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Increased risk of epilepsy in biopsy-verified celiac disease: a population-based cohort study.

Abstract

OBJECTIVES

Celiac disease (CD) is associated with several neurologic disorders but it is unclear whether CD is associated with epilepsy. We therefore investigated whether biopsy-verified CD is associated with epilepsy.

METHODS

Cohort study. Using biopsy report data from all Swedish pathology departments (n = 28), we identified individuals with CD who were diagnosed from 1969 to 2008 (Marsh 3: villous atrophy). Through Cox regression, we calculated hazard ratios (HRs) for epilepsy (defined as a diagnosis of epilepsy in the Swedish National Patient Register) in 28,885 individuals with CD and 143,166 controls matched for age, sex, calendar period, and county.

RESULTS

Individuals with CD were at an increased risk of future epilepsy (HR = 1.42; 95% confidence interval [CI] = 1.24-1.62) (272 individuals with CD had a diagnosis of epilepsy vs an expected 192). The absolute risk of future epilepsy in patients with CD was 92/100,000 person-years (excess risk = 27/100,000 person-years). This risk increase was seen in all ages, including children with CD. The HR for having at least 2 interactions with health care due to epilepsy was 1.41 (95% CI = 1.19-1.66). When we restricted epilepsy to those with both a diagnosis of epilepsy and an independent record of antiepileptic drug prescriptions, CD was associated with a 1.43-fold increased risk of epilepsy (95% CI = 1.10-1.86).

CONCLUSION

Individuals with CD seem to be at a moderately increased risk of epilepsy.

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  • Authors+Show Affiliations

    ,

    Department of Pediatrics, Örebro University Hospital, Örebro, Sweden. jonasludvigsson@yahoo.com

    , , ,

    Source

    Neurology 78:18 2012 May 01 pg 1401-7

    MeSH

    Adult
    Biopsy
    Celiac Disease
    Cohort Studies
    Comorbidity
    Cross-Sectional Studies
    Epilepsy
    Female
    Humans
    Intestinal Mucosa
    Male
    Middle Aged
    Proportional Hazards Models
    Retrospective Studies
    Risk
    Sweden
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22517096

    Citation

    Ludvigsson, J F., et al. "Increased Risk of Epilepsy in Biopsy-verified Celiac Disease: a Population-based Cohort Study." Neurology, vol. 78, no. 18, 2012, pp. 1401-7.
    Ludvigsson JF, Zingone F, Tomson T, et al. Increased risk of epilepsy in biopsy-verified celiac disease: a population-based cohort study. Neurology. 2012;78(18):1401-7.
    Ludvigsson, J. F., Zingone, F., Tomson, T., Ekbom, A., & Ciacci, C. (2012). Increased risk of epilepsy in biopsy-verified celiac disease: a population-based cohort study. Neurology, 78(18), pp. 1401-7. doi:10.1212/WNL.0b013e3182544728.
    Ludvigsson JF, et al. Increased Risk of Epilepsy in Biopsy-verified Celiac Disease: a Population-based Cohort Study. Neurology. 2012 May 1;78(18):1401-7. PubMed PMID: 22517096.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Increased risk of epilepsy in biopsy-verified celiac disease: a population-based cohort study. AU - Ludvigsson,J F, AU - Zingone,F, AU - Tomson,T, AU - Ekbom,A, AU - Ciacci,C, Y1 - 2012/04/18/ PY - 2012/4/21/entrez PY - 2012/4/21/pubmed PY - 2012/6/28/medline SP - 1401 EP - 7 JF - Neurology JO - Neurology VL - 78 IS - 18 N2 - OBJECTIVES: Celiac disease (CD) is associated with several neurologic disorders but it is unclear whether CD is associated with epilepsy. We therefore investigated whether biopsy-verified CD is associated with epilepsy. METHODS: Cohort study. Using biopsy report data from all Swedish pathology departments (n = 28), we identified individuals with CD who were diagnosed from 1969 to 2008 (Marsh 3: villous atrophy). Through Cox regression, we calculated hazard ratios (HRs) for epilepsy (defined as a diagnosis of epilepsy in the Swedish National Patient Register) in 28,885 individuals with CD and 143,166 controls matched for age, sex, calendar period, and county. RESULTS: Individuals with CD were at an increased risk of future epilepsy (HR = 1.42; 95% confidence interval [CI] = 1.24-1.62) (272 individuals with CD had a diagnosis of epilepsy vs an expected 192). The absolute risk of future epilepsy in patients with CD was 92/100,000 person-years (excess risk = 27/100,000 person-years). This risk increase was seen in all ages, including children with CD. The HR for having at least 2 interactions with health care due to epilepsy was 1.41 (95% CI = 1.19-1.66). When we restricted epilepsy to those with both a diagnosis of epilepsy and an independent record of antiepileptic drug prescriptions, CD was associated with a 1.43-fold increased risk of epilepsy (95% CI = 1.10-1.86). CONCLUSION: Individuals with CD seem to be at a moderately increased risk of epilepsy. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/22517096/Increased_risk_of_epilepsy_in_biopsy_verified_celiac_disease:_a_population_based_cohort_study_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=22517096 DB - PRIME DP - Unbound Medicine ER -