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Objective: To compare thyroid function tests, autoantibodies and ultrasound findings in pediatric celiac patients following a gluten-free diet with the non-celiac control group.
Material and Methods: The data of 64 celiac patients (median age 11 years) followed up with a gluten-free diet in the pediatric outpatient clinic and 143 control patients were retrospectively reviewed. The patient group consisted of 18 men, 46 women, and the control group 39 men and 103 women. The age range of the cases was 6-17 years. The duration of gluten-free diet was between three months and 15 years (median four years). The diagnosis of celiac disease was made according to the criteria of the European Society for Paediatric Gastroenterology, Association of Hepatology, and Nutrition. Free thyroxin, thyroid stimulating hormone (TSH), anti-thyroid peroxidase (anti-TPO), and antithyroglobulin (anti-Tg) levels were measured. In the thyroid ultrasound, gland volume, parenchymal structure, and thyroid nodules were evaluated. The positivity of thyroid autoantibodies and a heterogeneous appearance on ultrasound were assessed in favor of thyroiditis. The findings were compared between the celiac and control groups.
Results: Autoimmune thyroid disease was seen in 12.5% of celiac patients and 4.2% of the controls (p<0.05). The rate of abnormalities in thyroid function tests was 9.3% in the celiac group and 2.8% in the control group (p=0.05). The mean thyroid volume was 3.58 ml in celiac patients and 3.95 ml in controls (p>0.05). The parenchymal heterogeneity was 12.5% in the celiac group and 2.1% in the control group (p<0.05), and the incidence of thyroid nodules was 25% and 4.2%, respectively (p<0.05).
Conclusion: The autoimmune thyroiditis and thyroid dysfunction is more frequent in children with celiac disease. In addition, heterogeneous parenchyma and thyroid nodules are more common than the normal population on ultrasound. Celiac patients should be carefully evaluated for possible thyroid disease.
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