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“Hyperthyroidism,
Iron-deficiency Anemia, and
Celiac Disease”: An Important Case Report by
Dr. Cindy Huang, Dr. Amy Toscano-Zukor, and
Dr. Xiangbing Wang
March 16, 2009
We at Thyroid
Science are please to publish today
a special case report. It is
special for two reasons that I want to bring to the attention of our
readers.
In their report, Drs. Huang, Toscano-Zukor, and Wang explain that they first diagnosed their patient as having
hyperthyroidism and iron-deficiency anemia. Further testing then showed
that the patient had celiac disease. Their report is the first in the
research literature to describe a single patient with Graves’ disease,
iron-deficiency anemia, and celiac disease.
The outcome of these physicians’ care of the patient is noteworthy. They explain that through the appropriate treatment for celiac
disease—that is, withdrawal of gluten-containing foods from the
patient’s diet—she was no longer anemic and her hyperthyroidism
markedly improved. Two months after withdrawing from gluten, she
was clinically euthyroid. The outcome of the patient’s diagnosis and
treatment has important implications for clinical practice.
As Drs. Huang, Toscano-Zukor, and Wang note, celiac disease is on the
rise in Western countries.[1,p.1] Italian researchers have also reported
a recent increase of a milder, subclinical, or “silent” celiac
disorder.[2] Patients with this milder form of celiac may not have
symptoms that prompt their clinicians to test for the disorder. As a
result, the patient’s mild celiac condition may progress and intensify
before it is diagnosed. Consequently, the patients’ prolonged exposure
to dietary gluten may lead to other autoimmune diseases. The is
indicated by a study that showed that longer exposure to dietary gluten
was associated with a higher incidence of autoimmune diseases among celiac patients.[3]
Such study results highlight the importance of diagnosing celiac
disease, even the silent form, as expeditiously as possible.
As Drs. Huang, Toscano-Zukor, and Wang state in their report,
identifying and treating celiac disease by the withdrawal of gluten can
improve the patient’s quality of life. Moreover, this simple treatment
may protect the patient from further sickness. As the authors note, if a
patient is not effectively treated for celiac disease, he or she can
develop benign and even malignant complications. Such complications can
usually be avoided simply by gluten withdrawal—possibly without the
patient having to use medications, as in the case reported by the
physicians.
We thank Dr. Cindy Huang, Dr. Amy Toscano-Zukor, and Dr. Xiangbing Wang
for their case report. It is remarkable in that it is a first in the
medical research literature. In addition, their description of this case
provides other clinicians with practical clinical information.
Clinicians can use that information to better serve their patients whose
autoimmune thyroid disease and iron-deficiency may be improved by
identifying and treating underlying celiac disease.
Reference
1. Huang, C., Toscano-Zukor, A., Wang, X.:
Case Report: Hyperthyroidism,
Iron-deficiency Anemia, and Celiac Disease.
Thyroid Science, 4(3):CR1-3,
2009.
2. Brandimarte, G., Tursi, A., and Giorgetti, G.M.: Changing trends in
clinical form of celiac
disease. Which is now the main form of celiac
disease in clinical practice? Minerva
Gastroenterol. Dietol.,
48(2):121-130, 2002.
3. Ventura, A., Magazzù, G., and Greco, L.: Duration of exposure to
gluten and risk for
autoimmune disorders in patients with celiac
disease. Gastroenterology, 117(2):297-303, 1999.
A Call for Papers. Thyroid Science is an open-access electronic
journal. As, pro forma with new journals,
we are calling for manuscript submissions. We welcome any submission,
whether a paper or letter, that is earnestly intended to contribute to
truth in thyroid science and thyroid clinical practice. In that we are dedicated
to such truth, we consider Thyroid Science a stark contrast to
most major medical journals today—especially
endocrinology journals. In my judgment, most such journals have been co-opted
by corporations and are used as cloaked advertising media. We conceived
Thyroid Science as an alternative to those publications. We offer
it as a medium of expression for those who want their views
published—uncensored—despite
the views being unfavorable to the financial interests of
corporations that financially support the jounals.
Using the electronic format, Thyroid
Science will share a benefit with other journals that are now
published only electronically. That benefit is speed of publication. We can publish
papers as rapidly as the authors and our editors prepare them for publication.
Before submitting a letter or paper, please see our Authors'
Guidelines and How to Submit to Thyroid
Science. If you would like to communicate with us, please write to us at
Editor@ThyroidScience.com.
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