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

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

Journal of Pediatric Gastroenterology and Nutrition: June 18, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPG.0000000000002418
Original Article: Gastroenterology: PDF Only

Background: Patients with autoimmune disorders (ADs) are at increased risk for celiac disease (CD), but data is conflicting on the risk of ADs in treated patients with CD. We aimed to assess the incidence of ADs in treated CD patients.

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 CD patients who met accepted diagnostic criteria. For each CD patient, 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 (SD) ages of 32 (22) years and 33 (22) years, respectively. One-third of patients (n = 85) and controls (n = 170) were male. Five years after the index date, 5.0% of CD patients 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 vs controls (P < 0.001). Children had a significantly higher risk of AD development compared with adults (P = 0.010).

Conclusion: Treated CD patients are at higher risk for the development of ADs. The risk of a new AD is higher in children, especially when more than one AD diagnosis exists.

*Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota

Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.

Address correspondence and reprint requests to Imad Absah, MD, Division of Pediatric Gastroenterology and Hepatology, 200 First Street SW, Rochester, MN 55905 (e-mail:

Received 26 February, 2019

Accepted 24 May, 2019

Conflicts of Interest Disclosure: The authors have no conflicts of interest to declare.

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