Co-morbidity of cystic fibrosis and celiac disease in Scandinavian cystic fibrosis patients

G Fluge; H V Olesen; M Gilljam; P Meyer; T Pressler; O T Storrösten; F Karpati; L Hjelte

doi:10.1016/j.jcf.2009.02.002

Co-morbidity of cystic fibrosis and celiac disease in Scandinavian cystic fibrosis patients

G Fluge, H V Olesen, M Gilljam, P Meyer, T Pressler, O T Storrösten, F Karpati, L Hjelte

Ph.d.-studienævnet for Medicin

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

45 Citationer (Scopus)

Abstract

Udgivelsesdato: 2009-May

Originalsprog	Engelsk
Tidsskrift	Journal of Cystic Fibrosis
Vol/bind	8
Udgave nummer	3
Sider (fra-til)	198-202
Antal sider	4
ISSN	1569-1993
DOI	https://doi.org/10.1016/j.jcf.2009.02.002
Status	Udgivet - 2009

Bibliografisk note

Keywords: Adolescent; Adult; Celiac Disease; Child; Child, Preschool; Comorbidity; Cross-Sectional Studies; Cystic Fibrosis; Female; Humans; Immunoglobulin A; Infant; Male; Middle Aged; Prevalence; Scandinavia; Young Adult

Adgang til dokumentet

10.1016/j.jcf.2009.02.002

Citationsformater

@article{f780f25067ec11df928f000ea68e967b,

title = "Co-morbidity of cystic fibrosis and celiac disease in Scandinavian cystic fibrosis patients",

abstract = "BACKGROUND: The co-morbidity of cystic fibrosis (CF) and celiac disease (CD) has been reported sporadically since the 1960s. To our knowledge, this is the first time a systematic screening is performed in a large cohort of CF patients. METHODS: Transglutaminase-IgA (TGA), endomysium-IgA (EMA) and total IgA in serum were measured in 790 CF patients (48% females, 86% with pancreatic insufficiency). Six patients were diagnosed with CD prior to the study, all receiving a gluten-free diet. Patients with elevated TGA (>50 Units/mL) and a positive EMA test were offered a gastroscopy obtaining mucosal biopsies from the duodenum. RESULTS: Four new cases of CD were diagnosed. Two additional patients had positive serological tests, but normal biopsies. In total, 10 cases of CD (1.2%, 1:83) indicate a prevalence rate about three times higher than the general prevalence of CD in Norway and Sweden. No CD patients were detected in the Danish CF cohort. Patients diagnosed with untreated CD reported symptoms typical of both CF and CD (poor weight gain, loose and/or fatty stools, fatigue, irritability, abdominal pain). They improved after introduction of a gluten-free diet. CONCLUSIONS: Systematic screening for CD in a Scandinavian cohort of CF patients revealed a higher prevalence of CD than in the general population. Clinical signs of CD are difficult to differentiate from CF with malabsorption, and patients may go undiagnosed for a long time. In a population where CD is common we recommend screening for CD in patients with CF.",

author = "G Fluge and Olesen, {H V} and M Gilljam and P Meyer and T Pressler and Storr{\"o}sten, {O T} and F Karpati and L Hjelte",

note = "Keywords: Adolescent; Adult; Celiac Disease; Child; Child, Preschool; Comorbidity; Cross-Sectional Studies; Cystic Fibrosis; Female; Humans; Immunoglobulin A; Infant; Male; Middle Aged; Prevalence; Scandinavia; Young Adult",

year = "2009",

doi = "10.1016/j.jcf.2009.02.002",

language = "English",

volume = "8",

pages = "198--202",

journal = "Journal of Cystic Fibrosis",

issn = "1569-1993",

publisher = "Elsevier",

number = "3",

}

TY - JOUR

T1 - Co-morbidity of cystic fibrosis and celiac disease in Scandinavian cystic fibrosis patients

AU - Fluge, G

AU - Olesen, H V

AU - Gilljam, M

AU - Meyer, P

AU - Pressler, T

AU - Storrösten, O T

AU - Karpati, F

AU - Hjelte, L

N1 - Keywords: Adolescent; Adult; Celiac Disease; Child; Child, Preschool; Comorbidity; Cross-Sectional Studies; Cystic Fibrosis; Female; Humans; Immunoglobulin A; Infant; Male; Middle Aged; Prevalence; Scandinavia; Young Adult

PY - 2009

Y1 - 2009

N2 - BACKGROUND: The co-morbidity of cystic fibrosis (CF) and celiac disease (CD) has been reported sporadically since the 1960s. To our knowledge, this is the first time a systematic screening is performed in a large cohort of CF patients. METHODS: Transglutaminase-IgA (TGA), endomysium-IgA (EMA) and total IgA in serum were measured in 790 CF patients (48% females, 86% with pancreatic insufficiency). Six patients were diagnosed with CD prior to the study, all receiving a gluten-free diet. Patients with elevated TGA (>50 Units/mL) and a positive EMA test were offered a gastroscopy obtaining mucosal biopsies from the duodenum. RESULTS: Four new cases of CD were diagnosed. Two additional patients had positive serological tests, but normal biopsies. In total, 10 cases of CD (1.2%, 1:83) indicate a prevalence rate about three times higher than the general prevalence of CD in Norway and Sweden. No CD patients were detected in the Danish CF cohort. Patients diagnosed with untreated CD reported symptoms typical of both CF and CD (poor weight gain, loose and/or fatty stools, fatigue, irritability, abdominal pain). They improved after introduction of a gluten-free diet. CONCLUSIONS: Systematic screening for CD in a Scandinavian cohort of CF patients revealed a higher prevalence of CD than in the general population. Clinical signs of CD are difficult to differentiate from CF with malabsorption, and patients may go undiagnosed for a long time. In a population where CD is common we recommend screening for CD in patients with CF.

AB - BACKGROUND: The co-morbidity of cystic fibrosis (CF) and celiac disease (CD) has been reported sporadically since the 1960s. To our knowledge, this is the first time a systematic screening is performed in a large cohort of CF patients. METHODS: Transglutaminase-IgA (TGA), endomysium-IgA (EMA) and total IgA in serum were measured in 790 CF patients (48% females, 86% with pancreatic insufficiency). Six patients were diagnosed with CD prior to the study, all receiving a gluten-free diet. Patients with elevated TGA (>50 Units/mL) and a positive EMA test were offered a gastroscopy obtaining mucosal biopsies from the duodenum. RESULTS: Four new cases of CD were diagnosed. Two additional patients had positive serological tests, but normal biopsies. In total, 10 cases of CD (1.2%, 1:83) indicate a prevalence rate about three times higher than the general prevalence of CD in Norway and Sweden. No CD patients were detected in the Danish CF cohort. Patients diagnosed with untreated CD reported symptoms typical of both CF and CD (poor weight gain, loose and/or fatty stools, fatigue, irritability, abdominal pain). They improved after introduction of a gluten-free diet. CONCLUSIONS: Systematic screening for CD in a Scandinavian cohort of CF patients revealed a higher prevalence of CD than in the general population. Clinical signs of CD are difficult to differentiate from CF with malabsorption, and patients may go undiagnosed for a long time. In a population where CD is common we recommend screening for CD in patients with CF.

U2 - 10.1016/j.jcf.2009.02.002

DO - 10.1016/j.jcf.2009.02.002

M3 - Journal article

C2 - 19303374

VL - 8

SP - 198

EP - 202

JO - Journal of Cystic Fibrosis

JF - Journal of Cystic Fibrosis

SN - 1569-1993

IS - 3

ER -