Increased Risk of Systemic Lupus Erythematosus in 29,000 Patients with Biopsy-verified Celiac Disease
The Journal of Rheumatology, 08/03/2012
Ludvigsson JF et al. – Individuals with celiac disease (CD) were at a 3–fold increased risk of systemic lupus erythematosus compared to the general population. Although this excess risk remained more than 5 years after CD diagnosis, absolute risks were low.Methods
- The authors compared the risk of SLE in 29,048 individuals with biopsy–verified CD (villous atrophy, Marsh 3) from Sweden’s 28 pathology departments with that in 144,352 matched individuals from the general population identified through the Swedish Total Population Register.
- SLE was defined as having at least 2 records of SLE in the Swedish Patient Register.
- The authors used Cox regression to estimate hazard ratios (HR) for SLE.
- During followup, 54 individuals with CD had an incident SLE.
- his corresponded to an HR of 3.49 (95% CI 2.48–4.90), with an absolute risk of 17/100,000 person–years and an excess risk of 12/100,000.
- Beyond 5 years of followup, the HR for SLE was 2.54 (95% CI 1.57–4.10).
- While SLE was predominantly female, the authors found similar risk estimates in men and women.
- When the authors restricted the outcome to individuals who also had a dispensation for a medication used in SLE, the HR was 2.43 (95% CI 1.22–4.87).
- The HR for having 2 records of SLE diagnoses, out of which at least 1 had occurred in a department of rheumatology, nephrology/dialysis, internal medicine, or pediatrics, was 2.87 (95% CI 1.97–4.17).