- Fecal Incontinence
|The association of Inflammatory Bowel diseases with autoimmune disorders: a population-based report from the epi-IIRN
Bar Yehuda S1, Axlerod R1, Toker O2, Zigman N3, Goren I3, Mourad V3, Lederman N4, Cohen N4, Matz E5, Dushnitzky D5, Gavish M6, Borovsky N5, Schwarts D7, Dotan I8, Turner D1. J Crohns Colitis. 2018 Oct 9. doi: 10.1093/ecco-jcc/jjy166. [Epub ahead of print]
1 The Juliet Keidan Institute of Paediatric Gastroenterology, Hepatology and Nutrition, Shaare Zedek Medical Center, the Hebrew University of Jerusalem, Israel.
2 Shaare Zedek Medical Center, the Hebrew University of Jerusalem, Israel.
3 Maccabi Healthcare Services, Tel-Aviv, Israel.
4 Meuhedet Health Services, Tel-Aviv, Israel.
5 Leumit Health Services, Tel-Aviv, Israel.
6 School of Computer Science and Engineering, The Hebrew University, Jerusalem.
7 Soroka Medical Center, Beer Sheba, Israel.
8 Division of Gastroenterology, Rabin Medical Center, Petah Tikva, and the Sackler Faculty of Medicine, Tel Aviv University, Israel.
INTRODUCTION: There are conflicting data on the association between inflammatory bowel diseases (IBD) and autoimmunity disorders. The aim of this study was to explore this association including the effect of medications on this association.
METHODS: We utilized health administrative data collected by 3 of 4 Israel's Health Maintenance Organizations (HMO) covering 52% of the population of Israel. We explored the prevalence of the following autoimmune disorders: Insulin Dependent Diabetes Mellitus (IDDM), psoriasis, Sjögren syndrome, celiac, systemic lupus erythematosus (SLE), primary sclerosis cholangitis (PSC) and autoimmune thyroiditis, among all IBD patients versus non-IBD controls. Case ascertainment was determined according to validated computerized algorithms.
RESULTS: 12,625 IBD patients were compared to 12,625 controls. A total of 1,395 (11.1%) IBD patients had at least one autoimmune disease compared with 740 (5.9%) of non-IBD controls (OR 95%CI=1.99 (1.81-2.19); P<0.05); all autoimmune diseases, except for thyroiditis, were more prevalent among IBD patients. Adjusted for confounding variables, anti-TNF medications were associated with a higher prevalence of psoriasis (54 (5.7%) in IBD vs 177 (4.1%) in controls; OR 95%CI=1.50 (1.07-2.08); P<0.05) but lower prevalence of Sjögren (1 (0.1%) vs. 39 (0.9%); OR 95%CI=0.13 (0.02-0.94); P<0.05) and celiac disease (11 (1.2%) vs. 68 (1.6%); OR 95%CI=0.51 (0.27-0.99); P<0.05). Thiopurines and 5ASA were not associated with any autoimmune disorder.
CONCLUSION: IBD is associated with all autoimmune diseases explored here except for thyroiditis. Anti-TNF users have a higher prevalence of psoriasis, and lower prevalence of Sjögren and celiac disease.