Celiac Disease and Increased Risk of Pneumococcal Infection: A Systematic Review and Meta-Analysis - 08/12/17
, Lori A.J. Scott-Sheldon, PhD b, c, d, Yesenia Risech-Neyman, MD e, Steven F. Moss, MD e, Jonas F. Ludvigsson, MD, PhD f, g, h, i, Peter H.R. Green, MD iAbstract |
Background |
Celiac disease has been associated with hyposplenism, and multiple case reports link celiac disease and pneumococcal infections; however, increased risk of pneumococcal infection in celiac disease has not been confirmed. The purpose of this study was to conduct a systematic review to determine the risk of pneumococcal infections in celiac disease.
Methods |
Relevant studies were identified using electronic bibliographic searches of PubMed, OVID, Medline, and EMBASE (1980 to February 2017) and reviewing abstracts from major conferences in gastroenterology. Using number of events in celiac patients and referent patients, we calculated a summary relative risk of pneumococcal infections. All analyses were conducted in Comprehensive Meta-Analysis software using random-effects assumptions.
Results |
Of a total of 156 articles, 3, representing 3 large databases (the Swedish National Inpatient Register; the Oxford Record Linkage Study; and the English National Hospital Episode Statistics) were included. Each compared patients with celiac disease and confirmed pneumococcal infection to a specific reference group: inpatients and/or the general population. Overall, the odds of pneumococcal infection were higher among hospitalized celiac patients compared with controls (odds ratio 1.66; 95% confidence interval 1.43-1.92). There was no evidence of heterogeneity (Q[1] = 1.17, P = .56, I2 = 0%).
Conclusions |
Celiac disease is associated with an increased risk of pneumococcal infection. Preventive pneumococcal vaccination should be considered for those with celiac disease, with special attention to those aged 15-64 years who have not received the scheduled pneumococcal vaccination series as a child.
Le texte complet de cet article est disponible en PDF.Keywords : Celiac disease, Hyposplenism, Infection, Pneumococcus, Splenic atrophy
Plan
| Funding: None. |
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| Conflict of Interest: None. |
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| Authorship: Author contributions are as follows. MS: conception of the work, acquisition and interpretation of the data, lead author. LAJS-S: data analysis, author. YR-N: conceptualization, analysis of data, author. SM: contributing author, data analysis, critical review of the intellectual content. JFL: major contributing author, interpretation of data, critical revision of manuscript. PHRG: supervising author, critical revision of the data and intellectual content. All authors approve the final submitted draft. |
Vol 131 - N° 1
P. 83-89 - janvier 2018 Retour au numéro
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