Prevalence of Autoimmune Thyroiditis in Children with Celiac Disease and Effect of Gluten Withdrawal
Received 29 August 2008; received in revised form 24 November 2008; accepted 8 January 2009. published online 26 March 2009.
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.
Pediatric Clinic II, “Microcitemico” Hospital ASL 8, Department of Biological Sciences and Biotechnology, University of Cagliari, Sardinia, Italy
Reprint requests: Dr Antonella Meloni, Pediatric Clinic II, “Microcitemico” Hospital ASL 8, Department of Biological Sciences and Biotechnology, University of Cagliari, Sardinia, Italy.
Supported by a grant from Fritz-Thyssen-Stiftung, Germany (R.-D.J.). The authors declare no potential conflicts of interest, real or perceived.
ABSTRACT