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Celiac disease presenting as resistant hypothyroidism.

J H McDermott1, A Coss, C H Walsh

  • 1Department of Endocrinology, South Infirmary-Victoria Hospital, Old Blackrock Road, Cork, Republic of Ireland.

Thyroid : Official Journal of the American Thyroid Association
|May 7, 2005
PubMed
Summary

Celiac disease can present atypically in patients with autoimmune hypothyroidism, even without typical symptoms. Consider celiac disease in hypothyroid patients resistant to levothyroxine therapy.

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Area of Science:

  • Endocrinology
  • Gastroenterology
  • Immunology

Background:

  • Autoimmune hypothyroidism and celiac disease share a higher prevalence than in the general population.
  • Screening for celiac disease is not routinely recommended for asymptomatic individuals with autoimmune hypothyroidism.
  • Undiagnosed celiac disease is increasingly recognized due to atypical presentations.

Observation:

  • A 58-year-old woman with autoimmune hypothyroidism exhibited resistance to levothyroxine therapy.
  • This patient had no other clinical or laboratory indicators suggestive of celiac disease.
  • Previous cases of levothyroxine malabsorption due to celiac disease involved patients with other overt symptoms.

Findings:

  • This case highlights an atypical presentation of celiac disease.

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  • The patient's condition was initially suspected based on levothyroxine resistance.
  • No other typical or atypical symptoms of celiac disease were present.

    • Implications:

    • Celiac disease diagnosis should be considered in autoimmune hypothyroidism patients with unexplained levothyroxine resistance.
    • This consideration is important even with normal bowel habits and absence of other disease manifestations.
    • Further attention to atypical celiac disease presentations in hypothyroid patients is warranted.