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Patients with celiac disease have an increased risk for pancreatitis.

Abstract

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.

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  • Authors+Show Affiliations

    ,

    Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

    , ,

    Source

    MeSH

    Adolescent
    Adult
    Aged
    Aged, 80 and over
    Biopsy
    Celiac Disease
    Child
    Female
    Humans
    Male
    Middle Aged
    Pancreatitis
    Risk Assessment
    Sweden
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22801059

    Citation

    Sadr-Azodi, Omid, et al. "Patients With Celiac Disease Have an Increased Risk for Pancreatitis." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 10, no. 10, 2012, pp. 1136-1142.e3.
    Sadr-Azodi O, Sanders DS, Murray JA, et al. Patients with celiac disease have an increased risk for pancreatitis. Clin Gastroenterol Hepatol. 2012;10(10):1136-1142.e3.
    Sadr-Azodi, O., Sanders, D. S., Murray, J. A., & Ludvigsson, J. F. (2012). Patients with celiac disease have an increased risk for pancreatitis. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 10(10), pp. 1136-1142.e3. doi:10.1016/j.cgh.2012.06.023.
    Sadr-Azodi O, et al. Patients With Celiac Disease Have an Increased Risk for Pancreatitis. Clin Gastroenterol Hepatol. 2012;10(10):1136-1142.e3. PubMed PMID: 22801059.
    * Article titles in AMA citation format should be in sentence-case
    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, Y1 - 2012/07/16/ PY - 2012/03/20/received PY - 2012/06/05/revised PY - 2012/06/18/accepted PY - 2012/7/18/entrez PY - 2012/7/18/pubmed PY - 2013/1/31/medline SP - 1136 EP - 1142.e3 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 10 IS - 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. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/22801059/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(12)00787-2 DB - PRIME DP - Unbound Medicine ER -