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The Risk of Autoimmune Disorders in Treated Celiac Disease Patients in Olmsted County, Minnesota

Khan, Muhammad R.*; Nellikkal, Shilpa S.*; Barazi, Ahmed*; Larson, Joseph J.; Murray, Joseph A.; Absah, Imad*,‡

Journal of Pediatric Gastroenterology and Nutrition: October 2019 - Volume 69 - Issue 4 - p 438–442
doi: 10.1097/MPG.0000000000002418
Original Articles: Gastroenterology: Celiac Disease
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Background: Patients with autoimmune disorders (ADs) are at increased risk for celiac disease (CD), but data are conflicting on the risk of ADs in treated patients with CD. We aimed to assess the incidence of ADs in treated patients with CD.

Methods: Using the Rochester Epidemiology Project, we retrospectively searched for the medical records at Mayo Clinic and Olmsted Medical Center from January 1997 to December 2015 for patients with CD who met accepted diagnostic criteria. For each patient with CD, we identified 2 age and sex-matched controls during the same study period. The incidence rate of AD diagnosis 5 years after index date was calculated using Kaplan-Meier analysis for the CD cases and controls and compared using the log-rank test.

Results: We identified 249 treated patients with CD during the study period and 498 matched controls, with mean (standard deviation) ages of 32 (22) years and 33 (22) years, respectively. One third of patients (n = 85) and controls (n = 170) were boys. Five years after the index date, 5.0% of patients with CD and 1.3% of controls had a de novo AD diagnosis (P = 0.006). In the presence of a prior AD, the cumulative risk of a de novo or additional AD was significantly higher in the CD group compared with controls (P < 0.001). Children had a significantly higher risk of AD development compared with adults (P = 0.010).

Conclusions: Treated patients with CD are at higher risk for the development of ADs. The risk of a new AD is higher in children, especially when >1 AD diagnosis exists.

*Division of Pediatric Gastroenterology and Hepatology

Division of Biomedical Statistics and Informatics

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.

Address correspondence and reprint requests to Imad Absah, MD, Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (e-mail: absah.imad@mayo.edu).

Received 26 February, 2019

Accepted 24 May, 2019

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org).

The authors report no conflicts of interest.

© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,