Auteur Topic: Coeliakie, de ziekte van Crohn en Colitis Ulcerosa  (gelezen 211 keer)

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Coeliakie, de ziekte van Crohn en Colitis Ulcerosa
« Gepost op: mei 20, 2020, 20:56:48 »
Soms komt coeliakie niet alleen. En blijven er darmklachten. Dat kan een signaal zijn dat een (andere) ontstekingsziekte in de darmen actief is: de ziekte van Crohn of Colitis ulcerosa. Uit een analyse van de medische literatuur blijkt dat coeliakiepatiŽnten 10 keer zoveel kans hebben om de ziekte van Crohn of Colitis ulcerosa te ontwikkelen, in vergelijking met mensen zonder coeliakie. Andersom hebben patiŽnten met Crohn of Colitis 4 keer zoveel kans op coeliakie. Er is meer onderzoek nodig om deze ziekten in een vroeg stadium op te sporen, schrijven Canadese artsen in het tijdschrift Gastroenterology.


Gastroenterology 2020 May 8; Online ahead of print.
Association Between Inflammatory Bowel Diseases and Celiac Disease: A Systematic Review and Meta-Analysis
Maria Ines Pinto-Sanchez 1, Caroline L Seiler 1, Nancy Santesso 2, Armin Alaedini 3, Carol Semrad 4, Anne R Lee 3, Premysl Bercik 1, Benjamin Lebwohl 3, Daniel A Leffler 5, Ciaran P Kelly 5, Paul Moayyedi 1, Peter H Green 3, Elena F Verdu 6
 
Background & aims:

There is controversy over the association between celiac disease and inflammatory bowel diseases (IBD). We performed a systematic review and meta-analysis to assess evidence for an association between celiac disease and IBD.

Methods:

We searched databases including MEDLINE, EMBASE, CENTRAL, Web of Science, CINAHL, DARE, and SIGLE through June 25, 2019 for studies assessing the risk of celiac disease in patients with IBD, and IBD in patients with celiac disease, compared with controls of any type. We used the Newcastle-Ottawa Scale to evaluate the risk of bias and GRADE to assess the certainty of the evidence.

Results:

We identified 9791 studies and included 65 studies in our analysis. Moderate certainty evidence found an increased risk of celiac disease in patients with IBD vs controls (relative risk [RR], 3.96; 95% CI, 2.23-7.02) and increased risk of IBD in patients with celiac disease vs controls (RR, 9.88; 95% CI, 4.03-24.21). There was low-certainty evidence for the risk of anti-Saccharomyces antibodies, a serologic marker of IBD, in patients with celiac disease vs controls (RR, 6.22; 95% CI, 2.44-15.84). There was low certainty evidence for no difference in risk of HLA-DQ2 or DQ8 in patients with IBD vs controls (RR, 1.04; 95% CI, 0.42-2.56), and very low certainty evidence for an increased risk of anti-tissue transglutaminase in patients with IBD vs controls (RR, 1.52; 95% CI, 0.52-4.40). Patients with IBD had a slight decrease in risk of anti-endomysial antibodies vs controls (RR, 0.70; 95% CI, 0.18-2.74), but these results are uncertain.

Conclusions:

In a systematic review and meta-analysis, we found an increased risk of IBD in patients with celiac disease and increased risk of celiac disease in patients with IBD, compared with other patient populations. High-quality prospective cohort studies are needed to assess the risk of celiac disease-specific and IBD-specific biomarkers in patients with IBD and celiac disease.

PMID: 32416141 doi: 10.1053/j.gastro.2020.05.016.
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