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Risk of neuropathy among 28232 patients with biopsy-verified celiac disease
Peripheral Neuropathy Center, Neurological Institute, Columbia University College of Physicians and Surgeons, New York, NY, United States.
Peripheral Neuropathy Center, Neurological Institute, Columbia University College of Physicians and Surgeons, New York, NY, United States.
Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, United States; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solnavägen 1, Solna Alfred Nobels Allé 8, Huddinge, Stockholm, Sweden.
Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, United States.
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2015 (English)In: JAMA Neurology, ISSN 2168-6149, E-ISSN 2168-6157, Vol. 72, no 7, 806-811 p.Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE: Earlier research on celiac disease (CD) and neuropathy has been hampered by the use of inpatient data, low study power, and lack of neuropathic characteristics.

OBJECTIVE: To examine the relative risk and absolute risk of developing neuropathy in a nationwide population-based sample of patients with biopsy-verified CD.

DESIGN, SETTING, AND PARTICIPANTS: Between October 27, 2006, and February 12, 2008, we collected data on small-intestinal biopsies performed at Sweden's 28 pathology departments between June 16, 1969, and February 4, 2008. We compared the risk of neuropathy in 28 232 patients with CD (villous atrophy, Marsh 3) with that of 139 473 age-and sex-matched controls. Cox proportional hazards regression estimated hazard ratios (HRs) and 95% CIs for neuropathy defined according to relevant International Classification of Diseases codes in the Swedish National Patient Register (consisting of both inpatient and outpatient data).

MAIN OUTCOMES AND MEASURES: Neuropathy in patients with biopsy-verified CD.

RESULTS: Celiac disease was associated with a 2.5-fold increased risk of later neuropathy (95% CI, 2.1-3.0; P < .001). We also found an increased risk (with results reported as HRs [95% CIs]) of chronic inflammatory demyelinating neuropathy (2.8; 1.6-5.1; P = .001), autonomic neuropathy (4.2; 1.4-12.3; P = .009), and mononeuritis multiplex (7.6; 1.8-32.4; P = .006), but no association between CD and acute inflammatory demyelinating polyneuropathy (0.8; 0.3-2.1; P = .68).

CONCLUSIONS AND RELEVANCE: We found an increased risk of neuropathy in patients with CD. This statistically significant association in a population-based sample suggests that CD screening should be completed in patients with neuropathy.

Place, publisher, year, edition, pages
2015. Vol. 72, no 7, 806-811 p.
National Category
Neurology
Research subject
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-45539DOI: 10.1001/jamaneurol.2015.0475ISI: 000357931000014PubMedID: 25962148Scopus ID: 2-s2.0-84937580040OAI: oai:DiVA.org:oru-45539DiVA: diva2:845613
Funder
Swedish Research Council
Note

Funding Agencies:

National Center for Advancing Translational Sciences, National Institutes of Health UL1 TR000040

Swedish Society of Medicine

Available from: 2015-08-12 Created: 2015-08-12 Last updated: 2017-03-20Bibliographically approved

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CiteExportLink to record
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