Endocrine Abstracts

JOINT200

Introduction: Celiac disease and thyroid disorders are both common autoimmune conditions, but their coexistence is less frequently discussed. While both diseases share certain clinical features, their diagnosis can be challenging when they occur together. This study aims to describe the clinical features, diagnostic approaches, and management of patients with celiac disease and thyroid disorders.

Methods: We reviewed the medical records of patients diagnosed with both celiac disease and thyroid disorders at our hospital.

Results: The patients included four women and one man, with a mean age of 22.4 years at the onset of celiac disease (range: 10-39 years). We analyzed the clinical presentation, thyroid function tests, serology, and endoscopic findings. The diagnosis of celiac disease was confirmed by positive anti-transglutaminase antibodies and gastroscopy. The management strategy involved initiating a gluten-free diet for all patients. Among the five patients, thyroid disorders included patent hyperthyroidism in one case, mild hyperthyroidism in one case, hypothyroidism in two cases, and euthyroid thyroidopathy in one case. Celiac disease preceded thyroid dysfunction in three patients, with an average delay of 44 months (range: 24-84 months). In two patients, the diagnosis of celiac disease was concurrent with the thyroid disorder. Clinically, three patients presented with significant weight loss, while one patient had chronic diarrhea. Laboratory findings revealed iron deficiency anemia, malabsorption syndrome, and positive anti-transglutaminase antibodies in three patients. Three patients underwent gastroscopy, which showed typical findings of celiac disease, including flattened and scalloped duodenal folds without mosaic pattern in two cases and a mosaic pattern in one case. All patients were placed on a gluten-free diet, leading to favorable clinical outcomes.

Discussion: Although intestinal absorption disorders can occur in both hyperthyroidism and hypothyroidism independently of celiac disease, celiac disease must be considered in patients presenting with signs of malabsorption. Prompt diagnosis and gluten-free dietary intervention are critical to preventing complications. Recent studies suggest that screening for autoimmune thyroid disorders in patients with celiac disease could be beneficial. The overlapping clinical features of these diseases—such as weight loss, diarrhea, muscle weakness, anxiety, hair loss, and infertility—can complicate diagnosis, especially when hypothyroidism masks some symptoms of celiac disease.

Conclusion: The coexistence of celiac disease and thyroid disorders is relatively common and can complicate diagnosis due to overlapping symptoms. Early recognition of celiac disease in patients with thyroid dysfunction is essential for proper management and to avoid long-term complications.