PDF(Pubmed)
Abstract：
Celiac disease (CD) is frequently associated with other autoimmune disorders. Different studies have explored the association between CD and single autoimmune endocrine disease (AED), especially autoimmune thyroiditis (AIT) and type-1 diabetes mellitus (T1DM). Data about CD as a component of autoimmune polyendocrine syndrome (APS) are scant. We analyzed a large dataset including prospectively collected data from 920 consecutive adult CD patients diagnosed in a third-level Italian institution in the 2013-2023 period, The prevalence of isolated autoimmune endocrine diseases and APS were collected. A total of 262 (28.5%) CD patients had at least one associated AED, with AIT (n = 223, 24.2%) and T1DM (n = 27, 2.9%) being the most frequent conditions. In most cases (n = 173, 66%), AEDs were diagnosed after CD. Thirteen patients (1.4%) had at least two of the requested three endocrinopathies, satisfying the diagnosis of type 2 APS. APS-2 is a rare but not exceptional occurrence among Italian CD patients, underscoring the intricate and multifaceted nature of autoimmune disorders. Periodic evaluations of thyroid function and glycaemia should be recommended after the diagnosis of CD together with testing for autoantibodies that may be helpful in assessing disease risk before disease onset. Likewise, implementation of a systematic screening for CD amongst T1DM and other autoimmune endocrine diseases are paramount.
摘要：
乳糜泻（CD）通常与其他自身免疫性疾病有关。不同的研究探讨了CD与单一自身免疫性内分泌疾病（AED）之间的关系，尤其是自身免疫性甲状腺炎（AIT）和1型糖尿病（T1DM）。关于CD作为自身免疫性多内分泌综合征（APS）的组成部分的数据很少。我们分析了一个大型数据集，包括2013-2023年期间在意大利三级机构诊断的920名连续成人CD患者的前瞻性数据。收集孤立性自身免疫性内分泌疾病和APS的患病率。共有262例（28.5%）CD患者至少有1例相关AED，AIT（n=223，24.2%）和T1DM（n=27，2.9%）是最常见的疾病。在大多数情况下（n=173，66%），CD后诊断为AED。13名患者（1.4％）患有所要求的三种内分泌病中的至少两种，符合2型APS诊断。APS-2在意大利CD患者中很少见，但并非例外。强调自身免疫性疾病的复杂性和多面性。建议在诊断CD后定期评估甲状腺功能和血糖，同时检测可能有助于在疾病发作前评估疾病风险的自身抗体。同样，在T1DM和其他自身免疫性内分泌疾病中进行CD的系统筛查至关重要.
