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Celiac Disease and Increased Risk of Pneumococcal Infection: a Systematic Review and Meta-Analysis
Division of Internal Medicine, Alpert Medical School of Brown University and Rhode Island Hospital, Providence RI, USA.
Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence RI, USA.
Division of Gastroenterology, Alpert Medical School of Brown University and Rhode Island Hospital, Providence RI, USA.
Division of Gastroenterology, Alpert Medical School of Brown University and Rhode Island Hospital, Providence RI, USA.
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2017 (English)In: American Journal of Medicine, ISSN 0002-9343, E-ISSN 1555-7162, Vol. 131, no 1, 83-89 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Celiac disease has been associated with hyposplenism and multiple case reports link Celiac disease and pneumococcal infections; however, increased risk of pneumococcal infection in celiac disease has not been confirmed. The purpose of this study was to conduct a systematic review to determine the risk of pneumococcal infections in celiac disease.

METHODS: Relevant studies were identified using electronic bibliographic searches of PubMed, OVID Medline and EMBASE (1980 to February 2017) and reviewing abstracts from major conferences in gastroenterology. Using number of events in celiac patients and referent patients we calculated a summary relative risk of pneumococcal infections. All analyses were conducted in Comprehensive Meta-analysis software using random-effects assumptions.

RESULTS: Of a total of 156 manuscripts, 3, representing three large databases including the Swedish National Inpatient Register; the Oxford Record Linkage Study; and the English National Hospital Episode Statistics, were included. Each compared patients with celiac disease and confirmed pneumococcal infection to a specific reference group: inpatients and/or the general population. Overall, the odds of pneumococcal infection were higher among hospitalized celiac patients compared to controls (odds ratio= 1.66; CI 95% 1.43, 1.92). There was no evidence of heterogeneity (Q[1] = 1.17, p = .56, I(2) = 0%).

CONCLUSIONS: Celiac disease is associated with an increased risk of pneumococcal infection. Preventive pneumococcal vaccination should be considered for those with celiac disease, with special attention to those ages 15 to 64 who have not received the scheduled pneumococcal vaccination series as a child.

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 131, no 1, 83-89 p.
Keyword [en]
Celiac disease, hyposplenism, infection, pneumococcus, splenic atrophy
National Category
Cardiac and Cardiovascular Systems Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-61725DOI: 10.1016/j.amjmed.2017.07.021ISI: 000417605300034PubMedID: 28801224Scopus ID: 2-s2.0-85029699857OAI: oai:DiVA.org:oru-61725DiVA: diva2:1155218
Available from: 2017-11-07 Created: 2017-11-07 Last updated: 2018-01-12Bibliographically approved

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Ludvigsson, Jonas F.

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