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Prevalence of autoimmune thyroiditis in children with celiac disease and effect of gluten withdrawal.

Abstract

OBJECTIVE

To study the prevalence of autoimmune thyroiditis (AT) in Sardinian children with celiac disease (CD) and the effects of a gluten-free diet (GFD) on thyroid function.

STUDY DESIGN

Children with biopsy-proven CD (n = 324; female:male 2:1; mean age, 6.6 years) followed from 1 to 15 years, were retrospectively evaluated for AT at onset of CD and during GFD. Serum thyroid peroxidase and thyroglobulin antibodies (AbTPO, AbTG), thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), and thyroid ultrasonography were considered. Age-matched Sardinian schoolchildren (n = 8040), previously evaluated for antithyroid antibodies and thyroid function, were used as controls.

RESULTS

Thirty-four patients with CD (10.5%) developed AT (female:male 4,5:1; mean age, 10.5 years), 11 at onset of CD and 23 during GFD, with a higher prevalence than controls (P = 2.9(-13)). Twenty-eight patients were euthyroid and 6 hypothyroid. AbTPO and/or AbTG persisted elevated for 2 to 9 years despite the GFD in 9 of 11 patients with AT at onset of CD.

CONCLUSIONS

AT is strongly associated with CD in Sardinian children, has an age of onset of 10.5 years, and appears to be gluten-independent. In children with CD with AT, the female:male bias reported in adult AT is present before puberty.

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  • Authors+Show Affiliations

    ,

    Pediatric Clinic II, Microcitemico Hospital ASL 8, Department of Biological Sciences and Biotechnology, University of Cagliari, Sardinia, Italy. ameloni@mcweb.unica.it

    , ,

    Source

    The Journal of pediatrics 155:1 2009 Jul pg 51-5, 55.e1

    MeSH

    Adolescent
    Autoantibodies
    Case-Control Studies
    Celiac Disease
    Child
    Child, Preschool
    Diet, Gluten-Free
    Female
    Humans
    Hypothyroidism
    Infant
    Iodide Peroxidase
    Italy
    Male
    Prevalence
    Puberty
    Retrospective Studies
    Sex Factors
    Thyroglobulin
    Thyroiditis, Autoimmune

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    19324373

    Citation

    Meloni, Antonella, et al. "Prevalence of Autoimmune Thyroiditis in Children With Celiac Disease and Effect of Gluten Withdrawal." The Journal of Pediatrics, vol. 155, no. 1, 2009, pp. 51-5, 55.e1.
    Meloni A, Mandas C, Jores RD, et al. Prevalence of autoimmune thyroiditis in children with celiac disease and effect of gluten withdrawal. J Pediatr. 2009;155(1):51-5, 55.e1.
    Meloni, A., Mandas, C., Jores, R. D., & Congia, M. (2009). Prevalence of autoimmune thyroiditis in children with celiac disease and effect of gluten withdrawal. The Journal of Pediatrics, 155(1), pp. 51-5, 55.e1. doi:10.1016/j.jpeds.2009.01.013.
    Meloni A, et al. Prevalence of Autoimmune Thyroiditis in Children With Celiac Disease and Effect of Gluten Withdrawal. J Pediatr. 2009;155(1):51-5, 55.e1. PubMed PMID: 19324373.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Prevalence of autoimmune thyroiditis in children with celiac disease and effect of gluten withdrawal. AU - Meloni,Antonella, AU - Mandas,Chiara, AU - Jores,Rita Désirée, AU - Congia,Mauro, Y1 - 2009/03/25/ PY - 2008/08/29/received PY - 2008/11/24/revised PY - 2009/01/08/accepted PY - 2009/3/28/entrez PY - 2009/3/28/pubmed PY - 2009/7/23/medline SP - 51-5, 55.e1 JF - The Journal of pediatrics JO - J. Pediatr. VL - 155 IS - 1 N2 - OBJECTIVE: To study the prevalence of autoimmune thyroiditis (AT) in Sardinian children with celiac disease (CD) and the effects of a gluten-free diet (GFD) on thyroid function. STUDY DESIGN: Children with biopsy-proven CD (n = 324; female:male 2:1; mean age, 6.6 years) followed from 1 to 15 years, were retrospectively evaluated for AT at onset of CD and during GFD. Serum thyroid peroxidase and thyroglobulin antibodies (AbTPO, AbTG), thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), and thyroid ultrasonography were considered. Age-matched Sardinian schoolchildren (n = 8040), previously evaluated for antithyroid antibodies and thyroid function, were used as controls. RESULTS: Thirty-four patients with CD (10.5%) developed AT (female:male 4,5:1; mean age, 10.5 years), 11 at onset of CD and 23 during GFD, with a higher prevalence than controls (P = 2.9(-13)). Twenty-eight patients were euthyroid and 6 hypothyroid. AbTPO and/or AbTG persisted elevated for 2 to 9 years despite the GFD in 9 of 11 patients with AT at onset of CD. CONCLUSIONS: AT is strongly associated with CD in Sardinian children, has an age of onset of 10.5 years, and appears to be gluten-independent. In children with CD with AT, the female:male bias reported in adult AT is present before puberty. SN - 1097-6833 UR - https://www.unboundmedicine.com/medline/citation/19324373/Prevalence_of_autoimmune_thyroiditis_in_children_with_celiac_disease_and_effect_of_gluten_withdrawal_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(09)00012-2 DB - PRIME DP - Unbound Medicine ER -