Using a matched cohort design with 1215 cases of celiac disease and 6075 controls, C Canova and colleagues (J Pediatric 2016; 174: 146-52) provide data from 1989-2011 regarding the development of hypothyroidism and diabetes.  This retrospective, longitudinal, population-based Italian study relied on data from the integrated National Health Service.

Key findings:

• Over this >20 year period, the risk of developing hypothyroidism was HR 4.64 and the risk of developing type 1 diabetes mellitus was HR 2.50 (not statistically significant)
• The risk of hypothyroidism was more prevalent in males with HR 20.00.

The authors note: “The most plausible mechanism explaining the association between CD and T1DM/ATD [autoimmune thyroid disease] is a shared genetic background.”

Also noted: NASPGHAN Clinical Report on the Diagnosis and Treatment of Gluten-related Disorders. ID Hill et al. JPGN 2016; 63L 156-63.  Recommended monitoring for celiac disease, from Table 5:

• At diagnosis: CD serology, CBC, Iron profile, HFP, Thyroid tests (TSH, free T4), Calcium, Vit D.
• At 3-6 mo after diagnosis: CD serology (TTG IgA or DGP-IgG)
• Annually:  CD serology, CBC, Thyroid tests (TSH, free T4), Vit D.

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Congaree National Park (SC) and the “knees” of the Bald Cypress trees