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Persistent mucosal ...
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Kurien, MatthewAcademic Unit of Gastroenterology Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom,Univ Sheffield, England
(author)
Persistent mucosal damage and the risk of epilepsy in people with celiac disease
- Article/chapterEnglish2018
Publisher, publication year, extent ...
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2018-01-24
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John Wiley & Sons,2018
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LIBRIS-ID:oai:DiVA.org:oru-64035
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-64035URI
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https://doi.org/10.1111/ene.13564DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:137648021URI
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-145750URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Funding Agency:Swedish Celiac Society
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Funding Agencies|Swedish Society of Medicine; Swedish Research Council - Medicine [522-2A09-195]; Swedish Celiac Society
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BACKGROUND: Celiac disease (CD) is associated with an increased risk of developing epilepsy, a risk that persists after CD diagnosis. A significant proportion of CD patients have persistent villous atrophy (VA) on follow-up biopsy. This study's objective was to determine whether persistent VA on follow-up biopsy affects long-term epilepsy risk and epilepsy-related hospital emergency admissions.METHODS: Nationwide Cohort Study. We identified all people in Sweden with histological evidence of CD who underwent a follow-up small intestinal biopsy (1969-2008). We compared those with persistent VA to those who showed histological improvement, assessing the development of epilepsy and related emergency hospital admissions (defined according to relevant ICD codes in the Swedish Patient Register). Cox regression analysis was used to assess outcome measures.RESULTS: Of 7590 people with CD who had a follow-up biopsy, VA was present in 43%. The presence of persistent VA was significantly associated with a reduced risk of developing newly-diagnosed epilepsy (hazard ratio [HR] 0.61; 95% confidence interval [CI] 0.38-0.98). On stratified analysis this effect was primarily amongst males (HR 0.35; 95 CI 0.15-0.80). Among the 58 CD patients with a prior diagnosis of epilepsy, those with persistent VA were less likely to visit an emergency department with epilepsy (HR 0.37; 95%CI 0.09-1.09).CONCLUSIONS: In a population-based study of CD individuals, persisting VA on follow up biopsy was associated with reduced future risk of developing epilepsy but did not influence emergency epilepsy-related hospital admissions. Mechanisms as to why persistent VA confers this benefit requires further exploration. This article is protected by copyright. All rights reserved.
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Ludvigsson, Jonas F.,1969-Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Karolinska Inst, Sweden; Orebro Univ, Sweden(Swepub:oru)jsln
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Sanders, David S.Academic Unit of Gastroenterology Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom,Univ Sheffield, England
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Zylberberg, Haley M.Celiac Disease Center Department of Medicine, Columbia University College of Physicians and Surgeons, New York NY, USA,Columbia Univ Coll Phys and Surg, NY 10032 USA
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Green, Peter H.Celiac Disease Center Department of Medicine, Columbia University College of Physicians and Surgeons, New York NY, USA,Columbia Univ Coll Phys and Surg, NY 10032 USA
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Sundelin, HeléneLinköpings universitet,Avdelningen för barns och kvinnors hälsa,Medicinska fakulteten,Region Östergötland, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus(Swepub:liu)helsu63
(author)
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Lebwohl, BenjaminDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Celiac Disease Center Department of Medicine, Columbia University College of Physicians and Surgeons, New York NY, USA,Karolinska Inst, Sweden; Columbia Univ Coll Phys and Surg, NY 10032 USA
(author)
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Academic Unit of Gastroenterology Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United KingdomUniv Sheffield, England
(creator_code:org_t)
Related titles
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In:European Journal of Neurology: John Wiley & Sons25:3, s. 592-e381351-51011468-1331
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