Inflammatory eye disease is a risk factor for future microscopic colitis: A nationwide population‐based matched case control study

Author:

Bergman David1ORCID,Ebrahimi Fahim12,Sun Jiangwei1,Norin Cecilia3,Mollazadegan Kaziwe4,Ludvigsson Jonas F.156

Affiliation:

1. Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden

2. Department of Gastroenterology and Hepatology University Digestive Health Care Center Basel—Clarunis Basel Switzerland

3. Sankt Eriks Eye Hospital Stockholm Sweden

4. Department of Ophthalmology Västmanland Hospital Västerås Sweden

5. Department of Pediatrics Orebro University Hospital Orebro Sweden

6. Department of Medicine Columbia University College of Physicians and Surgeons New York New York USA

Abstract

AbstractBackgroundMicroscopic colitis (MC) is an inflammatory disorder of the colon. To date, the relationship between inflammatory eye diseases and MC is unclear.ObjectiveTo assess whether inflammatory eye disease (iridocyclitis and episcleritis) is a risk factor for MC.MethodsWe conducted a nationwide matched case control study in Sweden leveraging the ESPRESSO‐study (a Swedish database containing data on all biopsies from the gastrointestinal tract from 1965 to 2017). In total, we identified 14,338 patients with biopsy‐verified MC (diagnosed from 1981 to 2017). Patients with MC were matched (by age, sex, county and year of birth) with 68,753 controls from the general population and the occurrence of preceding inflammatory eye diseases (defined as diagnosis of episcleritis or iridocyclitis) in the two groups was compared. Multivariable adjusted odds ratios (aORs) were calculated using conditional logistic regression conditioned on the matching variables.ResultsA majority of patients with MC were women (71.9%) and the median age at MC diagnosis was 63.3 years (interquartile range (IQR) = 50.7–72.6). Some 225 (1.6%) MC patients had an earlier record of inflammatory eye disease compared with 614 (0.9%) in controls. These figures corresponded to an aOR of 1.77 (95% CI = 1.52–2.07) for inflammatory eye diseases in patients with MC. Compared to siblings, the aOR for previous inflammatory eye diseases in MC was 1.52 (95% CI = 1.17–1.98) and patients treated with budesonide, as a proxy for clinically significant disease, had a somewhat higher aOR for previous inflammatory eye diseases.ConclusionInflammatory eye diseases are more common in patients subsequently being diagnosed with MC. Our findings highlight that these conditions may have shared causes and inflammatory pathways and are of clinical interest to gastroenterologists, ophthalmologists and general practitioners.

Funder

Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung

Karolinska Institutet

Publisher

Wiley

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