A population-based study of coeliac disease, neurodegenerative and neuroinflammatory diseases.
BACKGROUND
It has been suggested that coeliac disease (CD) is associated with several neurological diseases. However, the evidence of such an association is inconclusive as earlier research has often been based on small numbers with retrospective data collection.


OBJECTIVE
To use Cox regression to examine the risk of neurological disease in individuals with CD.


METHODS
Through Swedish national registers we identified some 14 000 individuals with a diagnosis of CD (1964-2003) and 70 000 reference individuals matched for age, sex, calendar year and county.


RESULTS
Coeliac disease was associated with later polyneuropathy [hazard ratio (HR) = 3.4; 95% CI = 2.3-5.1]. We found no statistically significant association between CD and subsequent multiple sclerosis (HR = 0.9; 95% CI = 0.3-2.3), Parkinson's disease (HR = 1.2; 95% CI = 0.8-1.9), Alzheimer's disease (HR = 1.5; 95% CI = 0.9-2.6), hereditary ataxia (HR = 1.3; 95% CI = 0.5-3.6), the symptom ataxia (HR = 1.9; 95% CI = 0.6-6.2), Huntington's disease (HR = 1.7; 95% CI = 0.3-8.6), myasthenia gravis (HR = 0.8; 95% CI = 0.2-3.8) or spinal muscular atrophy (HR = 0.5; 95% CI = 0.1-3.8). Prior polyneuropathy was associated with subsequent CD (odds ratio = 5.4; 95% CI = 3.6-8.2).


CONCLUSIONS
The association between CD and polyneuropathy indicates shared risks. We suggest that individuals with polyneuropathy routinely undergo screening for CD. There is no notable association between CD and other neurological outcomes investigated in this study.
Ludvigsson
J F
JF
Department of Paediatrics, Orebro University Hospital, 70185 Orebro, Sweden. jonasludvigsson@yahoo.com
Olsson
T
T
Ekbom
A
A
Montgomery
S M
SM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009443:Neuritis / Q000453:epidemiology / Q000209:etiology*; D019636:Neurodegenerative Diseases / Q000453:epidemiology / Q000209:etiology*; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology