TY - JOUR
T1 - Mucosal healing and the risk of serious infections in patients with celiac disease
AU - Emilsson, Louise
AU - Lebwohl, Benjamin
AU - Green, Peter H.R.
AU - Murray, Joseph A.
AU - Mårild, Karl
AU - Ludvigsson, Jonas F.
N1 - Publisher Copyright:
© 2017, © Author(s) 2017.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Background: Patients with celiac disease (CD) are at increased risk of certain infections, but it is unknown if mucosal healing influences this risk. Methods: We collected data on 29,096 individuals with CD (equal to villous atrophy) through Sweden’s 28 pathology departments undergoing biopsy 1969–2008. Through the Swedish Patient Register we obtained information on any infection and specifically sepsis, streptococcal infection, influenza, Clostridium difficile, herpes zoster and pneumococcal infection up until December 2009. We used Cox regression to calculate hazard ratios (HRs) for the risk of future diagnosis of infection according to mucosal healing on follow-up biopsy (persistent villous atrophy vs mucosal healing). Results: Of 5598 CD individuals with no record of any infections before follow-up biopsy, 45% had persistent villous atrophy, 619 (24%) of them had a later infection, compared to 579 (19%) in those with mucosal healing (p < 0.01); the yearly incidence was 2.1% in both groups. Adjusting for age, sex, calendar period, time between biopsies and education, persistent villous atrophy was however not associated with later infection overall (HR = 0.99; 95% CI = 0.88–1.11) or with any of the specific infections. Conclusions: In CD, mucosal healing does not influence the risk of serious infection requiring hospital-based medical attention.
AB - Background: Patients with celiac disease (CD) are at increased risk of certain infections, but it is unknown if mucosal healing influences this risk. Methods: We collected data on 29,096 individuals with CD (equal to villous atrophy) through Sweden’s 28 pathology departments undergoing biopsy 1969–2008. Through the Swedish Patient Register we obtained information on any infection and specifically sepsis, streptococcal infection, influenza, Clostridium difficile, herpes zoster and pneumococcal infection up until December 2009. We used Cox regression to calculate hazard ratios (HRs) for the risk of future diagnosis of infection according to mucosal healing on follow-up biopsy (persistent villous atrophy vs mucosal healing). Results: Of 5598 CD individuals with no record of any infections before follow-up biopsy, 45% had persistent villous atrophy, 619 (24%) of them had a later infection, compared to 579 (19%) in those with mucosal healing (p < 0.01); the yearly incidence was 2.1% in both groups. Adjusting for age, sex, calendar period, time between biopsies and education, persistent villous atrophy was however not associated with later infection overall (HR = 0.99; 95% CI = 0.88–1.11) or with any of the specific infections. Conclusions: In CD, mucosal healing does not influence the risk of serious infection requiring hospital-based medical attention.
KW - Celiac disease
KW - epidemiology
KW - infectious disease
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U2 - 10.1177/2050640617707868
DO - 10.1177/2050640617707868
M3 - Article
AN - SCOPUS:85041134950
SN - 2050-6406
VL - 6
SP - 55
EP - 62
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
IS - 1
ER -