Immunological Comorbity in Coeliac Disease: Associations, Risk Factors and Clinical Implications

Purpose

Coeliac disease is frequently associated with other immunomediated diseases. Our aim was to identify immunological comorbidities and possible risk factors for their development in coeliac patients.

Methods

We recruited a cohort of 1,015 coeliac patients followed from 0 to 46?years in a single tertiary referral centre. Data were collected from the yearly scheduled clinical and serological evaluations. Possible risk factors such as demographic parameters, type of symptomatic presentation, gluten exposure, gluten-free diet compliance and family history were all evaluated. Subjects (848,606) from the regional health registry were investigated as controls.

Results

The prevalence of immunomediated diseases was higher in patients with coeliac disease compared to the registry population (23?% vs 0.4?%, p?p?=?0.0061). Type of presentation and dietetic compliance did not represent risk factors. Long-standing gluten exposure reduced the risk of developing immunomediated diseases in coeliac subjects (hazard ratio for 1?year longer exposure 0.23, 95?% confidence interval 0.16–0.33, p?Conclusions Our study suggests the need to investigate coeliac patients for other associated immunomediated diseases, independently of sex, gluten exposure and compliance to therapy; also subjects diagnosed in paediatric age should be carefully screened during follow up.