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Long-term clinical significance of thyroid autoimmunity in children with celiac disease

Alessandra Cassio1, Giampaolo Ricci, Federico Baronio

  • 1Department of Pediatrics, University of Bologna, Via Massarenti 11, 40138 Bologna, Italy. alessandra.cassio@unibo.it

The Journal of Pediatrics
|October 23, 2009
PubMed

Insights

In children with celiac disease, antithyroid antibodies have a low predictive value for developing thyroid hypofunction. Long-term monitoring is recommended for these patients.

Area of Science:

  • Pediatric Endocrinology
  • Gastroenterology
  • Immunology

Background:

  • Celiac disease is an autoimmune disorder triggered by gluten ingestion.
  • Thyroid dysfunction, including autoimmune thyroiditis, can be associated with celiac disease.
  • Understanding the long-term implications of thyroid autoimmunity in pediatric celiac disease is crucial.

Purpose of the Study:

  • To assess the long-term thyroid function and autoimmunity in a cohort of children diagnosed with celiac disease.
  • To determine the predictive value of antithyroid antibodies for thyroid hypofunction in this population.

Main Methods:

  • A longitudinal, retrospective study followed 135 children with celiac disease for an average of 8.9 years.
  • Patients were on a gluten-free diet with a minimum follow-up of 3 years.
  • Thyroid function (euthyroid, subclinical hypothyroidism) and antithyroid antibody titers were monitored.

Main Results:

  • Among 101 patients without positive antithyroid titers, 86 remained euthyroid.
  • Of 31 patients with persistently positive antibody titers, 74% remained euthyroid, while 26% developed subclinical hypothyroidism.
  • The presence of antibodies was not significantly correlated with growth retardation or initial symptoms.

Conclusions:

  • Antithyroid antibodies in children with celiac disease have a limited predictive value for developing thyroid hypofunction.
  • Continued surveillance is necessary to monitor thyroid function in these patients.
  • Further long-term studies are warranted to fully elucidate the relationship.
Abstract

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