Endocrine Abstracts

JOINT481

The prevalence of celiac disease (CD) in patients with chronic autoimmune thyroiditis (AIT) is estimated to be between 2 and 7.8%. The aim of the study is to determining the frequency of combined autoimmune pathology - AIT and CD, including gluten intolerance without CD in Ukrainian patients.

Materials and methods: 173 patients (three age groups: I – 5-20, II - 21-45, III – 46-60 yrs) with AIT and anti-thyroid peroxidase (ATPO) blood level exceeding 500 μIU/ml were examined: n = 35 M/138 F. Thyroid status was assessed using TSH and fT4 levels. Ultrasound diagnostics were also used to visualize the thyroid gland. Statistical processing of the results was performed using Package for Social Sciences v.16.0 (SPSS Inc, Chicago, Il, USA).

Results and discussion: It was found that 32.4% (n = 56) patients of all age had a high titer of anti-tissue transglutaminase antibody IgG (tTG) or anti-gliadin antibody IgG (AB AGA). In the I group a positive titer tTG IgG was in 14.3%, AGA IgG in 17.9%, in the II group – in 10.5% and 27.6%, respectively; in the III group – in 5.8% and 23.2%, respectively. Simultaneously positive titer of tTG and AGA IgG and IgA was only in 4 patients (2.3%), which in the presence of pronounced activity of antithyroid immunity, moderate hypothyroidism, as well as erased gastrointestinal symptoms and other nonspecific extraintestinal clinical signs, allows with a high degree of probability to establish the diagnosis of "CD" in these patients. In patients with only one elevated indicator - AGA IgG, it is possible to diagnose "Gluten intolerance without CD". Given the low frequency (2.9%) of high titer tTG IgA, the use of these indicators as a screening examination of patients with AIT is not advisable. Analysis of the dependence of the level of AGA IgG on the activity of thyroid autoimmunity revealed a positive correlation (r = 0.83, P = 0.01) with the level of ATPO, i.e., with high levels of ATPO, the frequency and severity of the immune response to the pathological effects of gluten increases.

Key words: autoimmune thyroiditis, celiac disease.