Celiac disease and hypothyroidism in an adult Brazilian female with Down syndrome

ABSTRACT

A high prevalence of celiac disease (CD) in pa»tients with Down syndrome (DS) has been re»ported, mainly in children. The authors present the case of a 47-years-old woman with a history of diarrhea in childhood and since adolescence; and with a treatment for pulmonary tuberculo»siso Currently she reports diarrhea, abdominal distension, weight loss, anemia and treatment for hypothyroidism with levothyroxine. CD was di»agnosed by intestinal biopsy and by positive IgA antiendomysium antibodies. Increased levels of thyroid stimulating hormone and positive anti»thyroperoxidase antibodies were detected. Ultra»sonography of the thyroid gland suggested chronic Iymphocytic thyroiditis. With a gluten»free diet she improved and could control the hypothyroidism. After 2 years, when the family reintroduced gluten she presented the same clin»ical complaints. Laboratory data confirmed the previous diagnosis. The same orientation was offered, with clinical recovery. The authors em»phasize the importance of 5creening for infec»tious and autoimmune diseases in patients with DS, in ali ages, because nowadays individuais with DS live 50 years or more. Both DS and CD can predispose the patients to malignancies, mainly in adult life.