Endocrine Abstracts

Introduction: The link between Celiac disease (CD) and type 1 diabetes mellitus is well known. CD is an autoimmune disorder which was considered as a disease of childhood. Now, we know that CD is life-long condition. It affects people of all ages and all body shapes. Screening for CD or type 1 diabetes is recommended in individuals already diagnosed with either disorder. When individuals have both diseases, type 1 diabetes is usually diagnosed first.

Objectives: Our aim is to demonstrate clinical case of CD in 40 years old woman and results of successful treatment of a Polyglandular Autoimmune Syndrome type IIIA (diabetes mellitus type 1, Hashimoto’s Thyroiditis and Celiac diasease).

Design and methods: 40 years old woman, who has had diabetes mellitus type 1 since the age of 6 years, attended our clinic as her glycemia was poor controlled. She had episodes of severe hypoglycemia and complained of weakness, weight loss, fatigue, diarrhea 4–5 watery stools daily. Laboratory analysis were performed. Thyroid function tests revealed primary hypothyroidism, Hashimoto’s Thyroiditis. It was believed that she had chronic diarrhea due to her diabetes and Alpha Lipoic Acid, B vitamins, Actovegin was initiated. After 2 weeks occured swollen abdomen and edema of lower extremities. Abdomen Ultrasound showed rush peristalsis of intestines, no liquid was observed. Biochemical profile was within normal range. CD was suspected as a disease frequently associated with Polyglandular Syndrome Type IIIA. The diagnosis of CD was confirmed by Serologic test for AGA and the biopsy. Gluten free diet was advised. After 2 weeks her diabetes was better controlled. She has had no complaints of diarrhea.

Conclusion: CD screening is recommended in elderly patients with Diabetes Mellitus type 1 as well as in children.