Prevalence of autoimmune thyroiditis in children with celiac disease and effect of gluten withdrawal

J Pediatr. 2009 Jul;155(1):51-5, 55.e1. doi: 10.1016/j.jpeds.2009.01.013. Epub 2009 Mar 25.


Objective: To study the prevalence of autoimmune thyroiditis (AT) in Sardinian children with celiac disease (CD) and the effects of a gluten-free diet (GFD) on thyroid function.

Study design: Children with biopsy-proven CD (n = 324; female:male 2:1; mean age, 6.6 years) followed from 1 to 15 years, were retrospectively evaluated for AT at onset of CD and during GFD. Serum thyroid peroxidase and thyroglobulin antibodies (AbTPO, AbTG), thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), and thyroid ultrasonography were considered. Age-matched Sardinian schoolchildren (n = 8040), previously evaluated for antithyroid antibodies and thyroid function, were used as controls.

Results: Thirty-four patients with CD (10.5%) developed AT (female:male 4,5:1; mean age, 10.5 years), 11 at onset of CD and 23 during GFD, with a higher prevalence than controls (P = 2.9(-13)). Twenty-eight patients were euthyroid and 6 hypothyroid. AbTPO and/or AbTG persisted elevated for 2 to 9 years despite the GFD in 9 of 11 patients with AT at onset of CD.

Conclusions: AT is strongly associated with CD in Sardinian children, has an age of onset of 10.5 years, and appears to be gluten-independent. In children with CD with AT, the female:male bias reported in adult AT is present before puberty.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Autoantibodies / blood
  • Case-Control Studies
  • Celiac Disease / diagnosis
  • Celiac Disease / diet therapy*
  • Celiac Disease / epidemiology*
  • Child
  • Child, Preschool
  • Diet, Gluten-Free*
  • Female
  • Humans
  • Hypothyroidism / epidemiology
  • Infant
  • Iodide Peroxidase / immunology
  • Italy / epidemiology
  • Male
  • Prevalence
  • Puberty
  • Retrospective Studies
  • Sex Factors
  • Thyroglobulin / immunology
  • Thyroiditis, Autoimmune / epidemiology*


  • Autoantibodies
  • Thyroglobulin
  • Iodide Peroxidase