open access

Vol 63, No 3 (2012)
Review paper
Submitted: 2013-02-15
Published online: 2012-06-28
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Coeliac disease in endocrine diseases of autoimmune origin

Piotr Miśkiewicz, Anna Kępczyńska-Nyk, Tomasz Bednarczuk
Endokrynol Pol 2012;63(3):240-249.

open access

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.
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Keywords

coeliac disease; autoimmune polyglandular syndrome; Graves’ disease; autoimmune thyroid disease; type 1 diabetes; autoimmune adrenal insufficiency

About this article
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

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