Frequency of hypothyroidism in children with Celiac disease: A cross-sectional study at a tertiary care hospital in Pakistan

Objective: The objective of this study was to assess the prevalence of hypothyroidism in children with celiac disease (CD). Patients and Methods: This cross-sectional study was conducted at the Pediatrics department of a tertiary care hospital in Pakistan from 1st Sep 2023 to 30 Nov 2024. The study included 196 children aged 2–12 years with a confirmed diagnosis of celiac disease (CD). Diagnosis was established through elevated serological markers, including anti-tissue transglutaminase (anti-tTG) antibodies and anti-endomysial antibodies (EMA), along with histopathological confirmation of CD when available. Data analysis was conducted using SPSS v.26 and P<0.05 was considered significant. Results: The majority among the study sample were aged 6–10 years (42.9%) and female (52%). Nutritional status revealed 41.8% were underweight, 46.9% had a normal BMI, and 11.2% were overweight/obese. The disease duration varied, with 44.9% having CD for 1–3 years. The prevalence of hypothyroidism was 21%, with younger children (1–5 years) showing a higher prevalence (40.9%) compared to older age groups (p = 0.048). Underweight children had a higher likelihood of hypothyroidism (50.0%) compared to those with normal or overweight BMI (p = 0.012). A family history of thyroid disease was significantly associated with hypothyroidism (p = 0.014). However, no significant associations were found with gender, CD duration, dietary adherence, or comorbidities (p > 0.05). Conclusions: The findings indicate a notable prevalence of hypothyroidism in children with CD, emphasizing the need for routine thyroid screening in this population. Early diagnosis and strict dietary adherence may reduce the risk of thyroid-related complications. Further studies are needed to explore the underlying mechanisms and to develop localized management strategies.