Risk of tuberculosis in a large sample of patients with coeliac disease - a nationwide cohort study

Ludvigsson, Jonas F.; Sanders, David S.; Maeurer, Markus; Jonsson, Jerker; Grünewald, Johan; Wahlström, Jan

doi:10.1111/j.1365-2036.2010.04572.x

Cited by 39 publications

(22 citation statements)

References 32 publications

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“…In contrast with some older studies on comorbidities in CD[14], we did not rely on inpatient data to identify our exposure variable (CD). This is important since inpatient care is not routine for the diagnosis of CD, and our earlier research has shown that complications are more frequent in individuals hospitalized with their CD than in those identified through biopsy record data (for instance the HR for tuberculosis was 3.7 in inpatients with CD[37] compared with 2.0 in CD patients identified through biopsy records[38]). We used biopsy reports from all of Sweden's pathology departments to identify CD.…”

Section: Discussionmentioning

confidence: 99%

Increased risk of non-alcoholic fatty liver disease after diagnosis of celiac disease

Reilly

Lebwohl

Hultcrantz

et al. 2015

Journal of Hepatology

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Background and Aims Nonalcoholic fatty liver disease is a common cause of chronic liver disease. Celiac disease alters intestinal permeability and treatment with a gluten-free diet often causes weight gain, but so far there are few reports of nonalcoholic fatty liver disease in patients with celiac disease. Methods Population-based cohort study. We compared the risk of nonalcoholic fatty liver disease diagnosed from 1997-2009 in individuals with celiac disease (n=26,816) to matched reference individuals (n=130,051). Patients with any liver disease prior to celiac disease were excluded, as were individuals with a lifetime diagnosis of alcohol-related disorder to minimize misclassification of nonalcoholic fatty liver disease. Cox regression estimated hazard ratios for nonalcoholic fatty liver disease were determined. Results During 246,559 person-years of follow-up, 53 individuals with celiac disease had a diagnosis of nonalcoholic fatty liver disease (21/100,000 person-years). In comparison, we identified 85 reference individuals diagnosed with nonalcoholic fatty liver disease during 1,488,413 person-years (6/100,000 person-years). This corresponded to a hazard ratio of 2.8 (95%CI=2.0-3.8), with the highest risk estimates seen in children (HR=4.6; 95%CI=2.3-9.1). The risk increase in the first year after celiac disease diagnosis was 13.3 (95%CI=3.5-50.3) but remained significantly elevated even beyond 15 years after the diagnosis of celiac disease (HR=2.5; 95% CI 1.0-5.9). Conclusion Individuals with celiac disease are at increased risk of nonalcoholic fatty liver disease compared to the general population. Excess risks were highest in the first year after celiac disease diagnosis, but persisted through 15 years beyond diagnosis with celiac disease.

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Section: Discussionmentioning

confidence: 99%

Increased risk of non-alcoholic fatty liver disease after diagnosis of celiac disease

Reilly

Lebwohl

Hultcrantz

et al. 2015

Journal of Hepatology

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“…In both these series, with strong associations between CD and intussusception, participants were recruited from single tertiary centers, making it is possible that this procedure selected cases with more severe CD and intussusception [11,13], or that these patients were at higher risk of undergoing investigation or contacting health care for a number of disorders. We have previously shown that the relative risk of another disorder in CD (tuberculosis) is twice as high in CD patients identified through hospital records [26] as in patients identified through biopsy reports [27]. Further, the risk of mortality in CD seems higher in patients with a hospital record of CD [28] than in patients diagnosed through biopsy reports [19].…”

Section: Discussionmentioning

confidence: 99%

A large nationwide population-based case–control study of the association between intussusception and later celiac disease

et al. 2013

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BackgroundCase reports and case series studies suggest a positive association between intussusception and celiac disease (CD).MethodsWe contacted Sweden’s 28 pathology departments and obtained data on 29,096 patients with biopsy-verified CD (equal to Marsh stage 3) through biopsy reports. Patients with CD were matched for age, sex, calendar period and county of residence with up to five reference individuals from the general population (n = 144,522). Cases of intussusception were identified from nationwide inpatient, hospital-based outpatient and day-surgery data from the Swedish Patient Register.Odds ratios (ORs) for future CD in patients with intussusception were estimated using conditional logistic regression.Results34 (0.12%) individuals with CD had a diagnosis of intussusception vs. 143 (0.10%) reference individuals, suggesting that intussusception was not a risk factor for later CD (OR = 1.17; 95% confidence interval (CI) = 0.82–1.67). The OR for CD in patients with at least two records of intussusception was 0.40 (95% CI = 0.06–2.99).In contrast, a post-hoc analysis showed that CD was associated with a statistically significantly increased risk of intussusception after CD diagnosis (hazard ratio = 1.95; 95% CI = 1.01–3.77); however, this analysis was based on only 12 cases with both CD and intussusception.ConclusionWe found no association between intussusception and future CD; and a mostly modest increased risk of intussusception after a diagnosis of CD.

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“…Swedish nationwide population-based cohort studies involving more than 28 000 coeliac disease cases with a median follow-up of 9 years have found that coeliac disease is associated with an increased risk of hospital admission for influenza (hazard ratio 2.1) [73], developing tuberculosis (hazard ratio 2.0) [74], lymphoproliferative malignancy (hazard ratio 2.82) [75], cataracts (hazard ratio 1.28) [76], psoriasis (hazard ratio 1.72) [77], asthma (hazard ratio 1.6) [78], atrial fibrillation (hazard ratio 1.34) [79], suicide (hazard ratio 1.55) [80], ESRD (hazard ratio 2.87) [81 && ] and a negligible risk of future stroke (hazard ratio 1.10) [82]. Most notably, the three-fold increased risk of future ESRD was irrespective of age at coeliac disease diagnosis [81 && ], prompting the need to monitor renal function in coeliac disease patients.…”

Section: Mortality and Morbidity Riskmentioning

confidence: 99%

Advances in coeliac disease

Armstrong

Hegade

Robins

2012

Current Opinion in Gastroenterology

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Risk of tuberculosis in a large sample of patients with coeliac disease - a nationwide cohort study

Abstract: SUMMARY BackgroundResearch suggests a positive association between coeliac disease and tuberculosis (TB), but that research has often been limited to in-patients and small sample size. We examined the relationship between TB and coeliac disease.

Cited by 39 publications

References 32 publications

Increased risk of non-alcoholic fatty liver disease after diagnosis of celiac disease

Increased risk of non-alcoholic fatty liver disease after diagnosis of celiac disease

A large nationwide population-based case–control study of the association between intussusception and later celiac disease

Advances in coeliac disease

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