Celiac Disease Patients Face Higher Risk of Systemic Lupus

Celiac.com 01/28/2013 - Some case studies point to a connection between celiac disease and systemic lupus, but there hasn't been much in the way of population-based studies.

Hoping to get data that would lead to a more solid answer, a research team recently set out to determine levels of systemic lupus erythematosus (SLE) in 29,000 patients with biopsy-verified celiac disease.

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The research team included J.F. Ludvigsson, A. Rubio-Tapia, V. Chowdhary, J. A. Murray, and J.F. Simard. They are affiliated with the Clinical Epidemiology Unit of Department of Medicine at Karolinska University Hospital and Karolinska Institutet in Stockholm, Sweden.

For their study, the team compared the risk of SLE in 29,048 individuals with biopsy-verified celiac disease (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.

For the study, the team defined SLE incidents as at least 2 records of SLE for any given patient in the Swedish Patient Register. They used Cox regression to estimate hazard ratios (HR).

They found that 54 individuals with celiac disease also had an SLE incident. This amounted to a HR of 3.49 (95% CI 2.48-4.90), with an absolute risk of 17 cases per 100,000 person-years and an excess risk of 12 cases per 100,000 person-years. After five years, the HR for SLE was 2.54 (95% CI 1.57-4.10).

Even though SLE incidents occurred mainly in female patients, the team found similar risk estimates in men and women.

When they 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).

From this data, the team concludes that people with celiac disease faced a three-times higher risk of SLE compared to the general population.

Although this elevated risk remained more than five years after celiac disease diagnosis, absolute risks were low.

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