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No Data to Support Link between Eosinophilic Esophagitis and Celiac Disease

Celiac.com 09/11/2014 - What’s the relationship, if any, between eosinophilic esophagitis (EoE) and celiac disease? Research studies have produced variable results.

Photo: CC--Elvert BarnesResearchers A. J. Lucendo, Á. Arias, and J. M. Teniaso recently set out to conduct a systematic review of medical literature to determine if there’s any evidence of a connection between both diseases. They used the MEDLINE, EMBASE and SCOPUS databases to conduct electronic searches with keywords relating to EoE and celiac disease.

Depending on study heterogeneity, they used random-effects models as needed (I2). To assess publication bias, they used funnel plot analysis, along with the Begg–Mazumdar, Harbord and Egger tests.

Their keyword search produced 197 significant study references; 30 were included in the quantitative summary, with most showing serious methodological inconsistencies. The team found significant publication bias in favor of short studies reporting positive connections between the two diseases.

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The prevalence of EoE in celiac patients ranged from 0% to 10.7% (I2 = 78.9%). Rates of celiac disease in EoE varied wildly, between 0.16% and 57.1% (I2 = 89%).

One high-quality, prospective, randomly selected, population-based study showed a celiac disease rate of 1.1%, with no cases of EoE. Numerous quantitative summaries of celiac prevalence suffer from clinical and methodological differences. That is, they are are not similar enough to draw good conclusions.

A gluten-free diet produced histological remission of EoE in 32.1% of celiac patients (95% confidence interval, 14.9–52.2%; I2 = 52.2%), which was similar to that expected for wheat elimination in EoE patients.

There are not really enough valid studies to completely rule in or out a true association between EoE and celiac disease, currently available evidence does not support any such connection. In fact, the only epidemiologically valid study indicates that these diseases are not connected.

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2 Responses:

 
MooseMalibu
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said this on
11 Sep 2014 11:38:48 AM PDT
This article is interesting. I was convinced my mother who has EoE had celiac disease, but she was tested for it and came up negative. I have celiac disease but only my mother has been retro-actively tested to see if she had it, too. I always thought they were linked.

 
michelepta
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said this on
16 Sep 2014 5:25:35 AM PDT
Interesting. My husband has EoE and celiac. Just found out he has Crohn's in his illeum too. Was sort of a relief to know that his anemia was not do to gluten (those biopsies came back stage 1.) He's doing well on his new medicine.




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