UH Rainbow Babies and Children's Hospital omaha, NE
Basma A. Dahash, MD1, Omar A. Alaber, MD2, Senthikumar Sankararaman, MD3, Maricruz Crespo, MD3, Thomas J. Sferra, MD1; 1UH Rainbow Babies and Children's Hospital, Cleveland, OH; 2Case Western Reserve University School of Medicine, Cleveland, OH; 3Rainbow Babies and Children's Hospital, Cleveland, OH
Introduction: Patients with celiac disease (CD) are reported to be at increased risk of pancreatitis. The degree of risk is not known in the U.S. population. Also, it is not clear whether other risk factors for pancreatitis are the underlying determinants of the development of pancreatitis in patients with CD.
Aims: To investigate whether CD is associated with an increased risk of pancreatitis within the U.S. population. Methods: Data were obtained from a commercial U.S. national database (IBM Explorys Solutions, IBM, Inc.). Explorys contains de-identified patient information from 27 U.S. healthcare networks from 1999 to the present. Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT) was used for data extraction. Cases were defined as being active within the database (index visit) who were subsequently diagnosed with CD and afterward diagnosed with pancreatitis (any type). Controls were defined as patients with an index visit who were subsequently diagnosed with pancreatitis without the diagnosis of CD. Patients with a previous diagnosis of pancreatitis were excluded from the analysis. Odds ratios (OR) and 95% confidence intervals (CI) were calculated between the cases and controls. Results: 133,640 (0.18% within the database) patients met our criteria for cases of celiac disease (Table). The prevalence of risk factors for pancreatitis was two-to-three times higher in the celiac disease cohort. The risk of being diagnosed with pancreatitis in a patient with celiac disease (cases) was 1.11% compared to 0.52% in the general population with no celiac disease diagnosis (controls). Cases had a 2.16 (CI 2.02–2.31) times higher odds of being subsequently diagnosed with pancreatitis. In sub-group analysis, the diagnosis of acute pancreatitis had a 2.84 (CI 2.50–3.22) times higher odds compared to chronic pancreatitis in the celiac disease cohort. Excluding patients with risk factors for pancreatitis from the analysis, the risk to develop pancreatitis in CD remained elevated (OR 2.67, CI 2.17 –3.28) as well as the risk of acute versus chronic disease (OR 3.06, CI 2.0 –4.63). Discussion: This study suggests that individuals with CD are at increased risk of pancreatitis, especially acute pancreatitis. This risk appears to be due to CD itself as other risk factors for pancreatitis did not alter this finding. Patients with celiac disease should be counseled as to this risk and to avoid the known risk factors for the development of pancreatitis.
Patients Demographics Characteristics
Disclosures: Basma Dahash indicated no relevant financial relationships. Omar Alaber indicated no relevant financial relationships. Senthikumar Sankararaman indicated no relevant financial relationships. Maricruz Crespo indicated no relevant financial relationships. Thomas Sferra: Merck & Co., Inc. – Grant/Research Support. Teledoc Health, Inc. – Other Financial or Material Support, Case Reviewer.