Spadaccino Aglaura Cinzia, Basso Daniela, Chiarelli Silvia, Albergoni Maria Paola, D'Odorico Anna, Plebani Mario, Pedini Beniamino, Lazzarotto Francesca, Betterle Corrado
Division of Endocrinology, Department of Medical and Surgical Sciences, University of Padova Medical School, Padova, Italy.
Autoimmunity. 2008 Feb;41(1):116-21. doi: 10.1080/08916930701620209.
Patients with autoimmune thyroid diseases (AITDs) are prone to develop other autoimmune manifestations and to display autoimmune polyendocrine syndromes. An increased prevalence of celiac disease (CD) was demonstrated in adult European and Italian patients with AITDs; conversely, an increased prevalence of AITDs was demonstrated in patients with CD. An IgA deficiency is the most frequent immunodeficiency in humans and, in general, high frequency of this disorder was demonstrated in those with autoimmune diseases.
To define the prevalence of both CD and IgA deficiency in North Italian patients with AITDs.
276 Italian patients with AITD were enrolled (mean age 42.6 years range 12-89, 186 of whom had chronic thyroiditis and 90 had Graves' disease). The tissue transglutaminase autoantibodies of the IgA class (IgA-tTGAbs) were evaluated using an ELISA method in these patients. Furthermore, the serological levels of the IgA were determined.
Five of the patients (1.8%) were affected by previously diagnosed CD and were on a gluten-free diet. Ten out of the remaining 271 patients (3.6%) were found to be positive for celiac-related autoantibodies. All of these patients agreed to undergo endoscopy and duodenal biopsies and silent CD was found in 5 of them but 5 had not histopathological signs of CD. CD (clinical, silent or latent) was present in 15/276 (5.4%) of the North Italian patients with AITD; this prevalence is significantly higher with respect to the general population (p < 0.00001). The genetic pattern of the 10 patients with both AITDs and CD was characterized by the presence of DQ2 in 8 patients and DQ8 in 2. An IgA deficiency was present in 2/276 of the patients (0.72%).
CD is significantly increased in patients with thyroid autoimmune disorders for this reason it is important to screen for CD in patients with AITDs.
自身免疫性甲状腺疾病（AITD）患者易于出现其他自身免疫表现，并呈现自身免疫性多内分泌综合征。在成年欧洲和意大利AITD患者中，乳糜泻（CD）的患病率有所增加；相反，CD患者中AITD的患病率也有所增加。IgA缺乏是人类最常见的免疫缺陷，一般来说，这种疾病在自身免疫性疾病患者中发病率较高。
确定意大利北部AITD患者中CD和IgA缺乏的患病率。
招募了276例意大利AITD患者（平均年龄42.6岁，范围12 - 89岁，其中186例患有慢性甲状腺炎，90例患有格雷夫斯病）。采用酶联免疫吸附测定（ELISA）法评估这些患者的IgA类组织转谷氨酰胺酶自身抗体（IgA - tTGAbs）。此外，还测定了IgA的血清学水平。
5例患者（1.8%）先前被诊断为CD，正在接受无麸质饮食。在其余271例患者中，有10例（3.6%）被发现与乳糜泻相关的自身抗体呈阳性。所有这些患者均同意接受内镜检查和十二指肠活检，其中5例发现无症状性CD，但5例没有CD的组织病理学迹象。15/276（5.4%）的意大利北部AITD患者存在CD（临床型、无症状型或潜伏型）；这一患病率相对于普通人群显著更高（p < 0.00001）。10例同时患有AITD和CD的患者的基因模式特征为，8例患者存在DQ2，2例患者存在DQ8。2/276的患者（0.72%）存在IgA缺乏。
甲状腺自身免疫性疾病患者中CD显著增加，因此对AITD患者进行CD筛查很重要。
