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| Open Access | Thyroid Dysfunction in Pediatric Celiac Disease: A Cross-Sectional Study on the Prevalence and Clinical Implications of Screening
Dr. Lina R. Haddad , MD, Department of Pediatric Gastroenterology, American University of Beirut Medical Center, Beirut, Lebanon Dr. Yasmin A. El-Zein , MD, Department of Pediatric Immunology and Nutrition, King Saud University Medical City, Riyadh, Saudi ArabiaAbstract
Celiac disease (CD) is a chronic autoimmune enteropathy triggered by gluten ingestion, with a well-established association with other autoimmune conditions, particularly autoimmune thyroid disease (AITD). Hypothyroidism, a common manifestation of AITD, can present with non-specific symptoms in children, often overlapping with those of untreated CD. This cross-sectional study aimed to determine the prevalence of thyroid dysfunction, including subclinical and overt hypothyroidism, and thyroid autoimmunity in a cohort of children diagnosed with celiac disease. We hypothesized that the prevalence of thyroid abnormalities would be significantly higher in this population compared to the general pediatric population, underscoring the necessity of routine thyroid screening. Our findings indicate a substantial prevalence of both thyroid autoantibodies and varying degrees of hypothyroidism, emphasizing the clinical importance of systematic thyroid function testing in all pediatric patients with celiac disease. Early detection and intervention are crucial for preventing long-term complications and improving the overall health outcomes of these children.
Keywords
Pediatric celiac disease, thyroid dysfunction, autoimmune disorders
References
Husby, S., Koletzko, S., Korponay-Szabó, I. R., Mearin, M. L., Phillips, A., Shamir, R., ... & Troncone, R. (2012). European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the Diagnosis of Coeliac Disease. Journal of Pediatric Gastroenterology and Nutrition, 54(1), 136-160.
Velikova, T. V., Stoyanova, N. V., & Stoyanov, G. S. (2018). Serological Update on Celiac Disease Diagnostics in Adults. International Journal of Celiac Disease, 6(1), 20-25.
Lebwohl, B., & Rubio-Tapia, A. (2021). Epidemiology, Presentation, and Diagnosis of Celiac Disease. Gastroenterology, 160(1), 63-75.
Younes, N., Al-Hussaini, A., & Al-Tawil, S. (2020). Immunogenetics of Celiac Disease: A Focus on Arab countries. Current Molecular Medicine, 20(4), 275-285.
Gallegos, C., & Merkel, R. (2019). Current Evidence in the Diagnosis and Treatment of Children with Celiac Disease. Gastroenterology Nursing, 42(1), 41-18.
Mainardi, E., Montanari, M., & Odetti, P. (2002). Thyroid-Related Autoantibodies and Celiac Disease, A Role for a Gluten-Free Diet?. Journal of Clinical Gastroenterology, 35(3), 245-248.
Minelli, R., Di Leo, G., & D’Angelo, N. (2018). Thyroid and Celiac Disease in Pediatric Age: A Literature Review. Acta Biomedica, 89(9S), 11-16.
Setian, N. (2007). Hypothyroidism in Children: Diagnosis and Treatment. Journal of Pediatrics, 83(5), 209-216.
Kalyoncu, D., & Urganci, N. (2015). Antithyroid Antibodies and Thyroid Function in Pediatric Patients with Celiac Disease. International Journal of Endocrinology, 2015, 1-14.
Bao, F., Green, P. H. R., & Bhagat, G. (2012). An Update on Celiac Disease Histopathology and the Road Ahead. Archives of Pathology & Laboratory Medicine, 136(7), 735-745.
Kelly, C. P., Bai, J. C., Liu, E., & Leffler, D. A. (2015). Advances in Diagnosis and Management of Celiac Disease. Gastroenterology, 148(6), 1175-1186.
Mehrdad, M., Alizadeh, S., & Ghasemi, A. (2012). Frequency of Celiac Disease in Patients with Hypothyroidism. Journal of Thyroid Research, 2012, 1-6.
Tunç, S., & Özkan, B. (2021). Retrospective Analysis of Hashimoto's Thyroiditis in Children and Adolescents: A Single Center Experience. Journal of Behcet UZ Children's Hospital, 11(3), 314-320.
Ashok, T., Rao, V. S., & Kumar, R. (2022). Celiac Disease and Autoimmune Thyroid Disease the Two Peas in a Pod. Cureus, 14(6).
Pallotta, D. P., Passariello, A., & Di Stasio, E. (2024). Autoimmune Polyendocrine Syndromes in Adult Italian Celiac Disease Patients. Journal of Clinical Medicine, 13(2), 1-9.
Şahin, Ş., & Demir Şahin, F. (2020). Autoimmune Thyroid Disease, Thyroid Functions, and Thyroid Ultrasonography in Pediatric Celiac Disease. Medical Science and Discovery, 7(11), 680-683.
Ansaldi, N., Cingolani, M., & De Giacomo, C. (2003). Autoimmune Thyroid Disease and Celiac Disease in Children. Journal of Pediatric Gastroenterology and Nutrition, 37(1), 63-66.
Niknam, R., Azizi, F., & Hekmatdoost, A. (2024). Thyroid Diseases in Children and Adults with Celiac Disease: A Cross-Sectional Study. Caspian Journal of Internal Medicine, 15(2), 307-312.
Oderda, G., D'Angelo, N., & Di Leo, G. (2002). Thyroid Autoimmunity in Childhood Celiac Disease. Journal of Pediatric Gastroenterology and Nutrition, 35(5), 704-705.
Zeeshan, M., Malik, A., & Bashir, M. H. (2018). Frequency of Hypothyroidism in Children with Celiac Disease at a Tertiary Care Hospital. Journal of Medicine, Physiology and Biophysics, 41, 89-92.
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