Endocrine Abstracts

Introduction: Celiac disease is an autoimmune disorder related to gluten ingestion in genetically predisposed individuals. Its clinical expression is polymorphic, rendering it a true systemic disease, and its management is based on a gluten-free diet (GFD). Autoimmune endocrinopathies are disorders affecting endocrine glands such as the thyroid or adrenal glands, also stemming from autoimmune reactions with complex pathophysiological mechanisms involving environmental, genetic, and immunological factors. While the impact of celiac disease on the digestive system is well-established, less is known about the connections between celiac disease and autoimmune endocrinopathies.

Patients & methods: This is a retrospective descriptive study which focuses on 18 cases of Celiac Disease presenting with autoimmune endocrinopathies, with follow-up managed by the Endocrinology and Metabolic Diseases Department of Ibn Sina University Hospital of Rabat. The study spans a 4-year period from October 2018 to October 2022. The aim of our study is to assess the prevalence of autoimmune endocrinopathies in patients with celiac disease and to better identify common underlying mechanisms.

Results: The mean age of our patients was 30.6±12.6 years, with a female predominance. Autoimmune thyroiditis (Hashimoto’s) was present in 16 cases (89%), while type 1 diabetes was present in 4 cases (22%). One case (5.56%) had corticotropin deficiency due to autoimmune hypophysitis. Six patients had 2 to 3 autoimmune pathologies associated with celiac disease, representing 33%.

Discussion & Conclusion: Celiac disease and autoimmune endocrine disorders are intricately interconnected medical conditions. Patients diagnosed with celiac disease exhibit an elevated susceptibility to the onset of endocrine disorders such as autoimmune thyroiditis, type 1 diabetes, and Addison’s disease. Through our study, we have illuminated this association by examining a series of 18 cases where individuals with celiac disease concurrently presented with autoimmune endocrinopathies. The intricate mechanisms behind this association remain incompletely understood, with suggestions pointing to the potential involvement of genetic, immune, and environmental factors. It has been proposed that gluten ingestion in celiac disease may trigger an inflammatory response, disrupting the immune equilibrium and resulting in endocrine dysfunction. This association emphasizes the critical need for a systematic assessment of endocrine function in individuals with celiac disease. Likewise, individuals diagnosed with autoimmune endocrine disorders should undergo screening for the possibility of celiac disease, facilitating early and effective intervention.