Vol 63, No 3 (2012)
Review paper
Submitted: 2013-02-15
Published online: 2012-06-28
Coeliac disease in endocrine diseases of autoimmune origin
Piotr Miśkiewicz, Anna Kępczyńska-Nyk, Tomasz Bednarczuk
Endokrynol Pol 2012;63(3):240-249.
Vol 63, No 3 (2012)
Reviews — Postgraduate Education
Submitted: 2013-02-15
Published online: 2012-06-28
Abstract
Abstract
Coeliac disease (CD, sometimes called gluten-sensitive enteropathy or nontropical sprue) is an inflammatory disorder of the small intestine
of autoimmune origin. It occurs in genetically predisposed people and is induced by a gluten protein, which is a component of wheat.
The prevalence of histologically confirmed CD is estimated in screening studies of adults in the United States and Europe to be between
0.2% and 1.0%. The results of previous studies have indicated that the prevalence of CD is increased in patients with other autoimmune
disorders such as: autoimmune thyroid diseases, type 1 diabetes mellitus, and Addison’s disease. A coincidence of the above diseases
constitutes autoimmune polyglandular syndrome (APS). The high prevalence of CD in APS is probably due to the common genetic
predisposition to the coexistent autoimmune diseases. The majority of adult patients have the atypical or silent type of the disease. This
is the main reason why CD so often goes undiagnosed or the diagnosis is delayed. CD, if undiagnosed and untreated, is associated with
many medical disorders including haematological (anaemia), metabolical (osteopenia/osteoporosis), obstetric-gynaecological (infertility,
spontaneous abortions, late puberty, early menopause), neurological (migraine, ataxia, epilepsy) as well as with an increased risk of
malignancy, especially: enteropathy-associated T-cell lymphoma, small intestine adenocarcinoma, and oesophageal and oropharyngeal
carcinomas. Early introduction of a gluten-free diet and lifelong adherence to this treatment decreases the risk of these complications.
Abstract
Abstract
Coeliac disease (CD, sometimes called gluten-sensitive enteropathy or nontropical sprue) is an inflammatory disorder of the small intestine
of autoimmune origin. It occurs in genetically predisposed people and is induced by a gluten protein, which is a component of wheat.
The prevalence of histologically confirmed CD is estimated in screening studies of adults in the United States and Europe to be between
0.2% and 1.0%. The results of previous studies have indicated that the prevalence of CD is increased in patients with other autoimmune
disorders such as: autoimmune thyroid diseases, type 1 diabetes mellitus, and Addison’s disease. A coincidence of the above diseases
constitutes autoimmune polyglandular syndrome (APS). The high prevalence of CD in APS is probably due to the common genetic
predisposition to the coexistent autoimmune diseases. The majority of adult patients have the atypical or silent type of the disease. This
is the main reason why CD so often goes undiagnosed or the diagnosis is delayed. CD, if undiagnosed and untreated, is associated with
many medical disorders including haematological (anaemia), metabolical (osteopenia/osteoporosis), obstetric-gynaecological (infertility,
spontaneous abortions, late puberty, early menopause), neurological (migraine, ataxia, epilepsy) as well as with an increased risk of
malignancy, especially: enteropathy-associated T-cell lymphoma, small intestine adenocarcinoma, and oesophageal and oropharyngeal
carcinomas. Early introduction of a gluten-free diet and lifelong adherence to this treatment decreases the risk of these complications.
Keywords
coeliac disease; autoimmune polyglandular syndrome; Graves’ disease; autoimmune thyroid disease; type 1 diabetes; autoimmune adrenal insufficiency
Title
Coeliac disease in endocrine diseases of autoimmune origin
Journal
Endokrynologia Polska
Issue
Vol 63, No 3 (2012)
Article type
Review paper
Pages
240-249
Published online
2012-06-28
Page views
988
Article views/downloads
2877
Bibliographic record
Endokrynol Pol 2012;63(3):240-249.
Keywords
coeliac disease
autoimmune polyglandular syndrome
Graves’ disease
autoimmune thyroid disease
type 1 diabetes
autoimmune adrenal insufficiency
Authors
Piotr Miśkiewicz
Anna Kępczyńska-Nyk
Tomasz Bednarczuk