Type 1 Diabetes and Autoimmune Thyroid Disease

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PubMed Abstracts: 

DIAGNOSIS, TREATMENT AND COURSE: These investigations indicated atypical celiac disease with malabsorption, anemia and osteoporosis. The patient received nutritional counseling and was put on a gluten-free diet. Supplementary iron, folic acid and vitamin B (12) were prescribed. A bloodtransfusion was given for the symptomatic anemia. The osteoporosis was treated with calcium and vitamin D3. A follow-up examination after four months revealed complete remission of the abnormal clinical and laboratory findings with partial remission of endoscopic and histologic changes (reduced to Marsh stage 2).

CONCLUSION: Because of the lack of gastrointestinal symptoms, the diagnosis of atypical celiac disease is often made only at an advanced stage and advanced age. The disease is often associated with other autoimmune disorders.

[Atypical celiac disease in a patient with type 1 diabetes mellitus and Hashimoto's thyreoiditis.]
PMID: 21225554  Jan 20100
CONCLUSION: : In this study, more than half of the patients with diabetes mellitus type 1 had at least one pathologically increased antibody titer apart from diabetes without clinical sign of an additional AIEK. 31% of patients with increased antibodies presented with symptoms of another AIEK (increase by 3.6% within 1 year). Patients with diabetes mellitus type 1 should be screened for other AIEKs. Thyropathy had the greatest prevalence and increased by 3.5% within 1 year's time.
[Prevalence of polyglandular autoimmune syndrome in patients with diabetes mellitus type 1.]
PMID: 19337707  Mar 2009

[Coexistance of autoimmunological diseases with type 1 diabetes mellitus in young patients based on literature and own experience]
PMID: 18624123 2008

RESULTS: Celiac disease has been associated with numerous disorders, including several conditions treated by endocrinologists-type 1 diabetes mellitus, autoimmune thyroid disease, Addison disease, osteomalacia, secondary hyperparathyroidism, vitamin D or iron deficiency, fertility problems, hypogonadism in men, and autoimmune hypopituitarism. After our clinical awareness was raised about these potential comorbidities, 18 patients were newly diagnosed with celiac disease in our clinical practice during a 5-year interval.
PMID: 18463048   April 2008

This paper presents a hypothesis of the aetiology of the increasing incidence of type 1 diabetes (T1D). This together with the global increased incidence of celiac disease (CD) and that these increases cannot be explained by genetic factors suggest a common environmental factor for these two diseases. Even though enterovirus (EV) infections are believed to trigger T1D and gluten is the trigger of CD, the increasing intake of gluten containing products all over the world could be the trigger for both diseases directly and indirectly. It has been shown that the duration of exposure to gluten is related to the prevalence of T1D. It has also been shown that T1D patients at onset have an inflammatory reaction in the gut. Hence, early diagnose of CD followed by elimination of dietary gluten will lead to a decreased incidence of T1D.
A unifying hypothesis on the development of type 1 diabetes and celiac disease: Gluten consumption may be a shared causative factor.
PMID: 18249499  Feb 2008

The most frequent reported CD associated conditions are type 1 diabetes mellitus and autoimmune thyroiditis. Associated autoimmune antibodies are frequent in CD and their first-degree relatives, spanning anti-endocrine, anti-gastrointestinal, anti-nuclear, anti-cytoskeleton and anti-neurological antibodies. More specifically, antibodies against thyroid and the endocrine pancreas, anti-gastric and liver, anti-nuclear constituents, anti-reticulin, actin, smooth muscle, calreticulin, desmin, collagens and bone, anti-brain, ganglioside, neuronal and blood vessel were described in sera of the patients in numerous studies.
Associated autoantibodies in celiac disease.
PMID: 17854749 Sept 2007

There is, however, growing evidence that the loss of the intestinal barrier function typical of celiac disease could be responsible of the onset of other autoimmune disease. This concept implies that the autoimmune response can be theoretically stopped and perhaps reversed if the interplay between autoimmune predisposing genes and trigger(s) is prevented or eliminated by a prompt diagnosis and treatment.
Systemic autoimmune disorders in celiac disease.
PMID: 17053448 Nov 2006

This paper presents a series of 10 hypotheses on the etiology of type 1 diabetes. We begin with the hypothesis that wheat gluten is one of the elusive environmental triggers in type 1 diabetes.
Putting the pieces of the puzzle together - a series of hypotheses on the etiology and pathogenesis of type 1 diabetes.
PMID: 17045415 Oct 2006

Both diseases have common immunology and genetic characters. Prevalence of celiac sprue in patients with type I diabetes is several times higher compared to prevalence of this disease in the population. There is the prevalence of celiac sprue 3.6-5.1% in children with type I diabetes mellitus in the Czech Republic, silent form of the disease is the most frequent one. It is necessary to assess (at least once per two years) actively and on regular basis endogenous myosin and/or tissue transglutaminase antibodies in patients with type I diabetes.
[Diabetes and celiac disease]
PMID: 15305643 May 2004

Thus, screening program for coeliac disease are recommended in individuals with type 1A diabetes and/or auto-immune thyroid conditions, as well as in their first-degree relatives.
Coeliac disease in patients with type 1 diabetes mellitus and auto-immune thyroid disorders
PMID: 14618956

Autoimmunity diseases, such as type 1 diabetes mellitus, thyroid diseases, and autoimmune polyglandular syndromes are known to be associated with CD, and they seem to be related to gluten exposure.
Endocrine aspects of coeliac disease
PMID: 12948292

A significant proportion of patients with Hashimoto's thyroiditis present signs of 'potential' CD and of activated mucosal T cell immunity. The gluten dependence of such findings remains to be ascertained.
Markers of potential coeliac disease in patients with Hashimoto's thyroiditis.
PMID: 11916614

Celiac disease will be increasingly detected provided the close association with autoimmune endocrinological diseases is recognized.
Endocrinological disorders and celiac disease
PMID: 12202461

There are numerous associated diseases as dermatitis herpetiformis, diabetes mellitus type I, thyroid and neurologic diseases. The most frequent complications are retardation of growth in childhood, early onset osteoporosis, and an increased risk of abortions. The most severe complication is intestinal lymphoma.
Diagnosis and therapy of celiac disease in adolescence and adulthood
PMID: 12199198

The main results of this study are the high incidence of thyroid and pancreatic antibodies, and the possible role of gluten in the induction of the antibodies as well as, in few cases, the consequent organ dysfunction.
Importance of gluten in the induction of endocrine autoantibodies and organ dysfunction in adolescent celiac patients.
PMID: 10925978

Celiac disease is a permanent intolerance to ingested gluten that results in immunologically mediated inflammatory damage to the small-intestinal mucosa. Celiac disease is associated with both human leukocyte antigen (HLA) and non-HLA genes and with other immune disorders, notably juvenile diabetes and thyroid disease
The widening spectrum of celiac disease.
PMID: 10075317  Full Text