Occurrence of overt celiac disease in the elderly following total thyroidectomy

J Endocrinol Invest. 2006 Oct;29(9):831-3. doi: 10.1007/BF03347379.


We report the case of a female patient in whom gluten-induced entheropathy was revealed at the age of 71 yr by resistance to treatment with levothyroxine (L-T4), calcium carbonate and alfacalcidol. Hypothyroidism and hypoparathyroidism were the consequence of a total thyroidectomy performed at the age of 65 yr for a large multinodular goiter. Six months after thyroid ablation the patient started to complain of abdominal pain, diarrhea and weight loss. Following, anemia and osteopenia were documented. A progressive increase of replacement therapy for hypothyroidism and hypoparathyroidism was necessary. The clinical presentation suggested a malabsorption syndrome: celiac disease (CD) was diagnosed by serological markers and duodenal biopsy. Following gluten-free diet a normalization of clinical and serological findings was observed, bone mass density improved and a reduction of L-T4, calcium and vitamin D requirements was observed.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Calcium / administration & dosage
  • Celiac Disease / complications
  • Celiac Disease / diagnosis*
  • Dose-Response Relationship, Drug
  • Drug Resistance / physiology*
  • Female
  • Hormone Replacement Therapy / methods
  • Humans
  • Hydroxycholecalciferols / administration & dosage
  • Hypoparathyroidism / drug therapy
  • Hypoparathyroidism / etiology
  • Hypothyroidism / drug therapy
  • Hypothyroidism / etiology
  • Intestinal Absorption
  • Thyroidectomy / adverse effects*
  • Thyroxine / administration & dosage
  • Thyroxine / pharmacokinetics
  • Thyroxine / therapeutic use


  • Hydroxycholecalciferols
  • Thyroxine
  • Calcium
  • alfacalcidol