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Published on: March 17, 2023
Prevalence of thyroid autoimmunity in children with celiac disease compared to healthy 12-year olds
Maria van der Pals1, Anneli Ivarsson2, Fredrik Norström2
1Department of Pediatrics, Clinical Sciences, Skåne University Hospital, Lund University, 205 02 Lund, Sweden.
Insights
Children with celiac disease have a higher risk of thyroid autoimmunity. This study found no increased risk for thyroid autoimmunity in untreated celiac disease, suggesting early treatment may not prevent other autoimmune conditions.
Area of Science:
- Pediatric autoimmune diseases
- Endocrinology
- Gastroenterology
Background:
- Celiac disease is linked to other autoimmune conditions.
- The specific relationship between untreated celiac disease and thyroid autoimmunity in children requires further investigation.
Purpose of the Study:
- To determine the prevalence of thyroid autoimmunity in children with diagnosed and treated celiac disease, newly diagnosed untreated celiac disease, and without celiac disease.
- To assess if untreated celiac disease increases the risk of developing thyroid autoimmunity.
Main Methods:
- A cohort study involving 12,632 children.
- Blood samples analyzed for thyroid peroxidase autoantibodies (TPOAb).
- Cases of celiac disease (diagnosed and screening-detected) were matched with referents.
Main Results:
- 335 celiac disease cases identified.
- 7.2% of children with celiac disease had elevated TPOAb, compared to 2.8% of referents.
- No significant difference in TPOAb positivity was found between treated and untreated celiac disease groups.
Conclusions:
- Children with celiac disease exhibit a higher prevalence of thyroid autoimmunity.
- The study did not support the hypothesis that untreated celiac disease is associated with an increased risk of thyroid autoimmunity.
- Early celiac disease treatment initiation may not reduce the risk of developing other autoimmune diseases.
Abstract:
Objectives. Studies have suggested a correlation between untreated celiac disease and risk for other autoimmune diseases. We investigated the prevalence of thyroid autoimmunity in 12-year-old children (i) with symptomatic celiac disease diagnosed and treated with a gluten-free diet, (ii) with screening-detected untreated celiac disease, and (iii) without celiac disease. Methods. Blood samples from 12632 children were collected. All celiac disease cases, previously diagnosed and newly screening-detected, were identified. Per case, 4 referents were matched. Blood samples were analyzed for autoantibodies against thyroid peroxidase (TPOAb). The cut-off value for TPO positivity was set to 100 U/mL. Results. Altogether, 335 celiac disease cases were found. In the entire celiac disease group, 7.2% (24/335) had elevated titers of TPOAb compared to 2.8% (48/1695) of the referents. Among the previously diagnosed celiac disease cases, 7.5% (7/93, OR 2.8, 95% CI 1.2-6.4) was TPOAb positive and among screening-detected cases, 7.0% (17/242, OR 2.6, 95% CI 1.5-4.6) was TPOAb positive. Conclusion. Children with celiac disease showed a higher prevalence of thyroid autoimmunity. We could not confirm the hypothesis that untreated celiac disease is associated with increased risk of developing thyroid autoimmunity. Early initiation of celiac disease treatment might not lower the risk for other autoimmune diseases.
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