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Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study.
Am J Gastroenterol 2001; 96(3):751-7AJ

Abstract

OBJECTIVES

Many afflictions have been associated with celiac disease, but chance associations may exists. The aim of this study was to establish, by means of a multicenter prospective study, the prevalence of thyroid impairment among adult patients with newly diagnosed celiac disease and to evaluate the effect of a 1-yr gluten withdrawal on thyroid function.

METHODS

A total of 241 consecutive untreated patients and 212 controls were enrolled. In 128 subjects a thorough assessment, including intestinal biopsy, was repeated within 1 yr of dietary treatment. Thyroid function was assayed by measuring the levels of TSH, free T3, free T4, thyroperoxidase, and thyroid microsome antibodies.

RESULTS

Thyroid disease was 3-fold higher in patients than in controls (p < 0.0005). Hypothyroidism, diagnosed in 31 patients (12.9%) and nine controls (4.2%), was subclinical in 29 patients and of nonautoimmune origin in 21. There was no difference regarding hyperthyroidism, whereas autoimmune thyroid disease with euthyroidism was present in 39 patients (16.2%) and eight controls (3.8%). In most patients who strictly followed a 1-yr gluten withdrawal (as confirmed by intestinal mucosa recovery), there was a normalization of subclinical hypothyroidism. Twenty-five percent of patients with euthyroid autoimmune disease shifted toward either a subclinical hyperthyroidism or subclinical hypothyroidism; in these subjects, dietary compliance was poor. In addition, 5.5% of patients whose thyroid function was normal while untreated developed some degree of thyroid dysfunction 1 yr later.

CONCLUSIONS

The greater frequency of thyroid disease among celiac disease patients justifies a thyroid functional assessment. In distinct cases, gluten withdrawal may single-handedly reverse the abnormality.

Authors+Show Affiliations

University of Torino, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

11280546

Citation

Sategna-Guidetti, C, et al. "Prevalence of Thyroid Disorders in Untreated Adult Celiac Disease Patients and Effect of Gluten Withdrawal: an Italian Multicenter Study." The American Journal of Gastroenterology, vol. 96, no. 3, 2001, pp. 751-7.
Sategna-Guidetti C, Volta U, Ciacci C, et al. Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study. Am J Gastroenterol. 2001;96(3):751-7.
Sategna-Guidetti, C., Volta, U., Ciacci, C., Usai, P., Carlino, A., De Franceschi, L., ... Brossa, C. (2001). Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study. The American Journal of Gastroenterology, 96(3), pp. 751-7.
Sategna-Guidetti C, et al. Prevalence of Thyroid Disorders in Untreated Adult Celiac Disease Patients and Effect of Gluten Withdrawal: an Italian Multicenter Study. Am J Gastroenterol. 2001;96(3):751-7. PubMed PMID: 11280546.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study. AU - Sategna-Guidetti,C, AU - Volta,U, AU - Ciacci,C, AU - Usai,P, AU - Carlino,A, AU - De Franceschi,L, AU - Camera,A, AU - Pelli,A, AU - Brossa,C, PY - 2001/3/31/pubmed PY - 2001/5/1/medline PY - 2001/3/31/entrez SP - 751 EP - 7 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 96 IS - 3 N2 - OBJECTIVES: Many afflictions have been associated with celiac disease, but chance associations may exists. The aim of this study was to establish, by means of a multicenter prospective study, the prevalence of thyroid impairment among adult patients with newly diagnosed celiac disease and to evaluate the effect of a 1-yr gluten withdrawal on thyroid function. METHODS: A total of 241 consecutive untreated patients and 212 controls were enrolled. In 128 subjects a thorough assessment, including intestinal biopsy, was repeated within 1 yr of dietary treatment. Thyroid function was assayed by measuring the levels of TSH, free T3, free T4, thyroperoxidase, and thyroid microsome antibodies. RESULTS: Thyroid disease was 3-fold higher in patients than in controls (p < 0.0005). Hypothyroidism, diagnosed in 31 patients (12.9%) and nine controls (4.2%), was subclinical in 29 patients and of nonautoimmune origin in 21. There was no difference regarding hyperthyroidism, whereas autoimmune thyroid disease with euthyroidism was present in 39 patients (16.2%) and eight controls (3.8%). In most patients who strictly followed a 1-yr gluten withdrawal (as confirmed by intestinal mucosa recovery), there was a normalization of subclinical hypothyroidism. Twenty-five percent of patients with euthyroid autoimmune disease shifted toward either a subclinical hyperthyroidism or subclinical hypothyroidism; in these subjects, dietary compliance was poor. In addition, 5.5% of patients whose thyroid function was normal while untreated developed some degree of thyroid dysfunction 1 yr later. CONCLUSIONS: The greater frequency of thyroid disease among celiac disease patients justifies a thyroid functional assessment. In distinct cases, gluten withdrawal may single-handedly reverse the abnormality. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/11280546/Prevalence_of_thyroid_disorders_in_untreated_adult_celiac_disease_patients_and_effect_of_gluten_withdrawal:_an_Italian_multicenter_study_ L2 - http://Insights.ovid.com/pubmed?pmid=11280546 DB - PRIME DP - Unbound Medicine ER -