ESPE2019 Poster Category 2 Multisystem Endocrine Disorders (14 abstracts)
Celiac Disease and Endocrine Autoimmunity in Children and Adolescents
Marina Mitrogiorgou 1 , Feneli Karachaliou 1 , Maria Karalexi 1 , Maria Georgantzi 1 , Helen Kontaki 1 , Periklis Foukas 2 , Konstantinos Triantafyllou 3 & Smaragdi Fesssatou 1
1Department of Pediatrics, National and Kapodistrian University of Athens, General University Hospital "Attikon", Athens, Greece. 2Department of Pathology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece. 3Hepatogastroenterology Unit, Department of Internal Medicine-Propedeutic, Research Institute and Diabetes Center, National and Kapodistrian University of Athens, Athens, Greece
Objectives: Celiac disease (CD) is a life-long inflammatory disease of the gastrointestinal tract that affects genetically susceptible individuals and is associated with several autoimmune diseases. The aim of the study was to evaluate the prevalence of coexistent autoimmune endocrine disorders in children and adolescents diagnosed with CD.
Patients and Methods: Children diagnosed with CD in the Paediatric Gastroenterology Outpatient Clinic of the General University Hospital "Attikon" were included in the study. Data were retrospectively reviewed. They were 62 patients, 48 girls, and 14 boys with a median age at diagnosis 9.0 years (range 2-17)
Results: 12.9% of children presented with positive antithyroid antibodies, a percentage significantly higher compared to the reported in the greek pediatric population (4.3%). Diabetes type 1(TD1) was present in 14.5% of patients compared to a prevalence of 0.08 to 0.24% in similar age ranges. This was partly due to the fact that all TD1 patients were routinely screened for CD. All children with T1D, abnormal anti-tTG IgA underwent esophagogastroduodenal endoscopy with Marsh classification consistent with CD. The percentage of biopsies with a Marsh score greater than IIIB was 42%, whereas 3 (4.8%) patients were also diagnosed with eosinophilic esophagitis (EoE). Moreover, 40% of our patients diagnosed with CD were referred from pediatric endocrinologists.
Conclusion: Our findings confirm the strong association between CD and endocrine autoimmunity. The systematic screening for CD in T1D and autoimmune thyroiditis is useful and clearly indicated. Conversely, there is no indication for systematic screening for endocrine autoimmunity in CD patients until effective preventive strategies for them are available
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