Celiac Disease and Risk of Henoch-Schonlein Purpura

Background and Aims: A recent study found a 10-fold increased risk of celiac disease (CD) in individuals with Henoch-Schonlein purpura (HSP), but the confidence interval (CI) was wide. Methods: The retrospective cohort study of all patients with CD in Sweden, diagnosed through small intestinal biopsy from 1969 to 2008 (n=29,077). Each individual with CD was matched to up to 5 controls (n=144,433). Data on study participants were linked to diagnostic codes for HSP in the National Patient Registry. Through Cox regression we estimated hazard ratios for CD and later HSP. Through logistic regression we calculated odds ratios for HSP preceding CD. Results: During follow-up 19 individuals with CD and 99 controls developed HSP. This corresponded to a hazard ratio of 0.96 (95% CI, 0.59-1.56). Looking backward, we found no increased risk of earlier HSP in patients with CD (odds ratio=1.02; 95% CI, 0.60-1.72). Conclusions: In this study of more than 29,000 patients with CD, we found no increased risk of HSP before or after CD.