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Cardiomyopathy, pericarditis and myocarditis in a population-based cohort of inpatients with coeliac disease
Örebro University, School of Health and Medical Sciences.
Örebro University, School of Health and Medical Sciences.ORCID iD: 0000-0001-6328-5494
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2007 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 262, no 5, p. 545-554Article in journal (Refereed) Published
Abstract [en]

Objectives: We investigated the risk of myocarditis, cardiomyopathy, and pericarditis in patients with celiac disease (CD) from a general population cohort.Subjects and methods: Through the Swedish national registers we identified 9363 children and 4969 adults with a diagnosis of CD (1964–2003). These individuals were matched with upto five reference individuals for age, sex, calendar year and county (n = 69 851). Cox regression estimated hazard ratios (HRs) for later heart disease. Main outcome measures: Myocarditis, cardiomyopathy (any or dilated), and pericarditis defined according torelevant international classification of disease codes in the Swedish national inpatient register.Results: Celiac disease diagnosed in childhood was not associated with later myocarditis (HR = 0.2; 95% CI = 0.0–1.5), cardiomyopathy of any type (HR = 0.8; 95% CI = 0.2–3.7), or pericarditis (HR = 0.4; 95% CI = 0.1–1.9). Restricting our analyses to adulthood CD and heart disease diagnosed from 1987 and onwards in departments of cardiology ⁄ internal medicine, we found no association between CD and later myocarditis (HR = 2.1; 95% CI = 0.4–11.7), dilated cardiomyopathy (HR = 1.7; 95% CI = 0.4– 6.5) or pericarditis (HR = 1.5; 95% CI = 0.5–4.0).Conclusion: This study found no association between CD, later myocarditis, cardiomyopathy or pericarditis

Place, publisher, year, edition, pages
Oxford: Blackwell Publishing , 2007. Vol. 262, no 5, p. 545-554
Keywords [en]
Autoimmunity, cardiology, coeliac disease, pericarditis.
National Category
Pediatrics Gastroenterology and Hepatology Cardiac and Cardiovascular Systems Medical and Health Sciences
Research subject
Pediatrics; Epidemiology
Identifiers
URN: urn:nbn:se:oru:diva-5217DOI: 10.1111/j.1365-2796.2007.01843.xOAI: oai:DiVA.org:oru-5217DiVA, id: diva2:158208
Note
Part of thesis: http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-5223Available from: 2009-01-30 Created: 2009-01-30 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Associated disorders in celiac disease
Open this publication in new window or tab >>Associated disorders in celiac disease
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Celiac disease (CD) is an autoimmune disorder that affects genetically susceptible individuals and is induced by dietary gluten. Treatment consists of a lifelong gluten-free diet. CD is common and affects about 1% of the general population. The classic symptoms include diarrhea and malabsorption, but many patients have only mild symptoms or no symptoms at all. The proportion of individuals presenting with atypical symptoms or discovered only when investigating an associated condition of CD is increasing.

Aims: The aim of this thesis was to investigate the risk of possible associated disorders through Swedish population-based registers. The objective was to gain more information on the consequences of having CD and to identify high risk groups where screening may be considered.

Materials and methods: We used the Swedish hospital discharge register to examine the risk of liver disease, autoimmune heart disease, Addison’s disease and thyroid disorders in a cohort of about 14,000 individuals with CD and an age and sex matched reference population of 70,000 individuals. In the last study we used all regional pathology registers and the cancer registry to examine the risk of hematopoietic cancer, including lymphoma in three different cohorts: I) 28,810 individuals with CD; II) 12,681 individuals with small intestinal mucosal inflammation but without villous atrophy; and III) 3552 individuals with latent CD (a positive serology test for CD with a normal small intestinal biopsy).

Results: CD is statistically significantly associated with an increased risk of liver disease, Addison’s disease, thyroid disease and lymphoma. We also found an increased risk of lymphoma in individuals with small intestinal mucosal inflammation. There was no statistically significant association between autoimmune heart disease or leukemia and CD. Latent CD was not associated with any hematopoietic cancers.

Conclusion: This thesis found a positive association between CD and a number of autoimmune and inflammatory disorders. Clinicians need to have a high awareness of this association and to test for these conditions when symptoms appear.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2009. p. 83
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 27
Keywords
Addison, autoimmune, biopsy, celiac, child, cohort study, cancer, heart, liver, lymphoma, thyroid
National Category
Pediatrics Medical and Health Sciences
Research subject
Pediatrics; Epidemiology; Medicine
Identifiers
urn:nbn:se:oru:diva-5223 (URN)978-91-7668-649-2 (ISBN)
Public defence
2009-02-27, Wilandersalen, Universitetssjukhuset Örebro, Örebro, 10:00 (English)
Opponent
Supervisors
Available from: 2009-02-06 Created: 2009-01-30 Last updated: 2017-10-18Bibliographically approved

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Publisher's full texthttp://www.ncbi.nlm.nih.gov/pubmed/17949363?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

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Elfström, PeterMontgomery, Scott M.

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