Patients who sustain head trauma are at slightly increased risk for developing celiac disease, according to recent results.
Researchers evaluated intestinal biopsy results collected from 29,096 patients with celiac disease (CD) across 28 pathology departments in Sweden and compared their risk for earlier head trauma with that of 144,522 matched controls who did not undergo biopsy. Patients with CD had a median age of 30 years at diagnosis, while those who experienced head trauma first did so at a median age of 18 years.
“Our research has shown that a large proportion of individuals with gluten ataxia show increased levels of tissue transglutaminase 6,” the researchers wrote. “We hypothesized that head trauma and secondary cerebral and cerebellar insult may trigger autoimmunity against TG6, which in turn may lead, in genetically susceptible individuals, to the development of CD.”
Prior head trauma was observed in 3.4% of patients with CD compared with 3.1% of controls. Investigators calculated a 1.1-fold risk increase (95% CI, 1.02-1.17) for future CD among those with previous trauma, independent of sex or age at diagnosis.
The observed risk increase was most pronounced within the first year after sustaining trauma (OR=1.35; 95% CI, 1.1-1.66), with no association observed after 5 or more years (OR=1.02; 95% CI, 0.94-1.11). Analysis according to sex indicated a significant association between head trauma and CD risk among females (OR=1.13; 95% CI, 1.03-1.24), but not males. Risk for future CD was also greater when head trauma was sustained during childhood (OR=1.17; 95% CI, 1.03-1.32 among those aged under 20 years at trauma). No association was observed between CD risk and the severity of the trauma sustained (OR=0.77; 95% CI, 0.51-1.16 for severe head trauma).
“We found a small increased risk of CD in individuals with earlier head trauma,” the researchers concluded. “This excess risk may be due to surveillance bias or due to an autoimmune response against transglutaminases triggered by the brain injury.”
Disclosure: The researchers report no relevant financial disclosures.