Coeliac disease and risk of sepsis

Ludvigsson, Jonas F.; Olén, Ola; Bell, Max; Ekbom, Anders; Montgomery, Scott

doi:10.1136/gut.2007.133868

Cited by 114 publications

(105 citation statements)

References 38 publications

(58 reference statements)

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“…GFD may have psychological effects on celiac patients [3], such as poor compliance to GFD itself. A plenty of literature data on malignancy in celiac patients are available [4], as well as literature data on nonmalignant complication in celiac disease under GFD are available on the risk to develop autoimmune diseases, sepsis or fractures [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Complications in Celiac Disease Under Gluten-Free Diet

et al. 2008

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We assessed the onset of malignant and nonmalignant complications in a cohort of celiac disease (CD) patients under gluten-free diet (GFD). Five hundred and forty-nine CD patients were retrospectively assessed. Two hundred and fifty-one (45.7%) showed classical, 262 (47.7%) subclinical, and 36 (6.6%) silent form of CD at the time of the diagnosis. The mean time under GFD was 7.13 years (range 1-15 years). Out of 549 patients, 381 (69.4%) were fully compliant, 112/549 (20.4%) reported less than one dietary transgression/month, and 56/549 (10.2%) reported at least one dietary transgression/month. Out of 549 patients, 18 (3.3%) patients developed complications under GFD (seven malignant and 11 nonmalignant complications). Fourteen patients were previously affected by classical CD (5.6% of the overall patients with classical CD), and four were affected by subclinical CD (1.5% of the overall patients with subclinical CD). None of the patients affected by silent CD developed complications. There was no statistical difference between the mean age of the two groups developing complications (P = n.s.). Complications appeared after a mean time under GFD of 6.5 years in classical CD, and after a mean time of 3.5 years in subclinical CD (P = n.s.). Finally, 6/14 (42.8%) patients with classical CD were not fully compliant to GFD, while 2/4 (50%) of subclinical CD patients were not fully compliant to GFD (P = n.s.). Less than 5% of CD patients may develop complications under GFD. Complications seem to affect more classical CD than subclinical CD, and seem to be irrespective of optimal GFD adherence.

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Section: Introductionmentioning

confidence: 99%

Complications in Celiac Disease Under Gluten-Free Diet

et al. 2008

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“…There is no statistically significant association between CD and subsequent development of Parkinson's disease, Alzheimer's disease, hereditary ataxia, symptoms of ataxia, Huntington's disease, or spinal musc ular atrophy [80] . Adult but not pediatric patients with CD have an increased risk of sepsis, particularly pneumococcus infection [81] . In CD there is an inc reased prevalenc e of splenic hypofunc tion [82] .…”

Section: Clinical Associationsmentioning

confidence: 99%

Recent advances in celiac disease

Freeman

Chopra²,

Clandinin³

et al. 2011

WJG

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Celiac disease now affects about one person in a hundred in Europe and North America. In this review, we consider a number of important and exciting recent developments, such as clinical associations, HLA-DQ2 and HLA-DQ8 predispositions, the concept of potential celiac disease, the use of new imaging/endoscopy techniques, and the development of refractory disease. This review will be of use to all internists, pediatricians and gastroenterologists.

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“…This makes IHD the leading cause of death for American men and women. 1 Individuals with CD are at increased risk of death, 2 infectious disease, 3 and fractures. 4 However, research findings on IHD are contradictory.…”

Section: Clinical Perspective On P 490mentioning

confidence: 99%

Nationwide Cohort Study of Risk of Ischemic Heart Disease in Patients With Celiac Disease

et al. 2011

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Background-Studies on ischemic heart disease (IHD) incidence in individuals with celiac disease (CD) are contradictory and do not take small intestinal pathology into account. Methods and Results-In this Swedish population-based cohort study, we examined the risk of IHD in patients with CD based on small intestinal histopathology. We defined IHD as death or incident disease in myocardial infarction or angina pectoris in Swedish national registers. In 2006 to 2008, we collected duodenal/jejunal biopsy data on CD (equal to villous atrophy; Marsh 3; nϭ28 190 unique individuals) and inflammation without villous atrophy (Marsh 1 to 2; nϭ12 598) from all 28 pathology departments in Sweden. A third cohort consisted of 3658 individuals with normal mucosa but positive CD serology (Marsh 0, latent CD). We found an increased risk of incident IHD in patients undergoing small intestinal biopsy that was independent of small intestinal histopathology Clinical Perspective on p 490One in 5 deaths in the United States is caused by ischemic heart disease (IHD), 1 and Ϸ500 000 people die of IHD each year in the United States. This makes IHD the leading cause of death for American men and women. 1 Individuals with CD are at increased risk of death, 2 infectious disease, 3 and fractures. 4 However, research findings on IHD are contradictory. Most 2,5-7 but not all 8 -10 studies have shown an increased risk of incident IHD, death resulting from IHD, or cardiovascular disease in CD. These contradictory results may be explained in part by differences in study design, method of data collection, and small sample sizes. The main objective of this study was therefore to examine the risk of IHD in a population-based large cohort of patients with CD.In recent years, there has been a growing interest in CD with only minor mucosal abnormalities (no VA), 11 not fulfilling traditional criteria for CD. 12 Despite this interest, we know of no study on IHD in patients with inflammation without VA or in patients with latent CD (defined by the National Institutes of Health as normal mucosa but positive CD serology). 13 A second objective was therefore to estimate the risk of IHD in patients with inflammation without VA or latent CD. MethodsIn this cohort study, we estimated the risk of incident IHD (defined as first myocardial infarction [MI] and angina pectoris [AP]) in patients with CD according to small intestinal histopathology and no prior history of IHD. We did so through linkage of nationwide histopathology data with inpatient and mortality data on IHD from Swedish national registers. (Table 1). Data were restricted to computerized biopsy reports; for this reason, most patients in this study had been biopsied after 1990 (Table 1). Data searches were carried out by local information technology technicians who obtained data on arrival date of the biopsies, personal identity number, 15 morphology based on the Swedish SnoMed classification codes, 14 and topography (duodenum or jejunum). We graded morphology as VA (Marsh stage 3 and equal to CD),...

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Coeliac disease and risk of sepsis

Cited by 114 publications

References 38 publications

Complications in Celiac Disease Under Gluten-Free Diet

Complications in Celiac Disease Under Gluten-Free Diet

Recent advances in celiac disease

Nationwide Cohort Study of Risk of Ischemic Heart Disease in Patients With Celiac Disease

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