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Patients With Celiac Disease Have an Increased Risk for Pancreatitis
Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Gastroenterology and Liver Unit, Royal Hallamshire Hospital, University of Sheffield, Sheffield, United Kingdom.
Division of Gastroenterology and Hepatology, Departments of Medicine and Immunology, Mayo Clinic College of Medicine, Rochester MN, United States.ORCID iD: 0000-0003-1941-9090
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Division of Gastroenterology and Hepatology, Departments of Medicine and Immunology, Mayo Clinic College of Medicine, Rochester MN, United States; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0003-1024-5602
2012 (English)In: Clinical Gastroenterology and Hepatology, ISSN 1542-3565, E-ISSN 1542-7714, Vol. 10, no 10, p. 1136-1142Article in journal (Refereed) Published
Abstract [en]

BACKGROUND & AIMS: Patients with celiac disease have been reported to be at increased risk for pancreatitis and pancreatic insufficiency, but the risk might have been overestimated because of patient selection and limited numbers of patients for analysis. Furthermore, no distinction has been made between patients with gallstone-related and non-gallstone-related pancreatitis. We performed a nationwide study to determine the risk for any pancreatitis or subtype of pancreatitis among patients with biopsy-verified celiac disease.

METHODS: We analyzed data from patients in Sweden with celiac disease (n = 28,908) who were identified on the basis of small intestinal biopsy records from 28 pathology departments (those with villous atrophy, Marsh 3). Biopsies were performed from 1969 to 2008, and biopsy report data were collected from 2006 to 2008. Patients with pancreatitis were identified on the basis of diagnostic codes in the Swedish Patient Register and records of pancreatic enzyme use in the Swedish Prescribed Drug Register. Data were matched with those from 143,746 individuals in the general population; Cox regression was used to estimate hazard ratios (HRs) for pancreatitis.

RESULTS: We identified 406 patients with celiac disease who were later diagnosed with pancreatitis (and 143 with expected pancreatitis) (HR, 2.85; 95% confidence interval [CI], 2.53-3.21). The absolute risk of any pancreatitis among patients with celiac disease was 126/100,000 person-years, with an excess risk of 81/100,000 person-years. The HR for gallstone-related acute pancreatitis was 1.59 (95% CI, 1.06-2.40), for non-gallstone-related acute pancreatitis HR was 1.86 (95% CI, 1.52-2.26), for chronic pancreatitis HR was 3.33 (95% CI, 2.33-4.76), and for supplementation with pancreatic enzymes HR was 5.34 (95% CI, 2.99-9.53). The risk of any pancreatitis within 5 years of diagnosis was 2.76 (95% CI, 2.36-3.22).

CONCLUSIONS: Based on an analysis of medical records from Sweden, patients with celiac disease have an almost 3-fold increase in risk of developing pancreatitis, compared with the general population.

Place, publisher, year, edition, pages
Elsevier, 2012. Vol. 10, no 10, p. 1136-1142
Keywords [en]
Epidemiology, Retrospective Analysis, Gluten Intolerance, Complication
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-55688DOI: 10.1016/j.cgh.2012.06.023ISI: 000309826200017PubMedID: 22801059Scopus ID: 2-s2.0-84866467008OAI: oai:DiVA.org:oru-55688DiVA, id: diva2:1074146
Funder
Swedish Society of MedicineSwedish Research Council, 522-2A09-195
Note

Funding Agencies:

Solvay

Alba Therapeutics

Karolinska Institute

Olle Engkvist Byggmästare foundation

Signe and Olof Wallenius Foundation

National Institutes of Health DK057892

Swedish Celiac Society

Fulbright Commission

Available from: 2017-02-14 Created: 2017-02-14 Last updated: 2018-05-14Bibliographically approved

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