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Coeliac disease and risk of sepsis
Örebro universitet, Hälsoakademin.ORCID-id: 0000-0003-1024-5602
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2008 (Engelska)Ingår i: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 57, nr 8, s. 1074-1080Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: To examine the risk of subsequent sepsis in individuals with coeliac disease.Design: We used Swedish national health registers to identify 15 325 individuals with a diagnosis of coeliac disease (1964–2003) and 14 494 inpatient reference individuals. Cox regression estimated the hazard ratios (HRs) for subsequent sepsis.Results: Compared with inpatient reference individuals, individuals with coeliac disease were at increased risk of sepsis (HR  = 1.6, 95% confidence interval (95% CI)  = 1.2 to 1.9, p<0.001). The highest risk estimates were seen for pneumococcal sepsis (HR  = 2.5, 95% CI  = 1.2 to 5.1, p = 0.014). Individuals with coeliac disease diagnosed in childhood were not at increased risk of subsequent sepsis (HR  = 1.0, 95% CI  = 0.6 to 1.9, p = 0.908). When individuals with coeliac disease were compared with reference individuals from the general population, coeliac disease was associated with an increased risk of sepsis (HR  = 2.6, 95% CI  = 2.1 to 3.0, p<0.001). The HR for pneumococcal sepsis was 3.9 (95% CI  = 2.2 to 7.0, p<0.001). In this comparison, children with coeliac disease were also at an increased risk of sepsis (HR  = 1.8, 95% CI  = 1.2 to 2.7, p = 0.003).Conclusion: This study showed a modestly increased risk of sepsis in patients with coeliac disease with the highest risk for pneumococcal sepsis. This risk increase was limited to those with coeliac disease diagnosed in adulthood. Potential explanations include hyposplenism, increased mucosal permeability and an altered composition of the intestinal glycocalyx in individuals with coeliac disease.

Ort, förlag, år, upplaga, sidor
London: BMJ Publishing , 2008. Vol. 57, nr 8, s. 1074-1080
Nyckelord [en]
Adolescent, Adult, Age Factors, Aged, Aged; 80 and over, Celiac Disease/*complications/epidemiology, Child, Child; Preschool, Epidemiologic Methods, Female, Hospitalization/statistics & numerical data, Humans, Infant, Infant; Newborn, Male, Middle Aged, Opportunistic Infections/*complications/epidemiology, Pneumococcal Infections/complications/epidemiology, Sepsis/*complications/epidemiology, Sweden/epidemiology
Nationell ämneskategori
Medicin och hälsovetenskap Klinisk medicin
Forskningsämne
Invärtesmedicin
Identifikatorer
URN: urn:nbn:se:oru:diva-3484DOI: 10.1136/gut.2007.133868PubMedID: 18270242OAI: oai:DiVA.org:oru-3484DiVA, id: diva2:137781
Tillgänglig från: 2008-12-08 Skapad: 2008-12-08 Senast uppdaterad: 2017-12-14Bibliografiskt granskad

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Ludvigsson, Jonas F.Montgomery, Scott M.

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