Diagnostic markers of celiac disease in patients with newly diagnosed graves’ hyperthyroidism at diagnosis and after control of hyperthyroidism
Background
The potential clinical value of early screening of celiac disease (CD), among patients with Graves’ disease (GD) at various clinical stages has not been determined precisely. Prevalence and confirmatory tests of CD in newly diagnosed GD are still debatable. We tracked the diagnostic markers of CD in patients with GD at the time of diagnosis and after control of hyperthyroidism.
Methods
Our study included 40 patients newly diagnosed with GD, who had undergone laboratory, ophthalmology, and radiology examinations. We screen patients for endomysial antibody (EMA-Ab), tissue transglutaminase antibody (tTG-Ab), and IgG and IgA antigliadin antibodies (AGA-IgG and AGA-IgA) initially and after confirmed euthyroid state with antithyroid treatment with small intestinal biopsy for histopathology for patients with persistent seropositive antibodies.
Results
Initially, out of all 40 GD patients who underwent screening, the prevalence of positive AGA-IgA was (17.5%, n = 7/40), AGA-IgG (30%, n = 12/40), EmA-Ab (5%, n = 2/40), and IgA-tTG was (7.5%, n = 3/40). While baseline positive tTG-Ab persisted in only two patients, baseline positive AGA-IgA, AGA-IgG, and EmA-Ab were converted to negative when patients achieved euthyroid state. Thyroid function tests showed significant differences before and after treatment (P < 0.001).
Conclusion
Seropositivity for CD during the active phase of Graves’ hyperthyroidism should be confirmed with clinical and histopathological stigma after control of hyperthyroidism.
