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Patients with celiac disease have slight increased risk for EoE
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Researchers observed a weak positive association between celiac disease and eosinophilic esophagitis in a recent study.
Previous studies of the relationship between celiac disease and eosinophilic esophagitis (EoE) have produced conflicting results. To further investigate associations between celiac disease and EoE, Evan S. Dellon, MD, MPH, from the University of North Carolina School of Medicine, and colleagues, used data from a U.S. national pathology database to perform a cross-sectional study of 88,517 patients (mean age, 51.1 ± 18.2 years; 38.2% male) with concomitant esophageal and duodenal biopsies examined from January 2009 through June 2012.
Evan S. Dellon
Overall, 4.6% of patients met criteria for EoE (mean age, 39.6 ± 17.6 years; 57.2% male) and 1.4% met criteria for celiac disease. Among patients with celiac disease, 6% had concomitant EoE compared with 5.6% of nonceliac patients. Patients with celiac disease were 26% more likely to have EoE compared with patients without celiac disease (adjusted OR = 1.26; 95% CI, 0.98-1.6). Sensitivity analyses using stricter definitions of EoE showed varying magnitudes of association with celiac disease, but all definitions suggested a weak positive association (aOR = 1.58; 95% CI, 1.04-2.41 for EoE defined as ≥ 50 eosinophils per high-power field). No associations were observed between celiac disease and reflux esophagitis or Barrett’s esophagus.
“This weak but persistent association builds on the discrepant results previously reported in the literature in smaller studies and offers reduced potential for selection bias with the use of comparison groups,” the investigators concluded. “Although this association is not strong enough to recommend obtaining esophageal biopsies in all celiac disease patients to assess for EoE, certain esophageal symptoms, such as dysphagia, chest discomfort, or heartburn, in a patient with celiac disease should raise the question of EoE as a possible cause. In patients identified to have both EoE and celiac disease, mechanistic studies are required to determine whether the two conditions truly share a similar pathogenesis.” – by Adam Leitenberger
Disclosure: Dellon reports he has received research funding from Meritage Pharma, is a consultant for Aptalis, Novartis, Receptos and Regeneron, and has received an educational grant from Diagnovus. Please see the study for a list of all other researchers’ relevant financial disclosures.
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