US Study: Celiacs at Greater Risk of Developing Eosinophilic Esophagitis

Eosinophilic EsophagitisCeliac disease (CeD) is associated with several immune-mediated disorders, but it is unclear whether it is associated with eosinophilic esophagitis (EoE).

  • 1

Researchers sought to examine the risk of EoE in patients with biopsy-verified CeD compared with matched controls and siblings.

Using nationwide population-based histopathology data, they identified 27,338 patients with CeD diagnosed in the period 2002 to 2017 in Sweden.

Patients with CeD were age- and sex-matched with up to 5 reference individuals (n = 134,987) from the general population. Cox Regression was used to estimate hazard ratios (HRs) for developing biopsy-verified EoE.

In a secondary analysis, we used unaffected siblings of patients with CeD as comparators to adjust for intrafamilial confounding.

The median age at CeD diagnosis was 27 years, and 63.3% were female patients.

During a median follow-up of 8.1 years, 17 patients with CeD and 13 matched reference individuals were diagnosed with EoE.

This corresponded to incidence rates of 0.08 versus 0.01 per 1000 person-years, respectively, and an adjusted HR for EoE of 6.65 (95% CI, 3.26-13.81).

Compared with their siblings without CeD, patients with CeD were however at a no increased risk of EoE (HR, 1.39; 95% CI, 0.55-3.51).

  • In this study, individuals with CeD were at a 6.6-fold increased risk of later EoE compared with the general population. This association might be explained by an altered health-seeking behavior or through shared genetic or early environmental factors because the excess risk disappeared in sibling analyses.

Niki Mitselou MD, PhD a, Amiko Uchida MD b, Bjorn Roelstraete PhD c, Erik Melén MD, PhD d, John J. Garber MD e, David Katzka MD f, Benjamin Lebwohl MD f, Peter H.R. Green MD f, Jonas F. Ludvigsson MD, PhD a c f