Celiac Disease and Autoimmune Endocrinologic Disorders

Patients with insulin-dependent diabetesmellitus, autoimmune thyroid disease, Addison's disease,and alopecia areata are at increased risk of celiacdisease. We investigated whether patients with more than one autoimmune endocrinologic disorder areeven more susceptible to celiac disease or haveceliac-type mucosal inflammation. All 62 patients foundto have such multiple diseases in 1994-1996 were investigated. Small bowel biopsy was performedon all voluntary nonceliac subjects. The villousstructure and density of intraepithelial lymphocyteswere examined, and HLA-DQ alleles were determined. Seven (11%) patients had celiac disease: six caseswere detected earlier and there was one new case; inaddition, two had minor villous deterioration and fivean increased density of mucosal intraepithelial⁺ T-cells. HLA-DQ2 or DQ8 alleles were found inall subjects with mucosal changes. Patients withmultiple autoimmune disorders clearly run an increasedrisk of developing celiac disease, and some of them have minor mucosal changes compatible with theearly signs of the disease.