20 Immune-Mediated Diseases More Common With IBD

The incidence of immune-mediated disease is significantly higher among individuals with inflammatory bowel diseases (IBD) like Crohn disease (CD) and ulcerative colitis (UC), according to a recent study.

For their study, the researchers evaluated 47,325 living patients with IBD who were registered in the Danish National Patient Registry on December 16, 2013. Additionally, individuals who were registered in the Danish Civil Registration System were randomly selected as controls and matched for sex, age, and municipality.
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ICD-10 codes were used to identify patients’ diagnoses. Patients with IBD were classified as having either UC, CD, or both. Odds-ratios (ORs) and 95% confidence intervals were calculated for each IBD group and for controls. The Bonferoni post-test correction was used to adjust the significance level. Fisher’s exact test was used to estimate P-values.

The researchers noted that there were significantly more women than men in the registry. Ultimately, results indicated that the incidence of 20 different immune-mediated diseases was significantly higher in the IBD group. A total of 16 immune-mediated diseases were found to be associated with UC, compared with 12 for CD. ORs for UC and CD were significantly higher for primary sclerosing cholangitis, celiac disease, type 1 diabetes, sarcoidosis, asthma, iridocyclitis, psoriasis, pyoderma gangrenosum, rheumatoid arthritis (RA), and ankylosing spondylitis.

In particular, UC was associated with a higher risk of autoimmune hepatitis, primary biliary cholangitis, Grave disease, polymyalgia rheumatica, temporal arteritis, and atrophic gastritis, according to the researchers. Additionally, the incidence of atrophic gastritis, RA, temporal arteritis, and polymyalgia rheumatica was higher among women with UC.

Furthermore, CD was specifically associated with a higher risk of psoriatic arthritis (PsA) and episcleritis. The incidence of episcleritis, RA, and PsA was higher among women with CD, while the incidence of sarcoidosis was higher among men with CD.

“Immune mediated diseases were significantly more frequent in patients with IBD,” the researchers concluded. “Our results strengthen the hypothesis that some [immune mediated diseases] and IBD may have overlapping pathogenic pathways.”

—Christina Vogt

Reference:

Halling ML, Kjeldsen J, Knudsen T, Nielsen J, Koch Hansen L. Patients with inflammatory bowel disease have increased risk of autoimmune and inflammatory diseases. World J Gastroenterol. 2017;23(33):6137-6146. doi:10.3748/wjg.v23.i33.6137.