Increased risk of epilepsy in biopsy-verified celiac disease: A population-based cohort study.
Widodo Judarwanto. Children Allergy Online Clinic, Jakarta Indonesia
Ludvigsson JF, et al.
Neurology. 2012 Apr 18.
OBJECTIVES: Celiac disease (CD) is associated with several neurologic disorders but it is unclear whether CD is associated with epilepsy. We therefore investigated whether biopsy-verified CD is associated with epilepsy.
METHODS: Cohort study. Using biopsy report data from all Swedish pathology departments (n = 28), we identified individuals with CD who were diagnosed from 1969 to 2008 (Marsh 3: villous atrophy). Through Cox regression, we calculated hazard ratios (HRs) for epilepsy (defined as a diagnosis of epilepsy in the Swedish National Patient Register) in 28,885 individuals with CD and 143,166 controls matched for age, sex, calendar period, and county.
RESULTS: Individuals with CD were at an increased risk of future epilepsy (HR = 1.42; 95% confidence interval [CI] = 1.24-1.62) (272 individuals with CD had a diagnosis of epilepsy vs an expected 192). The absolute risk of future epilepsy in patients with CD was 92/100,000 person-years (excess risk = 27/100,000 person-years). This risk increase was seen in all ages, including children with CD. The HR for having at least 2 interactions with health care due to epilepsy was 1.41 (95% CI = 1.19-1.66). When we restricted epilepsy to those with both a diagnosis of epilepsy and an independent record of antiepileptic drug prescriptions, CD was associated with a 1.43-fold increased risk of epilepsy (95% CI = 1.10-1.86).
CONCLUSION: Individuals with CD seem to be at a moderately increased risk of epilepsy.
Source: Source: From the Department of Pediatrics (J.F.L.), Örebro University Hospital, Örebro; Clinical Epidemiology Unit (J.F.L., A.E.), Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Clinical and Experimental Medicine (F.Z.), Federico II University of Naples, Naples, Italy; Department of Clinical Neuroscience (T.T.), Karolinska Institutet, Stockholm, Sweden; and Department of Gastroenterology (C.C.), University of Salerno, Salerno, Italy.
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