Toqeer Butt, Asim Mumtaz, Akif Qasim, Nadeem Hameed, Ibrahim M, Kanwal Azhar.
Assessment of thyroid dysfunction in children with celiac disease.
Biomedica Jan ;27(2):123-7.

Introduction: Celiac Disease (CD) is an immune response to ingested wheat gluten and related proteins of rye and barley that leads to inflammation, villous atrophy and intestinal crypt hyperplasia. 1,2 CD was considered as a rare malabsorption syndrome in the previously that can only occur in children, now it is a common condition that may be diagnosed at any age.3 The aim of this study was to assess the thyroid functions in Celiac Disease patients by measuring serum levels of free thyroxine (fT4) and thyroid stimulating hormone (TSH). Anti thyroid peroxidase antibodies (Anti TPO) were also measured to assess the autoimmune nature of thyroid disease. Patients and Methods: It was an analytical cross sectional study, on 50 patients of celiac disease and 25 apparently healthy non celiac children were included in the study. CD patients were already diagnosed by elevated levels of serum anti tissue transglutaminase (IgA class) antibodies (> 15X ULN). CD was ruled out in control group by normal levels of serum anti tissue transglutaminase (IgA class) antibodies. TSH and fT4 were performed on Vitros ECIQ immunodiagnostic system and anti-TPO Antibodies were performed by manual ELISA technique. Results: Mean age of the patients included in the study was 5.3 ± 3.3 (range, 1.5 – 13) years. Mean age of individuals in control group was 5.8 ± 2.5 (range, 2.0 – 12) years. Statistically significant increase levels of TSH and Anti TPO Antibodies were observed in the patient group. No statistically significant difference was observed between means of fT4 in patients and control group. Subclinical hypothyroidism was noticed in 10% patients of celiac disease while anti TPO Antibodies were positive in 16% patients. Conclusion: The present study showed an increased occurrence of thyroid dysfunction and serological evidence of thyroid autoimmunity in patients with CD. Assessment of thyroid function in patients of celiac disease is recommended at regular intervals.

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