IgA anti-tTG assays by ELISA are highly sensitive (90%-98%) and specific (94-97) for diagnosis of coeliac disease. patients with autoimmune thyroiditis have an increased risk of coeliac disease and serological screening may be useful for early detection of coeliac disease in these patients. Our findings need to be confirmed in a larger series of patients. test. The statistical analyses were performed using a statistical program for Sorafenib (D3) PC (SPSS 11.0 for Windows, SPSS Inc., IL, USA). values of less than 0.05 were considered statistically significant. RESULTS The age and gender were comparable in both groups (= 0.21 and = 0.32, respectively). Clinical, serologic and his-tological features of the patients with AT are shown in Table ?Table11. Table 1 Clinical, antibody and histological features of 8 autoimmune throiditis patients with positive IgA anti-tTG test = 0.04). Six patients (5 female and 1 male) and one control subject agreed to endoscopy and duodenal biopsy. Four patients (3 female and 1 male) and one control subject had histological findings of CD, and two patients with AT experienced normal duodenal histology. Histopathological examination revealed changes classified as Marsh IIIa in one, Marsh II in one, Marsh I in two patients with AT, and MarshIin one blood donor. Among the 8 patients who were KR2_VZVD antibody positive in antibody assessments, one patient (case 7), a 61 years old female with histological CD as Marsh IIIa, experienced iron-deficiency anemia and osteopenia, and one patient (case 8), a 40 years aged female with histological CD as Marsh II, experienced iron-deficiency, but no anemia (Table ?(Table1).1). The other 6 patients with AT and one control subject who experienced positive antibody test did not have any symptoms, indicators or laboratory findings of malabsorbtion. All subjects with histologically confirmed CD were prescribed gluten-free diet. Conversation The association between coeliac disease and autoimmune thyroiditis has been previously reported. An increased prevalence of coeliac disease has been found in patients with AT and Graves disease[11-14]. Moreover, it has been demonstrated that many coeliacs are prone to autoimmune thyroid dysfunction[18,19]. This association could be related to a common genetic background (HLA-DQ2 and HLA-DQ8). Serologic assessments developed in the past decade provide a noninvasive tool to screen both individuals at risk for the disease and general populace. IgA anti-tTG assays by ELISA are highly sensitive (90%-98%) and specific (94-97) for diagnosis of coeliac disease. It is now widely available, less costly, and easier to perform than the immunofluorescence assay used to Sorafenib (D3) detect IgA EMA[2]. Screening studies show a high prevalence (between 1/80-1/300) of CD among both healthy children and adults in European countries[6,7]. The prevalence of coeliac disease in 2000 healthy blood donors has recently been found to be 1.3% (1/77) in Turkey[20]. This study shows that the prevalence of CD in the Turkish populace is relatively high in comparison to Western world. In our study, the prevalence of positive IgA anti-tTG test in patients with AT was significantly higher than the controls (5.9% 0.8%). Additionally, in our study, the prevalence rate of CD in patients with AT was higher than in Sorafenib (D3) the previous studies (mean value 3.7%)[11-14]. This might be associated with the higher prevalence rate of CD in Turkish populace. In the literature, there are some studies with different results. Ravaglia et al[21] reported that only the patients aged 65 and older with AT experienced an increased risk of CD. In our study, the risk increased in patients under 66 years of age. In contrary to our findings, in a recent study from Italy, CD prevalence was reported as 0% in patients with autoimmune thyroiditis[15]. Racial and regional differences may explain these opposing findings. It is of great importance to identify early CD in patients with AT, since a rigid adherence to a gluten-free diet not only helps prevent the severe complications of untreated gluten-sensitive enteropathy such as ulcerative jejunoileitis, intestinal lymphoma and neoplasm[22], but also helps improve the associated autoimmune disease[12]. This is the first study conducted about association of CD with AT in a Turkish populace. The relatively small sample size may be a limitation for our study. Studies with larger populations would bring more accurate results. In conclusion, this study suggests that Turkish patients with AT have an increased risk of CD. Serological screening may be useful for early detection of CD in these patients. Sorafenib (D3) However, our findings need to be confirmed in a larger series of patients. Footnotes S- Editor Liu Y L- Editor Ma JY E- Editor Chin GJ.