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Coeliac disease and invasive pneumococcal disease: a population-based cohort study
Örebro University, School of Medical Sciences. Department of Paediatrics, Kalmar County Hospital, Kalmar, Sweden.ORCID iD: 0000-0001-8126-9738
Department of Infectious Diseases, Kalmar County Hospital, Kalmar, Sweden; Zoonotic Ecology and Epidemiology, Faculty of Health and Life Sciences, Linnaeus University, Sweden.
Lund University, Department of Clinical Sciences Lund, Section for Infection Medicine, Lund, Sweden.
Respiratory Medicine and Allergology, Department of Clinical sciences, Lund University, Lund, Sweden.
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2017 (English)In: Epidemiology and Infection, ISSN 0950-2688, E-ISSN 1469-4409, Vol. 145, no 6, 1203-1209 p.Article in journal (Refereed) Published
Abstract [en]

Severe infections are recognized complications of coeliac disease (CD). In the present study we aimed to examine whether individuals with CD are at increased risk of invasive pneumococcal disease (IPD). To do so, we performed a population-based cohort study including 29 012 individuals with biopsy-proven CD identified through biopsy reports from all pathology departments in Sweden. Each individual with CD was matched with up to five controls (n = 144 257). IPD events were identified through regional and national microbiological databases, including the National Surveillance System for Infectious Diseases. We used Cox regression analyses to estimate hazard ratios (HRs) for diagnosed IPD. A total of 207 individuals had a record of IPD whereas 45/29 012 had CD (0.15%) and 162/144 257 were controls (0.11%). This corresponded to a 46% increased risk for IPD [HR 1.46, 95% confidence interval (CI) 1.05-2.03]. The risk estimate was similar after adjustment for socioeconomic status, educational level and comorbidities, but then failed to attain statistical significance (adjusted HR 1.40, 95% CI 0.99-1.97). Nonetheless, our study shows a trend towards an increased risk for IPD in CD patients. The findings support results seen in earlier research and taking that into consideration individuals with CD may be considered for pneumococcal vaccination.

Place, publisher, year, edition, pages
Cambridge University Press, 2017. Vol. 145, no 6, 1203-1209 p.
Keyword [en]
Coeliac disease, pneumococcal infection, pneumococci, septicaemia
National Category
Public Health, Global Health, Social Medicine and Epidemiology Infectious Medicine
Identifiers
URN: urn:nbn:se:oru:diva-57618DOI: 10.1017/S0950268816003204ISI: 000398972000012ScopusID: 2-s2.0-85010858898OAI: oai:DiVA.org:oru-57618DiVA: diva2:1094642
Funder
The Swedish Medical AssociationSwedish Research Council
Note

Funding Agencies:

Public Health Agency of Sweden  

Kalmar County Council  

Swedish Coeliac Society  

Stockholm County Council 

Available from: 2017-05-10 Created: 2017-05-10 Last updated: 2017-05-10Bibliographically approved

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Röckert Tjernberg, AnnaLudvigsson, Jonas F.
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CiteExportLink to record
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