Coeliac disease in Dutch patients with Hashimoto＇s thyroiditis and vice versa

Coeliac disease in Dutch patients with Hashimoto's thyroiditis and vice versa

AIM To define theassociation between Hashimoto's thyroiditis and coeliac disease in Dutch patients.METHODSA total of 104 consecutive patients with Hashimoto's thyroiditis underwent coeliacserological tests (antigliadins, transglutaminase and endomysium antibodies) and HLA-DQtyping. Small intestinal biopsy was performed when any of coeliac serological tests waspositive. On the other hand, 184 patients with coeliac disease were subjected to thyroidbiochemical (thyroid stimulating hormone and free thyroxine) and thyroid serological tests(thyroglobulin and thyroid peroxidase antibodies).RESULTS Of 104 patients withHashimoto's thyroiditis, sixteen (15%) were positive for coeliac serology and fivepatients with documented villous atrophy were diagnosed with coeliac disease (4.8%; 95% CI0.7-8.9). HLA-DQ2 (and/or -DQ8) was present in all the five and 53 patients withHashimoto's thyroiditis (50%; 95% CI 43-62). Of 184 patients with coeliac disease, 39(21%) were positive for thyroid serology. Based on thyroid biochemistry, the 39 patientswere subclassified into euthyroidism in ten (5%; 95% CI 2-9), subclinicalhypothyroidism inseven (3.8%; 95% CI 1.8-7.6), and overt hypothyroidism (Hashimoto's thyroiditis) in 22(12%; 95% CI 8-16). Moreover, four patients with coeliac disease had Graves' disease (2%;95% CI 0.8-5) and one patient had post-partum thyroiditis.CONCLUSION The data from aDutch population confirm the association between Hashimoto's thyroiditis and coeliacdisease. Screening patients with Hashimoto's thyroiditis for coeliac disease and viceversa is recom mended.