine D deficiency, hypocalcemia and anemia were found as predominant findings in these 30 patients; 33/35 patients with AITDs-CD association had HT and 2/35 GD. Eighty four patients had another autoimmune disease: rheumatoid arthritis: 20, vitiligo:16, type I diabetes: 8, Sjögren syndrome: 7, 21-hydroxilase antibodies without adrenal insufficency: 7, Addisons disease: 5, premature ovarian failure: 4, pemphigus: 3, antiphospholipid syndrome: 3, systemic lupus erythematosus: 3, psoriasis: 3, alopecia: 3, pernicious anemia: 2, ulcerative colitis: 2, autoimmune hepatitis: 2, thrombocytopenic purpura: 1, discoid lupus: 1, myasthenia gravis: 1, scleroderma: 1, seronegative spondyloarthropathy: 1, vasculitis: 1. Six patients (18.1%) with HT-CD had a third autoimmune disease; 6 patients (0.9%) with HT had 2 other autoimmune diseases, but not CD. Conclusions: In our patients with AITDs, the prevalance of CD was 4.7%, 4 times over the prevalence in the general population as it was reported in other studies. We suggest assessing the presence of CD in subjects with AITDs who present unspecified symptoms as the ones found in our patients in order to prevent complications resulting from non-diagnosed CD and to consider the presence of other autoimmune diseases.
18 - 21 May 2019
European Society of Endocrinology