Persistent mucosal damage and the risk of epilepsy in people with celiac disease

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Persistent mucosal damage and the risk of epilepsy in people with celiac disease

Kurien, Matthew (författare): Academic Unit of Gastroenterology Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom,Univ Sheffield, England

Ludvigsson, Jonas F., 1969- (författare): 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

Sanders, David S. (författare): 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. (författare): 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

Green, Peter H. (författare): 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

Sundelin, Heléne (författare): Linköpings universitet,Avdelningen för barns och kvinnors hälsa,Medicinska fakulteten,Region Östergötland, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus

Lebwohl, Benjamin (författare): Department 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

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2018-01-24
2018
Engelska.
Ingår i: European Journal of Neurology. - : John Wiley & Sons. - 1351-5101 .- 1468-1331. ; 25:3, s. 592-e38

Relaterad länk:: http://eprints.white...; visa fler...; https://urn.kb.se/re...; https://doi.org/10.1...; http://kipublication...; https://urn.kb.se/re...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

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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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Geriatrik (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Geriatrics (hsv//eng)

Nyckelord

Celiac
cohort study
epilepsy
villous atrophy

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Av författaren/redakt...: Kurien, Matthew; Ludvigsson, Jona ...; Sanders, David S ...; Zylberberg, Hale ...; Green, Peter H.; Sundelin, Heléne; visa fler...; Lebwohl, Benjami ...; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Neurologi

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Geriatrik

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Av lärosätet: Örebro universitet; Karolinska Institutet; Linköpings universitet

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