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Positive association of Addison's disease with celiac disease

Elfström P et al. (2007) Risk of primary adrenal insufficiency in patients with celiac disease. J Clin Endocrinol Metab 92: 3595–3598

Addison's disease (primary adrenal insufficiency) is commonly caused by an autoimmune reaction. Several studies have suggested an increased risk of celiac disease in patients with Addison's disease. These studies were, however, limited in size and the risk of Addison's disease in celiac disease had not been estimated.

A study by Elfström et al. examined 14,366 individuals with celiac disease (identified through the national inpatient register of the Swedish National Board of Health) as well as a control group of 70,095 individuals without celiac disease. None of the patients had Addison's disease at, or 1 year after, study entry. Subjects with celiac disease were at an 11-fold increased risk of subsequent Addison's disease. The incidence rate for Addison's disease was 15 per 191,780 person-years in individuals with celiac disease and nine per 971,639 person-years in reference individuals. Subjects who developed Addison's disease were at an eight-fold increased risk of subsequent celiac disease. The positive association between the two disorders was seen both before and after the diagnosis of celiac disease.

The authors conclude that the risk of developing Addison's disease is highly increased in patients with celiac disease and suggest that these findings might be explained by the presence of shared genetic traits. They recommend screening of individuals with Addison's disease for celiac disease, as well as being increasingly aware of Addison's disease in subjects with celiac disease.

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Positive association of Addison's disease with celiac disease. Nat Rev Endocrinol 3, 732 (2007).

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