Association of celiac disease with eosinophilic esophagitis: Nationwide register-based cohort study with sibling analyses.
J Allergy Clin Immunol Glob
; 3(3): 100254, 2024 Aug.
Article
en En
| MEDLINE
| ID: mdl-38784439
ABSTRACT
Background:
Celiac disease (CeD) is associated with several immune-mediated disorders, but it is unclear whether it is associated with eosinophilic esophagitis (EoE).Objective:
We sought to examine the risk of EoE in patients with biopsy-verified CeD compared with matched controls and siblings.Methods:
Using nationwide population-based histopathology data, we identified 27,338 patients with CeD diagnosed in the period 2002 to 2017 in Sweden. Patients with CeD were age- and sex-matched with up to 5 reference individuals (n = 134,987) from the general population. Cox Regression was used to estimate hazard ratios (HRs) for developing biopsy-verified EoE. In a secondary analysis, we used unaffected siblings of patients with CeD as comparators to adjust for intrafamilial confounding.Results:
The median age at CeD diagnosis was 27 years, and 63.3% were female patients. During a median follow-up of 8.1 years, 17 patients with CeD and 13 matched reference individuals were diagnosed with EoE. This corresponded to incidence rates of 0.08 versus 0.01 per 1000 person-years, respectively, and an adjusted HR for EoE of 6.65 (95% CI, 3.26-13.81). Compared with their siblings without CeD, patients with CeD were however at a no increased risk of EoE (HR, 1.39; 95% CI, 0.55-3.51).Conclusions:
In this study, individuals with CeD were at a 6.6-fold increased risk of later EoE compared with the general population. This association might be explained by an altered health-seeking behavior or through shared genetic or early environmental factors because the excess risk disappeared in sibling analyses.
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Bases de datos:
MEDLINE
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En
Revista:
J Allergy Clin Immunol Glob
Año:
2024
Tipo del documento:
Article
País de afiliación:
Suecia