Hyposplenism, Hashimoto's Autoimmune Thyroiditis and Overlap Syndrome (Celiac Disease and Autoimmune Hepatitis Type 1)

Am J Med Sci. 2020 Sep;360(3):293-299. doi: 10.1016/j.amjms.2020.04.022. Epub 2020 Apr 25.


Hyposplenism is associated with autoimmune diseases, inflammatory bowel disease, severe celiac disease, autoimmune thyroiditis, untreated HIV infection and chronic graft-versus-host disease. The aim of this study was to review the existing data on hyposplenism associated with celiac disease and Hashimoto's autoimmune thyroiditis. Our research was based on a clinical case concerning a 41-year-old female who presented with asthenia, fatigue, dyspepsia and chronic diarrhea. The medical history revealed autoimmune Hashimoto's thyroiditis, type 2 diabetes, fatty liver disease, chronic gastritis and thrombocytosis. Multiple investigations showed hyposplenism and complex autoimmune dysfunction with positive serum markers for celiac disease and type 1 autoimmune hepatitis along with minor symptomatology. The intestinal symptomatology of celiac disease is often hid by hypothyroidism-associated autoimmune thyroiditis. Asymptomatic or minimally symptomatic celiac disease associated with Hashimoto's autoimmune thyroiditis is diagnosed by biomarkers. Hyposplenism in celiac disease can occur regardless of the disease stage, latent or symptomatic.

Keywords: Autoimmune hepatitis; Celiac disease; Hashimoto's thyroiditis; Hyposplenism; Thrombocytosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Biopsy
  • Celiac Disease / complications*
  • Celiac Disease / pathology
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / pathology
  • Duodenum / pathology
  • Fatty Liver / complications
  • Female
  • Gastritis / complications
  • Hashimoto Disease / complications*
  • Hashimoto Disease / pathology
  • Hepatitis, Autoimmune / complications*
  • Hepatitis, Autoimmune / pathology
  • Humans
  • Magnetic Resonance Imaging
  • Spleen / pathology*
  • Thrombocytosis / complications