Endocrine Autoimmunity and Inflammatory Signatures in Pediatric Celiac Disease: Context-Dependent Patterns.

Area of Science:

• Pediatric Gastroenterology
• Immunology
• Endocrinology

Background:

• Celiac disease (CD) is often linked to autoimmune conditions like Hashimoto's thyroiditis and type 1 diabetes.
• The prevalence and clinical significance of endocrine autoantibodies in pediatric CD are not well-established.
• This study aimed to assess endocrine autoantibodies and inflammatory markers in pediatric CD for improved diagnostics.

Purpose of the Study:

• To evaluate the prevalence of endocrine autoantibodies in children with celiac disease.
• To analyze inflammatory profiles, including cytokine levels, in pediatric celiac disease.
• To determine if routine endocrine autoantibody screening is warranted in pediatric CD.

Main Methods:

• Retrospective cross-sectional study of 240 children with suspected CD or autoimmune endocrine disorders.
• Diagnosis of CD based on ESPGHAN criteria.
• Laboratory tests included thyroid autoantibodies (anti-TPO, anti-Tg), diabetes-related autoantibodies (GAD, IA-2, ZnT8), and cytokine analysis in a subgroup.

Main Results:

• No significant difference in thyroid autoimmunity (anti-TPO) or islet autoantibody prevalence between CD and control groups.
• Anti-TPO positivity was associated with older age, irrespective of CD status.
• Girls with CD showed significantly higher levels of IL-2, IL-4, and IL-10 compared to boys.

Conclusions:

• Pediatric celiac disease is not associated with increased thyroid or pancreatic autoimmunity in this cohort.
• Distinct sex-based differences in inflammatory profiles suggest unique immune patterns in girls with CD.
• Findings support a clinically guided approach to endocrine autoantibody screening, with potential for cytokine-based immune stratification.