Autoimmune Thyroid Disease with Hypothyroidism in Adult Celiac Disease

Evidence largely from earlier prevalence studies and recent population-based studies indicate that there is a strong clinical association between autoimmune thyroid disease and adult celiac disease. In part, at least, this appears to be related to common genetically-based determinants as well as a common embryonic origin since the fetal thyroid is derived from the pharyngeal gut. Specific phenotypic features have been described if both disorders are defined, including dermatitis herpetiformis, and a greater risk for a malignant complication, including lymphoma, especially if celiac disease is initially diagnosed at a late age. Some phenotypic characteristics of autoimmune thyroid disease, such as orbitopathy, may be an important clue to occult celiac disease. Similarly, a high thyroxine dose requirement for treatment of autoimmune thyroid disease may be another phenotypic characteristic of undetected celiac disease. Serological screening for celiac disease should be considered if autoimmune thyroid disease is detected.