Coeliac patients in Sweden at greater risk for influenza hospital admission

A team led by Karl Mårild (Karolinska University Hospital, Solna, Sweden) and colleagues analyzed data from 29,008 patients with celiac disease (CD) and villous atrophy (Marsh 3), 13,200 patients with CD and inflammation (Marsh 1-2), and 3709 patients seropositive for CD, but with no mucosal inflammation (Marsh 0) to assess risks for hospitalisation for influenza. A total of 224,114 age- and gender-matched controls from the general population with no CD were also included for comparison. For the purposes of this study, the team collected duodenal or jejunal biopsy data on CD and inflammation from pathology departments across Sweden.

They found that 402, 81, 65, and six people in the control, CD, CD inflammation, and latent CD groups, respectively, had a hospital admission for influenza over a mean period of 9 years.

Using the controls as the reference group, the CD and CD inflammation group were a significant 2.1- and 1.9-fold more likely to be hospitalised for influenza, respectively. However, those with latent CD did not have a significantly increased risk compared with the general population.

Alarmingly celiac disease, but not CD inflammation or latent CD, was associated with a significant 10.2-fold increased risk for dying within 28 days of hospital admission for influenza compared with controls.

The researchers suggest that the increased risk may be due to malnutrition or increased mucosal permeability.

Am J Gastroenterol 2010

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