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World J Gastroenterol. Mar 21, 2007; 13(11): 1715-1722
Published online Mar 21, 2007. doi: 10.3748/wjg.v13.i11.1715
Coeliac disease in Dutch patients with Hashimoto’s thyroiditis and vice versa
Muhammed Hadithi, Hans de Boer, Jos WR Meijer, Frans Willekens, Jo A Kerckhaert, Roel Heijmans, Amado Salvador Peña, Coen DA Stehouwer, Chris JJ Mulder
Muhammed Hadithi, Chris JJ Mulder, Department of Gastroenterology, Rijnstate Hospital, PO Box 9555, 6800 TA Arnhem, The Netherlands
Hans de Boer, Department of Endocrinology, Rijnstate Hospital, PO Box 9555, 6800 TA Arnhem, The Netherlands
Jos WR Meijer, Department of Pathology, Rijnstate Hospital, PO Box 9555, 6800 TA Arnhem, The Netherlands
Frans Willekens, Laboratory of Biochemistry, Rijnstate Hospital, PO Box 9555, 6800 TA Arnhem, The Netherlands
Jo A Kerckhaert, Laboratory of Biochemistry Immunology, Rijnstate Hospital, PO Box 9555, 6800 TA Arnhem, The Netherlands
Roel Heijmans, Amado Salvador Peña, Laboratory of Immunogenetics, VU University Medical Center, Amsterdam, PO Box 7057, 1007 MB Amsterdam, The Netherlands
Coen DA Stehouwer, Department of Internal Medicine, University Hospital Maastricht, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
Author contributions: All authors contributed equally to the work.
Correspondence to: M Hadithi, Department of Gastroenterology, Groene Hart Ziekenhuis, PO Box 1098, 2800 BB Gouda, The Netherlands. muhammed.hadithi@ghz.nl
Telephone: +31-182-505050 Fax: +31-182-505578
Received: November 24, 2006
Revised: December 20, 2006
Accepted: March 15, 2007
Published online: March 21, 2007
Abstract

AIM: To define the association between Hashimoto’s thyroiditis and coeliac disease in Dutch patients.

METHODS: A total of 104 consecutive patients with Hashimoto’s thyroiditis underwent coeliac serological tests (antigliadins, transglutaminase and endomysium antibodies) and HLA-DQ typing. Small intestinal biopsy was performed when any of coeliac serological tests was positive. On the other hand, 184 patients with coeliac disease were subjected to thyroid biochemical (thyroid stimulating hormone and free thyroxine) and thyroid serological tests (thyroglobulin and thyroid peroxidase antibodies).

RESULTS: Of 104 patients with Hashimoto’s thyroiditis, sixteen (15%) were positive for coeliac serology and five patients with documented villous atrophy were diagnosed with coeliac disease (4.8%; 95% CI 0.7-8.9). HLA-DQ2 (and/or -DQ8) was present in all the five and 53 patients with Hashimoto’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 patients were subclassified into euthyroidism in ten (5%; 95% CI 2-9), subclinical hypothyroidism in seven (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 a Dutch population confirm the association between Hashimoto’s thyroiditis and coeliac disease. Screening patients with Hashimoto’s thyroiditis for coeliac disease and vice versa is recom-mended.

Keywords: Autoimmune disease; Coeliac disease; Hashimoto’s thyroiditis