TY - JOUR
T1 - Patients With Celiac Disease Have an Increased Risk for Pancreatitis
AU - Sadr-Azodi, Omid
AU - Sanders, David S.
AU - Murray, Joseph A.
AU - Ludvigsson, Jonas F.
N1 - Funding Information:
Conflicts of interest These authors disclose the following: David Sanders has received an educational and research grant from Solvay (formerly involved with Creon). Joseph Murray has received grant support from Alba Therapeutics ; has been on the advisory board for Alvine Pharmaceuticals, Inc and Nexpep; and has been a consultant for Ironwood, Inc, Flamentera, Actogenix, Ferring Research Institute, Bayer Healthcare Pharmaceuticals, Vysera Biomedical, 2G Pharma, Inc, ImmunosanT, Inc, and Shire US, Inc. The remaining authors disclose no conflicts.
Funding Information:
Funding Supported by grants from Swedish Society of Medicine , Karolinska Institute , Olle Engkvist Byggmästare foundation , and Signe and Olof Wallenius Foundation (O.S.A.); the National Institutes of Health , DK057892 (J.A.M.); and by grants from the Swedish Society of Medicine , the Swedish Research Council - Medicine ( 522-2A09-195 ), the Swedish Celiac Society , and the Fulbright Commission (J.F.L.).
PY - 2012/10
Y1 - 2012/10
N2 - Background & Aims: Patients with celiac disease have been reported to be at increased risk for pancreatitis and pancreatic insufficiency, but the risk might have been overestimated because of patient selection and limited numbers of patients for analysis. Furthermore, no distinction has been made between patients with gallstone-related and non-gallstone-related pancreatitis. We performed a nationwide study to determine the risk for any pancreatitis or subtype of pancreatitis among patients with biopsy-verified celiac disease. Methods: We analyzed data from patients in Sweden with celiac disease (n = 28,908) who were identified on the basis of small intestinal biopsy records from 28 pathology departments (those with villous atrophy, Marsh 3). Biopsies were performed from 1969 to 2008, and biopsy report data were collected from 2006 to 2008. Patients with pancreatitis were identified on the basis of diagnostic codes in the Swedish Patient Register and records of pancreatic enzyme use in the Swedish Prescribed Drug Register. Data were matched with those from 143,746 individuals in the general population; Cox regression was used to estimate hazard ratios (HRs) for pancreatitis. Results: We identified 406 patients with celiac disease who were later diagnosed with pancreatitis (and 143 with expected pancreatitis) (HR, 2.85; 95% confidence interval [CI], 2.53-3.21). The absolute risk of any pancreatitis among patients with celiac disease was 126/100,000 person-years, with an excess risk of 81/100,000 person-years. The HR for gallstone-related acute pancreatitis was 1.59 (95% CI, 1.06-2.40), for non-gallstone-related acute pancreatitis HR was 1.86 (95% CI, 1.52-2.26), for chronic pancreatitis HR was 3.33 (95% CI, 2.33-4.76), and for supplementation with pancreatic enzymes HR was 5.34 (95% CI, 2.99-9.53). The risk of any pancreatitis within 5 years of diagnosis was 2.76 (95% CI, 2.36-3.22). Conclusions: Based on an analysis of medical records from Sweden, patients with celiac disease have an almost 3-fold increase in risk of developing pancreatitis, compared with the general population.
AB - Background & Aims: Patients with celiac disease have been reported to be at increased risk for pancreatitis and pancreatic insufficiency, but the risk might have been overestimated because of patient selection and limited numbers of patients for analysis. Furthermore, no distinction has been made between patients with gallstone-related and non-gallstone-related pancreatitis. We performed a nationwide study to determine the risk for any pancreatitis or subtype of pancreatitis among patients with biopsy-verified celiac disease. Methods: We analyzed data from patients in Sweden with celiac disease (n = 28,908) who were identified on the basis of small intestinal biopsy records from 28 pathology departments (those with villous atrophy, Marsh 3). Biopsies were performed from 1969 to 2008, and biopsy report data were collected from 2006 to 2008. Patients with pancreatitis were identified on the basis of diagnostic codes in the Swedish Patient Register and records of pancreatic enzyme use in the Swedish Prescribed Drug Register. Data were matched with those from 143,746 individuals in the general population; Cox regression was used to estimate hazard ratios (HRs) for pancreatitis. Results: We identified 406 patients with celiac disease who were later diagnosed with pancreatitis (and 143 with expected pancreatitis) (HR, 2.85; 95% confidence interval [CI], 2.53-3.21). The absolute risk of any pancreatitis among patients with celiac disease was 126/100,000 person-years, with an excess risk of 81/100,000 person-years. The HR for gallstone-related acute pancreatitis was 1.59 (95% CI, 1.06-2.40), for non-gallstone-related acute pancreatitis HR was 1.86 (95% CI, 1.52-2.26), for chronic pancreatitis HR was 3.33 (95% CI, 2.33-4.76), and for supplementation with pancreatic enzymes HR was 5.34 (95% CI, 2.99-9.53). The risk of any pancreatitis within 5 years of diagnosis was 2.76 (95% CI, 2.36-3.22). Conclusions: Based on an analysis of medical records from Sweden, patients with celiac disease have an almost 3-fold increase in risk of developing pancreatitis, compared with the general population.
KW - Complication
KW - Epidemiology
KW - Gluten Intolerance
KW - Retrospective Analysis
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U2 - 10.1016/j.cgh.2012.06.023
DO - 10.1016/j.cgh.2012.06.023
M3 - Article
C2 - 22801059
AN - SCOPUS:84866467008
SN - 1542-3565
VL - 10
SP - 1136-1142.e3
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 10
ER -