Gluten-Free Diet in Patients with Celiac Disease Triggers Remission of Pituitary Autoimmunity

06/08/2020 - Many doctors and celiac patients have found that a gluten-free diet seems to improve some autoimmune diseases associated with celiac disease. A team of researchers recently set out to determine the effect of a gluten-free diet on autoimmune pituitary impairment in patients with celiac disease and potential/subclinical lymphocytic hypophysitis (LYH) by conducting a five-year longitudinal observational study.

The research team included Giuseppe Bellastella, Maria Ida Maiorino, Paolo Cirillo, Miriam Longo, Vlenia Pernice, Angela Costantino, Carmen Annunziata, Antonio Bellastella, Katherine Esposito, and Annamaria De Bellis.

Celiac.com Sponsor (A12):
They are variously affiliated with University of Campania “Luigi Vanvitelli,” in Naples, Italy; the Unit of Endocrinology and Metabolic Diseases, University of Campania “Luigi Vanvitelli,” in Naples, Italy; the Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy; and the Unit of Diabetes, University of Campania “Luigi Vanvitelli,” Naples, Italy.

The study took place in the tertiary referral center for immunoendocrinology at the University of Campania “Luigi Vanvitelli.”

In all, from 2000 to 2013, the team assessed ninety-three newly diagnosed LYH patients, with high titer of antipituitary antibodies [APA], and a second group with normal or subclinically impaired pituitary function. The first group included 43 patients with LYH and celiac disease. The second group included 50 patients with just isolated LYH. Patients diagnosed with celiac disease initiated a gluten-free diet. 

The team assessed APA titers and pituitary function in both groups at the start of the study, and then every year for 5 years. The team did not follow-up on patients who developed clinically overt LYH.

Nearly 35% of patients in group 1 experienced remission of LYH (defined as the disappearance of APA and recovery of pituitary function in patients with previous subclinical hypopituitarism). Just a single patient (2% of total) in group 2 experienced remission. 

Two patients in group 1 and 25 in group 2 developed clinically overt hypopituitarism, and left the study to receive appropriate therapy. The big takeaway here is that the presence of celiac disease was the only independent predictor of pituitary function recovery.

A gluten-free diet helps a significant number of patients with LYH and celiac disease to achieve remission of subclinical LYH, or prevent disease progression to more severe stages.

Stay tuned for more on this and related stories.

Read more at the Journal of Clinical Endocrinology & Metabolism, Volume 105, Issue 7, July 2020