Abstract
Background
Patients with celiac disease (CD) often have articular complaints, and small prior
studies suggest an association with Ehlers-Danlos syndrome (EDS)/joint hypermobility
syndrome (JHS).
Aims
This study examines the risks of EDS/JHS in patients with CD.
Methods
This cohort study compared all individuals in Sweden diagnosed with CD based on small
intestinal biopsy between 1969–2008 (n = 28,631) to 139,832 matched reference individuals, and to a second reference group
undergoing biopsy without having CD (n = 16,104). Rates of EDS/JHS were determined based on diagnostic codes in the Swedish
Patient Register. Hazard ratios (HRs) for EDS/JHS were estimated through Cox regression.
Results
There are 45 and 148 cases of EDS/JHS in patients with CD and reference individuals,
respectively. This corresponds to a 49% increased risk of EDS/JHS in CD (95%CI = 1.07–2.07). The HR for EDS was 2.43 (95%CI = 1.20–4.91) and for JHS 1.34 (95%CI = 0.93–1.95). Compared to reference individuals undergoing intestinal biopsy, CD was
not a risk factor for EDS/JHS. A stronger association was seen in patients initially
diagnosed with EDS/JHS and subsequently diagnosed with CD (odds ratio = 2.29; 95%CI = 1.21–4.34).
Conclusions
Individuals with CD have higher risk of EDS/JHS than the general population, which
may be due to surveillance bias or factors intrinsic to celiac development.
Keywords
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Article info
Publication history
Published online: June 17, 2016
Accepted:
May 21,
2016
Received:
April 8,
2016
Identification
Copyright
© 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.