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Autoimmune endocrinopathies spike after celiac disease diagnosis

 

Key clinical point: Once patients are diagnosed with celiac disease, they have a high incidence of autoimmune endocrinopathies, especially autoimmune thyroid disorders.

Major finding: Following celiac disease diagnosis, the annual incidence of autoimmune endocrinopathies was 0.9%.

Data source: Review of 249 patients diagnosed with celiac disease in the Rochester Epidemiology Project database.

Disclosures: Dr. Absah had no disclosures.


 

AT THE WORLD CONGRESS OF GASTROENTEROLOGY

Patients diagnosed with celiac disease subsequently showed a high incidence of autoimmune endocrinopathies in a review of 249 patients in a longitudinal, population-based database.

The finding that celiac disease patients developed autoimmune endocrinopathies (AE) at a rate of 9.14 cases per person-year of follow-up suggests that “screening for AEs is recommended in treated celiac disease patients,” Imad Absah, MD, said at the World Congress of Gastroenterology at ACG 2017.

Dr. Imad Absah a pediatric gastroenterologist at the Mayo Clinic in Rochester, Minn Mitchel L. Zoler/Frontline Medical News
Dr. Imad Absah

Autoimmune thyroid disorders are the screening focus, and Dr. Asbah recommended a screening interval of every 2 years. Among the 14 patients in the review who developed an AE following a diagnosis of celiac disease, the two most common conditions were Hashimoto’s thyroiditis (4 patients) and hypothyroidism (4 patients), said Dr. Absah, a pediatric gastroenterologist at the Mayo Clinic in Rochester, Minn. One additional patient developed Graves disease.

He also suggested screening for type 1 diabetes in patients who show symptoms of diabetes. In the review, one patient developed type 1 diabetes following an index diagnosis of celiac disease.

His study used data collected in the Rochester Epidemiology Project on residents of Olmsted County, Minn. during 1997-2015. The database included 90 children and 159 adults less than 80 years old diagnosed with celiac disease after they entered the study. The children averaged 9 years old, and the adults averaged 32 years old; about two-thirds were girls or women.

Fifty-four of these people (22%) had been diagnosed with an AE prior to developing celiac disease, and then an additional 20 people (8%) had an incident AE during an average 5.7 years of follow-up for the children and an average 8.5 years of follow-up among the adults. Six of these 20 patients also had a different AE prior to their celiac disease diagnosis. Dr. Absah censored out these six patients and focused his analysis on the 14 patients with no AE prior to developing celiac disease. The incidence rate in both subgroups was 7%, which worked out to an overall incidence rate of 9.14 cases of AE for every person-year of follow-up in newly diagnosed patients with celiac disease.

Finding similar incidence rates among both children and adults suggests that “the length of gluten exposure prior to celiac disease did not affect the risk for an AE,” Dr. Absah said.

Dr. Absah had no relevant disclosures.

This article was updated 10/30/17.

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