BACKGROUND: Research suggests a positive association between coeliac disease and tuberculosis (TB), but that research has often been limited to in-patients and small sample size. We examined the relationship between TB and coeliac disease. AIM: To examine the association of TB and coeliac disease. METHODS: We collected biopsy data from all pathology departments in Sweden (n=28) to identify individuals who were diagnosed with coeliac disease between 1969 and 2007 (Marsh 3: villous atrophy; n=29,026 unique individuals). Population-based sex- and age-matched controls were selected from the Total Population Register. Using Cox regression, we calculated hazard ratios (HRs) for TB from data in the Swedish national health registers. RESULTS: Individuals with coeliac disease were at increased risk of TB (HR=2.0; 95% CI=1.3-3.0) (during follow-up, 31 individuals with coeliac disease and 74 reference individuals had a diagnosis of TB). The absolute risk of TB in patients with coeliac disease was 10/100,000 person-years with an excess risk of 5/100,000. Risk estimates were the highest in the first year. Restricting our outcome to a diagnosis of TB confirmed by (I) a record of TB medication (HR=2.9; 95% CI=1.0-8.3), (II) data in the National Surveillance System for Infectious Diseases in Sweden (HR=2.6; 95% CI=1.3-5.2) or (III) positive TB cultivation (HR=3.3; 95% CI=1.6-6.8) increased risk estimates. The positive association between coeliac disease and TB was also observed before the coeliac disease diagnosis (odds ratio=1.6; 95% CI=1.2-2.1). CONCLUSION: We found a moderately increased risk of tuberculosis in patients with coeliac disease.
BACKGROUND: Research suggests a positive association between coeliac disease and tuberculosis (TB), but that research has often been limited to in-patients and small sample size. We examined the relationship between TB and coeliac disease. AIM: To examine the association of TB and coeliac disease. METHODS: We collected biopsy data from all pathology departments in Sweden (n=28) to identify individuals who were diagnosed with coeliac disease between 1969 and 2007 (Marsh 3: villous atrophy; n=29,026 unique individuals). Population-based sex- and age-matched controls were selected from the Total Population Register. Using Cox regression, we calculated hazard ratios (HRs) for TB from data in the Swedish national health registers. RESULTS: Individuals with coeliac disease were at increased risk of TB (HR=2.0; 95% CI=1.3-3.0) (during follow-up, 31 individuals with coeliac disease and 74 reference individuals had a diagnosis of TB). The absolute risk of TB in patients with coeliac disease was 10/100,000 person-years with an excess risk of 5/100,000. Risk estimates were the highest in the first year. Restricting our outcome to a diagnosis of TB confirmed by (I) a record of TB medication (HR=2.9; 95% CI=1.0-8.3), (II) data in the National Surveillance System for Infectious Diseases in Sweden (HR=2.6; 95% CI=1.3-5.2) or (III) positive TB cultivation (HR=3.3; 95% CI=1.6-6.8) increased risk estimates. The positive association between coeliac disease and TB was also observed before the coeliac disease diagnosis (odds ratio=1.6; 95% CI=1.2-2.1). CONCLUSION: We found a moderately increased risk of tuberculosis in patients with coeliac disease.
Authors: Jonas F Ludvigsson; Olle Kämpe; Benjamin Lebwohl; Peter H R Green; Shonni J Silverberg; Anders Ekbom Journal: J Clin Endocrinol Metab Date: 2012-01-11 Impact factor: 5.958
Authors: Norelle R Reilly; Benjamin Lebwohl; Rolf Hultcrantz; Peter H R Green; Jonas F Ludvigsson Journal: J Hepatol Date: 2015-01-21 Impact factor: 25.083
Authors: Jonas F Ludvigsson; Benjamin Lebwohl; Alberto Rubio-Tapia; Joseph A Murray; Peter H R Green; Anders Ekbom; Fredrik Granath Journal: Eur J Epidemiol Date: 2013-03-05 Impact factor: 8.082
Authors: A Röckert Tjernberg; J Bonnedahl; M Inghammar; A Egesten; G Kahlmeter; P Nauclér; B Henriques-Normark; J F Ludvigsson Journal: Epidemiol Infect Date: 2017-01-23 Impact factor: 4.434