Abstract
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 hypoparathyridism 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.
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References
Ciccocioppo R, D’Alo S, Di Sabatino A, et al. Mechanisms of villous atrophy in autoimmune enteropathy and coeliac disease. Clin Exp Immunol 2002, 128: 88–93.
Green P, Jabri B. Coeliac disease. Lancet 2003, 362: 383–91.
Tai V, Crowe M, O’Keefe S. Celiac disease in older people. J Am Geriatr Soc 2000, 48: 1690–6.
Menardo G, Bertolotti MG, Minetti F, Brizzolara R, Salmaso C, Bagnasco M. Hyperimmunoglobulin a and celiac disease in the elderly. J Am Geriatr Soc 2005, 53: 1074–5.
Rewers M. Epidemiology of celiac disease: what are the prevalence, incidence, and progression of celiac disease? Gastroenterology 2005, 128: S47–51.
Farrell RJ, Kelly C P. Celiac sprue. N Engl J Med 2002, 346: 180–8.
Catassi C, Bearzi I, Holmes GK. Association of celiac disease and intestinal lymphomas and other cancers. Gastroenterology 2005, 128: 79–86.
Matos-Santos A, Lacerda Nobre E, Garcia J, et al. Relationship between the number and impact of stressful life events and the onset of Graves’ disease and toxic nodular goitre. Clin Endocrinol (Oxf) 2001, 55: 15–9.
Isaia GC, Casalis S, Grosso I, Molinatti PA, Tamone C, Sategna-Guidetti C. Hypoparathyroidism and co-existing celiac disease. J Endocrinol Invest 2004, 27: 778–81.
d’Esteve-Bonetti L, Bennet AP, Malet D, Hoff M, Louvet JP, Caron P. Gluten-induced enteropathy (coeliac disease) revealed by resistance to treatment with levothyroxine and alfacalcidol in a sixty-eight-year-old patient: a case report. Thyroid 2002, 12: 633–6.
McDermott JH, Coss A, Walsh CH. Celiac disease presenting as resistant hypothyroidism. Thyroid 2005, 15: 386–8.
Sawin CT, Geller A, Hershman JM, Castelli W, Bacharach P. The aging thyroid. The use of thyroid hormone in older persons. JAMA 1989, 261: 2653–5.
Csako G, McGriff NJ, Rotman-Pikielny P, Sarlis NJ, Pucino F. Exaggerate levothyroxine malabsorption due to calcium carbonate supplementation in gastrointestinal disorders. Ann Pharmacother 2001, 35: 1578–83.
Collin P. Should adults be screened for celiac disease? What are the benefits and harms of screening? Gastroenterology 2005, 128: 104–
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Caputo, M., Brizzolara, R., Schiavo, M. et al. Occurrence of overt celiac disease in the elderly following total thyroidectomy. J Endocrinol Invest 29, 831–833 (2006). https://doi.org/10.1007/BF03347379
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DOI: https://doi.org/10.1007/BF03347379