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Celiac disease and autoimmune endocrinologic disorders.

K Kaukinen¹, P Collin, A H Mykkänen

¹Department of Internal Medicine, Tampere University Hospital, Finland.

Digestive Diseases and Sciences

|September 18, 1999

Summary

Patients with multiple autoimmune disorders face a higher risk of celiac disease. Some exhibit early mucosal changes, indicating potential disease development.

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Area of Science:

Immunology
Gastroenterology
Endocrinology

Background:

Patients with autoimmune endocrinologic disorders like type 1 diabetes, autoimmune thyroid disease, Addison's disease, and alopecia areata have an increased risk of celiac disease.
The susceptibility to celiac disease in patients with multiple co-occurring autoimmune endocrinologic disorders remains under investigation.

Purpose of the Study:

To investigate the prevalence of celiac disease and celiac-type mucosal inflammation in patients diagnosed with more than one autoimmune endocrinologic disorder.

Main Methods:

A cohort of 62 patients with multiple autoimmune endocrinologic disorders diagnosed between 1994-1996 was studied.
Small bowel biopsies were performed on voluntary non-celiac subjects to examine villous structure and intraepithelial lymphocyte density.

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HLA-DQ alleles were determined for all participants.

Main Results:

Seven (11%) patients were diagnosed with celiac disease, including one new case.
Two patients showed minor villous deterioration, and five had increased mucosal intraepithelial gammadelta+ T-cells.
All individuals with observed mucosal changes possessed HLA-DQ2 or DQ8 alleles.

Conclusions:

Patients with multiple autoimmune disorders exhibit a significantly increased risk for developing celiac disease.
Minor mucosal abnormalities suggestive of early celiac disease were identified in some patients with multiple autoimmune conditions.