Celiac Disease Is Associated with Microscopic Colitis in Refractory Cases in Adults: A Systematic Review and Meta-Analysis of Observational Studies

Aziz, Muhammad; Haghbin, Hossein; Khan, Raheel; Khan, Zubair; Weissman, Simcha; Kamal, Faisal; Lee‐Smith, Wade; Chandan, Saurabh; Feuerstein, Joseph D.; Adler, Douglas G.

doi:10.1007/s10620-021-07232-7

Cited by 8 publications

(11 citation statements)

References 48 publications

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“…Finally, a Danish study recently found an OR of 10.1 for earlier CD in patients with MC 6 . The concomitance of these conditions was supported by a 2021 systematic review and meta‐analysis 9 . Because of their respective overrepresentation, the authors concluded that MC and CD should be considered if either of these diagnoses is refractory 10 .…”

Section: Discussionmentioning

confidence: 92%

“…A 2021 systematic review and meta‐analysis 9 based on five studies including 2589 patients found that 4.5% of patients with refractory CD also had MC. This meta‐analysis also reported a pooled prevalence of 6.7% in CD in patients with refractory MC 9 …”

Section: Introductionmentioning

confidence: 99%

“… 8 The American study 7 ( n = 1009) found a 70‐fold increased risk of MC in CD compared with the general population, and the Canadian study 8 reported a standardized incidence ratio (SIR) of 52.7. A 2021 systematic review and meta‐analysis 9 based on five studies including 2589 patients found that 4.5% of patients with refractory CD also had MC. This meta‐analysis also reported a pooled prevalence of 6.7% in CD in patients with refractory MC.…”

Section: Introductionmentioning

confidence: 99%

“…This meta‐analysis also reported a pooled prevalence of 6.7% in CD in patients with refractory MC. 9 …”

Section: Introductionmentioning

confidence: 99%

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Celiac disease and risk of microscopic colitis: A nationwide population‐based matched cohort study

et al. 2023

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Background: An association has been reported between celiac disease (CD) and microscopic colitis (MC). However, large, population-based cohort studies are rare.Objective: To systematically examine the association between CD and MC in a large, nationwide cohort. Methods: We conducted a nationwide population-based matched cohort study in Sweden of 45,138 patients with biopsy-verified CD (diagnosed in 1990-2016), 223,149 reference individuals, and 51,449 siblings of CD patients. Data on CD and MC were obtained from all (n = 28) pathology departments in Sweden. Adjusted hazard ratios (aHRs) were calculated using Cox regression. Results: During follow-up, 452 CD patients and 197 reference individuals received an MC diagnosis (86.1 vs. 7.5 per 100,000 person-years). This difference corresponded to an aHR of 11.6 (95% confidence interval [CI] = 9.8-13.8) or eight extraMC cases in 1000 CD patients followed up for 10 years. Although the risk of MC was highest during the first year of follow-up (aHR 35.2; 95% CI = 20.1-61.6), it remained elevated even after 10 years (aHR 8.1; 95% CI = 6.0-10.9). Examining MC subtypes lymphocytic colitis (LC) and collagenous colitis (CC) separately, the aHR was 12.4 (95% CI = 10.0-15.3) for LC and 10.2 (95% CI = 7.7-13.6) for CC. MC was also more common before CD (adjusted odds ratio [aOR] = 52.7; 95% CI = 31.4-88.4). Compared to siblings, risk estimates decreased but remained elevated (CD and later MC: HR = 6.2; CD and earlier MC: aOR = 7.9). Conclusion:Our study demonstrated a very strong association of MC with CD with an increased risk of future and previous MC in CD patients. The magnitude of the associations underscores the need to consider the concomitance of these diagnoses in cases in which gastrointestinal symptoms persist or recur despite a gluten-free diet or conventional MC treatment. The comparatively lower risk estimates in sibling comparisons suggest that shared genetic and early environmental factors may contribute to the association between CD and MC.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…This meta‐analysis also reported a pooled prevalence of 6.7% in CD in patients with refractory MC. 9 …”

Section: Introductionmentioning

confidence: 99%

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Celiac disease and risk of microscopic colitis: A nationwide population‐based matched cohort study

et al. 2023

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“…The conclusion is similar to those of other population-based and epidemiological studies [ 73 , 75–78 ]. A meta-analysis summarized the prevalence of each of these two diseases in refractory cases [ 79 ]. In patients with refractory coeliac disease, the prevalence of MC was 4.5% and similarly in patients with refractory MC, the prevalence of coeliac disease was 6.7%.…”

Section: Relationship Between MC and Other Lymphocytic Disorders Of T...mentioning

confidence: 99%

Insights into the underlying mechanisms and clinical management of microscopic colitis in relation to other gastrointestinal disorders

Liu

Chen

2022

Gastroenterology Report

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Microscopic colitis (MC) is a chronic inflammatory disease of the large intestine and as a relatively late recognized condition, its relationship with other disorders of the gastrointestinal tract is gradually being understood and investigated. As a multifactorial disease, MC interacts with inflammatory bowel disease, celiac disease, and irritable bowel syndrome through genetic overlap, immunological factors, and gut microflora. The risk of colorectal cancer was significantly lower in MC, gastrointestinal infections increased the risk of developing MC, and there was an inverse association between Helicobacter pylori infection and MC. A variety of associations are found between MC and other gastrointestinal disorders, where aspects such as genetic effects, resemblance of immunological profiles, and intestinal microecology are potential mechanisms behind the relationships. Clinicians should be aware of these connections to achieve a better understanding and management of MC.

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« …ites » lymphocytaires, de l’œsophage au côlon

Guenzi

Poté

2023

Annales de Pathologie

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Celiac Disease Is Associated with Microscopic Colitis in Refractory Cases in Adults: A Systematic Review and Meta-Analysis of Observational Studies

Cited by 8 publications

References 48 publications

Celiac disease and risk of microscopic colitis: A nationwide population‐based matched cohort study

Celiac disease and risk of microscopic colitis: A nationwide population‐based matched cohort study

Insights into the underlying mechanisms and clinical management of microscopic colitis in relation to other gastrointestinal disorders

« …ites » lymphocytaires, de l’œsophage au côlon

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