BACKGROUND Celiac disease(CeD)is an autoimmune disorder triggered by the immune response to gluten in genetically predisposed individuals.Recent research has unveiled a heightened risk of developing specific malignant...BACKGROUND Celiac disease(CeD)is an autoimmune disorder triggered by the immune response to gluten in genetically predisposed individuals.Recent research has unveiled a heightened risk of developing specific malignant neoplasms(MN)and various malignancies,including gastrointestinal,lymphomas,skin,and others,in individuals with CeD.AIM To investigate the prevalence of MN in hospitalized CeD patients in the United States.METHODS Using data from the National Inpatient Sample spanning two decades,from January 2000 to December 2019,we identified 529842 CeD patients,of which 78128(14.75%)had MN.Propensity score matching,based on age,sex,race,and calendar year,was employed to compare CeD patients with the general non-CeD population at a 1:1 ratio.RESULTS Positive associations were observed for several malignancies,including small intestine,lymphoma,nonmelanoma skin,liver,melanoma skin,pancreas myelodysplastic syndrome,biliary,stomach,and other neuroendocrine tumors(excluding small and large intestine malignant carcinoid),leukemia,uterus,and testis.Conversely,CeD patients exhibited a reduced risk of respiratory and secondary malignancies.Moreover,certain malignancies showed null associations with CeD,including head and neck,nervous system,esophagus,colorectal,anus,breast,malignant carcinoids,bone and connective tissues,myeloma,cervix,and ovary cancers.CONCLUSION Our study is unique in highlighting the detailed results of positive,negative,or null associations between different hematologic and solid malignancies and CeD.Furthermore,it offers insights into evolving trends in CeD hospital outcomes,shedding light on advancements in its management over the past two decades.These findings contribute valuable information to the understanding of CeD’s impact on health and healthcare utilization.展开更多
Celiac disease(CD) is now recognized as a common disorder among Middle Eastern(ME) and North African(NA) populations.The aim of this review is to assess the available data regarding CD in the ME and NA and to compare ...Celiac disease(CD) is now recognized as a common disorder among Middle Eastern(ME) and North African(NA) populations.The aim of this review is to assess the available data regarding CD in the ME and NA and to compare this information with that of Western countries.A literature review was performed using the electronic databases PubMed and Medline(1950-2008) as search engines,and "celiac disease" was used as a Mesh term.The search was limited to ME and NA countries.The prevalence of CD in ME and NA countries among low risk populations is similar to that of Western countries,but is higher in high risk populations such as those with type 1 diabetes.It is underestimated because of lack of clinical suspicion and lack of patient awareness.Clinical presentations in term of gastrointestinal,hematologic,skeletal,and liver manifestations are similar between both populations except for a high prevalence of short stature in some ME and NA countries.Few studies have addressed atypical or silent CD.As in the West,diagnosis is initially made by serological tests and is confirmed by small intestinal biopsies.Gluten-free diet is the main mode of treatment with a higher apparent adherence rate than in the West.Most disease complications result from malabsorption.The disease is strongly associated with HLA DQ2 and to a lesser extent with HLA DQ8 alleles.In conclusion,CD prevalence is underestimated,with little data available about its malignant complications.Disease parameters in the ME and NA are otherwise similar to those in Western countries.展开更多
文摘BACKGROUND Celiac disease(CeD)is an autoimmune disorder triggered by the immune response to gluten in genetically predisposed individuals.Recent research has unveiled a heightened risk of developing specific malignant neoplasms(MN)and various malignancies,including gastrointestinal,lymphomas,skin,and others,in individuals with CeD.AIM To investigate the prevalence of MN in hospitalized CeD patients in the United States.METHODS Using data from the National Inpatient Sample spanning two decades,from January 2000 to December 2019,we identified 529842 CeD patients,of which 78128(14.75%)had MN.Propensity score matching,based on age,sex,race,and calendar year,was employed to compare CeD patients with the general non-CeD population at a 1:1 ratio.RESULTS Positive associations were observed for several malignancies,including small intestine,lymphoma,nonmelanoma skin,liver,melanoma skin,pancreas myelodysplastic syndrome,biliary,stomach,and other neuroendocrine tumors(excluding small and large intestine malignant carcinoid),leukemia,uterus,and testis.Conversely,CeD patients exhibited a reduced risk of respiratory and secondary malignancies.Moreover,certain malignancies showed null associations with CeD,including head and neck,nervous system,esophagus,colorectal,anus,breast,malignant carcinoids,bone and connective tissues,myeloma,cervix,and ovary cancers.CONCLUSION Our study is unique in highlighting the detailed results of positive,negative,or null associations between different hematologic and solid malignancies and CeD.Furthermore,it offers insights into evolving trends in CeD hospital outcomes,shedding light on advancements in its management over the past two decades.These findings contribute valuable information to the understanding of CeD’s impact on health and healthcare utilization.
文摘Celiac disease(CD) is now recognized as a common disorder among Middle Eastern(ME) and North African(NA) populations.The aim of this review is to assess the available data regarding CD in the ME and NA and to compare this information with that of Western countries.A literature review was performed using the electronic databases PubMed and Medline(1950-2008) as search engines,and "celiac disease" was used as a Mesh term.The search was limited to ME and NA countries.The prevalence of CD in ME and NA countries among low risk populations is similar to that of Western countries,but is higher in high risk populations such as those with type 1 diabetes.It is underestimated because of lack of clinical suspicion and lack of patient awareness.Clinical presentations in term of gastrointestinal,hematologic,skeletal,and liver manifestations are similar between both populations except for a high prevalence of short stature in some ME and NA countries.Few studies have addressed atypical or silent CD.As in the West,diagnosis is initially made by serological tests and is confirmed by small intestinal biopsies.Gluten-free diet is the main mode of treatment with a higher apparent adherence rate than in the West.Most disease complications result from malabsorption.The disease is strongly associated with HLA DQ2 and to a lesser extent with HLA DQ8 alleles.In conclusion,CD prevalence is underestimated,with little data available about its malignant complications.Disease parameters in the ME and NA are otherwise similar to those in Western countries.