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Article ; Online: Mortality in patients with Crohn's disease in Örebro, Sweden 1963-2010.

Zhulina, Yaroslava / Udumyan, Ruzan / Tysk, Curt / Halfvarson, Jonas

Scandinavian journal of gastroenterology

2021 Volume 57, Issue 2, Page(s) 158–164

Abstract: Background: Some studies have suggested a reduced life expectancy in patients with Crohn's disease (CD) compared with the general population. The evidence, however, is inconsistent.: Aims: Prompted by such studies, we studied survival of CD patients ... ...

Abstract	Background: Some studies have suggested a reduced life expectancy in patients with Crohn's disease (CD) compared with the general population. The evidence, however, is inconsistent. Aims: Prompted by such studies, we studied survival of CD patients in Örebro county, Sweden. Methods: From the medical records, we identified all patients diagnosed with CD during 1963-2010 with follow-up to the end of 2011. We estimated: overall survival, net and crude probabilities of dying from CD, relative survival ratio (RSR), and excess mortality rate ratios (EMRR) at 10-year follow-up. Results: The study included 492 patients (226 males, 266 females). Median age at diagnosis was 32 years (3-87). Net and crude probabilities of dying from CD increased with increasing age and were higher for women. Net survival of patients aged ≥60 at diagnosis was worse for patients diagnosed during 1963-1985 (54%) than for patients diagnosed during 1986-1999 (88%) or 2000-2010 (93%). Overall, CD patients' survival was comparable to that in the general population [RSR = 0.98; 95% CI: (0.95-1.00)]. However, significantly lower than expected survival was suggested for female patients aged ≥60 diagnosed during the 1963-1985 [RSR = 0.47 (0.07-0.95)]. The adjusted model suggested that, compared with diagnostic period 1963-1985, disease-related excess mortality declined during 2000-2010 [EMRR = 0.36 (0.07-1.96)]; and age ≥60 at diagnosis [EMRR = 7.99 (1.64-39.00), reference: age 40-59], female sex [EMRR = 4.16 (0.62-27.85)], colonic localization [EMRR = 4.20 (0.81-21.88), reference: ileal localization], and stricturing/penetrating disease [EMRR = 2.56 (0.52-12.58), reference: inflammatory disease behaviour] were associated with poorer survival. Conclusion: CD-related excess mortality may vary with diagnostic period, age, sex and disease phenotype.Key summaryThere is inconsistent evidence on life expectancy of patients with Crohn's diseaseCrohn's disease-specific survival improved over time.Earlier diagnosis period, older age at diagnosis, female sex, colonic disease and complicated disease behaviour seems to be associated with excess Crohn's disease-related mortality.
MeSH term(s)	Adult ; Aged ; Colon ; Constriction, Pathologic ; Crohn Disease/diagnosis ; Female ; Humans ; Ileum ; Male ; Middle Aged ; Sweden/epidemiology
Language	English
Publishing date	2021-10-25
Publishing country	England
Document type	Journal Article
ZDB-ID	82042-8
ISSN	1502-7708 ; 0036-5521
ISSN (online)	1502-7708
ISSN	0036-5521
DOI	10.1080/00365521.2021.1991466
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Zs.A 567: Show issues

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Article ; Online: Large intestine: Remission of lymphocytic colitis with budesonide.

Tysk, Curt

Nature reviews. Gastroenterology & hepatology

2009 Volume 6, Issue 9, Page(s) 506–507

Abstract: Few randomized, controlled trials have investigated the efficacy of pharmacological treatment for lymphocytic colitis. data from a new randomized, placebo-controlled trial have demonstrated the efficacy of budesonide in inducing remission of this disease; ...

Abstract	Few randomized, controlled trials have investigated the efficacy of pharmacological treatment for lymphocytic colitis. data from a new randomized, placebo-controlled trial have demonstrated the efficacy of budesonide in inducing remission of this disease; this study is an important contribution to this field.
MeSH term(s)	Anti-Inflammatory Agents/therapeutic use ; Biopsy ; Budesonide/therapeutic use ; Colitis, Lymphocytic/drug therapy ; Colitis, Lymphocytic/pathology ; Humans ; Intestine, Large/pathology ; Remission Induction ; Treatment Outcome
Chemical Substances	Anti-Inflammatory Agents ; Budesonide (51333-22-3)
Language	English
Publishing date	2009-08-28
Publishing country	England
Document type	News
ZDB-ID	2493722-8
ISSN	1759-5053 ; 1759-5045
ISSN (online)	1759-5053
ISSN	1759-5045
DOI	10.1038/nrgastro.2009.139
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Zs.A 6020: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article ; Online: The changing face of Crohn's disease: a population-based study of the natural history of Crohn's disease in Örebro, Sweden 1963-2005.

Zhulina, Yaroslava / Udumyan, Ruzan / Tysk, Curt / Montgomery, Scott / Halfvarson, Jonas

Scandinavian journal of gastroenterology

2016 Volume 51, Issue 3, Page(s) 304–313

Abstract: Objective: Changes in medical therapy and surgery might have influenced the natural history of Crohn's disease (CD). Our aim was to explore the short-term outcome of CD and to specifically assess trends in disease phenotype, medications and surgery in ... ...

Abstract	Objective: Changes in medical therapy and surgery might have influenced the natural history of Crohn's disease (CD). Our aim was to explore the short-term outcome of CD and to specifically assess trends in disease phenotype, medications and surgery in the first five years from diagnosis. Material and methods: A population-based cohort comprising 472 CD patients diagnosed within the primary catchment area of Örebro University Hospital 1963-2005 were identified retrospectively and described. Data on medication, surgery, progression in disease location and behavior, were extracted from the medical records. Patients were divided into three cohorts based on year of diagnosis. Results: The proportion of patients with complicated disease behavior five years after diagnosis decreased from 54.4% (95%CI, 43.9-65.6) to 33.3% (27.4-40.0) in patients diagnosed 1963-1975 and 1991-2005, respectively (p = 0.002), whereas the proportion of patients progressing to complicated disease behavior was stable among those with non-stricturing, non-penetrating disease at diagnosis (p = 0.435). The proportion of patients undergoing surgery decreased from 65.8% (55.4-76.0) to 34.6% (28.6-41.5) in patients diagnosed 1963-1975 and 1991-2005, respectively (p < 0.001). The reduction in surgery preceded an increased use of immunomodulators and was explained by a decrease in surgery within three months from diagnosis (p = 0.001). Conclusions: We observed a striking decrease in complicated disease behavior and surgery five years after CD diagnosis, the latter largely due to a decrease in early surgery. Our findings suggest that the introduction of new treatments alone does not explain the reduction in surgery rates, the increasing proportion of patients with inflammatory disease at diagnosis also play an important role.
MeSH term(s)	Adolescent ; Adrenal Cortex Hormones/therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Aminosalicylic Acid/therapeutic use ; Anti-Inflammatory Agents/therapeutic use ; Budesonide/therapeutic use ; Child ; Child, Preschool ; Crohn Disease/complications ; Crohn Disease/drug therapy ; Crohn Disease/surgery ; Digestive System Surgical Procedures/trends ; Disease Progression ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Male ; Middle Aged ; Phenotype ; Retrospective Studies ; Sweden ; Time Factors ; Young Adult
Chemical Substances	Adrenal Cortex Hormones ; Anti-Inflammatory Agents ; Immunosuppressive Agents ; Budesonide (51333-22-3) ; Aminosalicylic Acid (5B2658E0N2)
Language	English
Publishing date	2016-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	82042-8
ISSN	1502-7708 ; 0036-5521
ISSN (online)	1502-7708
ISSN	0036-5521
DOI	10.3109/00365521.2015.1093167
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Zs.A 567: Show issues

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Article ; Online: What Are the Most Challenging Aspects of Inflammatory Bowel Disease? An International Survey of Gastroenterologists Comparing Developed and Developing Countries.

Gearry, Richard B / McCombie, Andrew M / Vatn, Morten / Rubin, David T / Steinwurz, Flavio / Loftus, Edward V / Kruis, Wolfgang / Tysk, Curt / Colombel, Jean-Frederic / Ng, Siew C / Van Assche, Gert / Bernstein, Charles N

Inflammatory intestinal diseases

2021 Volume 6, Issue 2, Page(s) 78–86

Abstract: Background and aims: As inflammatory bowel disease (IBD) becomes more prevalent, the challenges that gastroenterologists face in managing these patients evolve. We aimed to describe the most important challenges facing gastroenterologists from around ... ...

Abstract	Background and aims: As inflammatory bowel disease (IBD) becomes more prevalent, the challenges that gastroenterologists face in managing these patients evolve. We aimed to describe the most important challenges facing gastroenterologists from around the world and compare these between those working in developed and developing countries. Methods: An online questionnaire was developed, and a link distributed to gastroenterologists. Data were analyzed descriptively using Friedman and Wilcoxon matched-pair signed rank tests to compare rankings for responses. Mann-Whitney Results: Of 872 who started, 397 gastroenterologists (45.5%) completed the survey. Respondents represented 65 countries (226 [56.9%] from developed countries). Overall, the challenge ranked most important (smallest number) was increasing IBD prevalence (13.6%). There were significant differences in mean ranking scores for many simple aspects of care for those from developing countries compared to providers from developed countries, such as access to simple IBD treatments (5.52 vs. 6.02, Conclusions: Increasing IBD prevalence is seen by gastroenterologists as the greatest challenge facing them. There are significant differences between the IBD challenges facing gastroenterologists from developed and developing countries that reflect inequities in access to health care.
Language	English
Publishing date	2021-02-05
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2817967-5
ISSN	2296-9365 ; 2296-9403
ISSN (online)	2296-9365
ISSN	2296-9403
DOI	10.1159/000512310
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Article ; Online: Family history, comorbidity, smoking and other risk factors in microscopic colitis: a case-control study.

Wickbom, Anna / Nyhlin, Nils / Montgomery, Scott M / Bohr, Johan / Tysk, Curt

European journal of gastroenterology & hepatology

2017 Volume 29, Issue 5, Page(s) 587–594

Abstract: Objectives: Data on heredity, risk factors and comorbidity in microscopic colitis, encompassing collagenous colitis (CC) and lymphocytic colitis (LC), are limited.: Aim: The aim was to carry out a case-control study of family history, childhood ... ...

Abstract	Objectives: Data on heredity, risk factors and comorbidity in microscopic colitis, encompassing collagenous colitis (CC) and lymphocytic colitis (LC), are limited. Aim: The aim was to carry out a case-control study of family history, childhood circumstances, educational level, marital status, smoking and comorbidity in microscopic colitis. Methods: A postal questionnaire was sent in 2008-2009 to microscopic colitis patients resident in Sweden and three population-based controls per patient, matched for age, sex and municipality. Results: Some 212 patients and 627 controls participated in the study. There was an association with a family history of microscopic colitis in both CC [odds ratio (OR): 10.3; 95% confidence interval (CI): 2.1-50.4, P=0.004] and LC (OR not estimated, P=0.008). Current smoking was associated with CC [OR: 4.7; 95% CI: 2.4-9.2, P<0.001) and LC (OR: 3.2; 95% CI: 1.6-6.7, P=0.002). The median age at diagnosis was around 10 years earlier in ever-smokers compared with never-smokers.CC was associated with a history of ulcerative colitis (UC) (OR: 8.7, 95% CI: 2.2-33.7, P=0.002), thyroid disease (OR: 2.3; 95% CI: 1.1-4.5, P=0.02), coeliac disease (OR: 13.1; 95% CI: 2.7-62.7, P=0.001), rheumatic disease (OR 1.9; 95% CI: 1.0-3.5, P=0.042) and previous appendicectomy (OR: 2.2; 95% CI: 1.3-3.8, P=0.003), and LC with UC (OR: 6.8; 95% CI: 1.7-28.0, P=0.008), thyroid disease (OR: 2.4; 95% CI: 1.1-5.4, P=0.037) and coeliac disease (OR: 8.7; 95% CI: 2.8-26.7, P<0.001). Conclusion: Association with a family history of microscopic colitis indicates that familial factors may be important. The association with a history of UC should be studied further as it may present new insights into the pathogenesis of microscopic colitis and UC.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Autoimmune Diseases/epidemiology ; Case-Control Studies ; Colitis, Collagenous/diagnosis ; Colitis, Collagenous/epidemiology ; Colitis, Collagenous/etiology ; Colitis, Collagenous/genetics ; Colitis, Lymphocytic/diagnosis ; Colitis, Lymphocytic/epidemiology ; Colitis, Lymphocytic/etiology ; Colitis, Lymphocytic/genetics ; Colitis, Microscopic/diagnosis ; Colitis, Microscopic/epidemiology ; Colitis, Microscopic/etiology ; Colitis, Microscopic/genetics ; Colitis, Ulcerative/epidemiology ; Comorbidity ; Educational Status ; Female ; Genetic Predisposition to Disease ; Humans ; Male ; Marital Status ; Middle Aged ; Risk Factors ; Smoking/adverse effects ; Smoking/epidemiology ; Sweden/epidemiology
Language	English
Publishing date	2017-05
Publishing country	England
Document type	Journal Article
ZDB-ID	1034239-4
ISSN	1473-5687 ; 0954-691X
ISSN (online)	1473-5687
ISSN	0954-691X
DOI	10.1097/MEG.0000000000000832
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Article: Recent advances in diagnosis and treatment of microscopic colitis.

Tysk, Curt / Wickbom, Anna / Nyhlin, Nils / Eriksson, Sune / Bohr, Johan

Annals of gastroenterology

2014 Volume 24, Issue 4, Page(s) 253–262

Abstract: Microscopic colitis, comprising collagenous colitis and lymphocytic colitis, is a common cause of chronic diarrhea. It is characterized clinically by chronic watery diarrhea and a macroscopically normal colonic mucosa where diagnostic histopathological ... ...

Abstract	Microscopic colitis, comprising collagenous colitis and lymphocytic colitis, is a common cause of chronic diarrhea. It is characterized clinically by chronic watery diarrhea and a macroscopically normal colonic mucosa where diagnostic histopathological features are seen on microscopic examination. The annual incidence of each disorder is 4-6/100,000 inhabitants, with a peak incidence in individuals 60-70 years old and a noticeable female predominance in collagenous colitis. The etiology is unknown. Chronic diarrhea, abdominal pain, weight loss, fatigue, and fecal incontinence are common symptoms that impair the health-related quality of life of the patient. There is an association with other autoimmune disorders, such as celiac disease, thyroid disorders, diabetes mellitus, and arthritis. Budesonide is the best-documented treatment, both short-term and long-term. Recurrence of symptoms is common after withdrawal of successful budesonide therapy, and the optimal long-term treatment strategy needs further study. The long-term prognosis is good, and the risk of complications including colon cancer is low. We review the epidemiology, clinical features, diagnosis and treatment of microscopic colitis.
Language	English
Publishing date	2014-04-08
Publishing country	Greece
Document type	Review
ZDB-ID	2032850-3
ISSN	1108-7471
ISSN	1108-7471
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Zs.A 2455: Show issues

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Article ; Online: Incidence, prevalence and clinical outcome of anaemia in inflammatory bowel disease: a population-based cohort study.

Eriksson, Carl / Henriksson, Ida / Brus, Ole / Zhulina, Yaroslava / Nyhlin, Nils / Tysk, Curt / Montgomery, Scott / Halfvarson, Jonas

Alimentary pharmacology & therapeutics

2018 Volume 48, Issue 6, Page(s) 638–645

Abstract: Background: The incidence and short-term outcome of anaemia in inflammatory bowel disease (IBD) are largely unknown.: Aim: To determine the incidence, prevalence and clinical outcome of anaemia in terms of resolution of anaemia within 12 months. We ... ...

Abstract	Background: The incidence and short-term outcome of anaemia in inflammatory bowel disease (IBD) are largely unknown. Aim: To determine the incidence, prevalence and clinical outcome of anaemia in terms of resolution of anaemia within 12 months. We also planned to assess risk factors for anaemia in IBD. Methods: A random sample of 342 patients was obtained from the population-based IBD cohort of Örebro University Hospital, Sweden, consisting of 1405 patients diagnosed between 1963 and 2010. Haemoglobin measurements recorded from 1 January 2011 to 31 December 2013 were extracted from the Clinical Chemistry data system. Results: In Crohn's disease, the incidence rate of anaemia was 19.3 (95% CI: 15.4-23.7) per 100 person-years and the prevalence was 28.7% (CI: 22.0-36.2), compared with 12.9 (CI: 9.8-16.5) and 16.5% (CI: 11.2-22.9) for ulcerative colitis. Crohn's disease was associated with an increased incidence (OR = 1.60; CI: 1.02-2.51) and prevalence of anaemia (OR = 2.04; CI: 1.20-3.46) compared to ulcerative colitis. Stricturing disease phenotype in Crohn's disease (HR = 2.59; CI: 1.00-6.79) and extensive disease in ulcerative colitis (HR = 2.40; CI: 1.10-5.36) were associated with an increased risk of anaemia. Despite a higher probability of receiving specific therapy within 3 months from the diagnosis of anaemia, Crohn's disease patients had a worse outcome in terms of resolution of anaemia within 12 months (56% vs 75%; P = 0.03). Conclusions: Anaemia is a common manifestation of IBD even beyond the first years after the diagnosis of IBD. Crohn's disease is associated with both an increased risk and a worse outcome.
MeSH term(s)	Adult ; Aged ; Anemia/complications ; Anemia/diagnosis ; Anemia/epidemiology ; Cohort Studies ; Colitis, Ulcerative/complications ; Colitis, Ulcerative/diagnosis ; Colitis, Ulcerative/epidemiology ; Crohn Disease/complications ; Crohn Disease/diagnosis ; Crohn Disease/epidemiology ; Female ; Humans ; Incidence ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/diagnosis ; Inflammatory Bowel Diseases/epidemiology ; Male ; Middle Aged ; Phenotype ; Prevalence ; Retrospective Studies ; Risk Factors ; Sweden/epidemiology ; Treatment Outcome
Language	English
Publishing date	2018-08-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639012-2
ISSN	1365-2036 ; 0269-2813 ; 0953-0673
ISSN (online)	1365-2036
ISSN	0269-2813 ; 0953-0673
DOI	10.1111/apt.14920
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Zs.A 2206: Show issues

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Article ; Online: Hepatotoxicity by bosentan in a patient with portopulmonary hypertension: a case-report and review of the literature.

Eriksson, Carl / Gustavsson, Anders / Kronvall, Thomas / Tysk, Curt

Journal of gastrointestinal and liver diseases : JGLD

2011 Volume 20, Issue 1, Page(s) 77–80

Abstract: Bosentan is an endothelin receptor antagonist approved for treatment of pulmonary arterial hypertension. Mild liver reactions occur in about 10% of treated patients but severe hepatotoxicity is rare. We present clinical data and treatment outcome of a ... ...

Abstract	Bosentan is an endothelin receptor antagonist approved for treatment of pulmonary arterial hypertension. Mild liver reactions occur in about 10% of treated patients but severe hepatotoxicity is rare. We present clinical data and treatment outcome of a severe drug induced liver injury due to bosentan in a patient with non-cirrhotic portopulmonary hypertension. After 18 months of uncomplicated therapy with bosentan 125 mg b.i.d., the patient developed a severe mixed hepatic injury. Serum levels of bilirubin were 316 µmol/l (ref. value <20 micromol/l), AST 14 µkat/l (ref. value < 0.9 µkat/l), ALT 10 µkat/l (ref. value < 0.9 µkat/l), ALP 8 µkat/l (ref. value <1.8 µkat/l) and INR 1.8 (ref. value 0.9-1.1). Complete diagnostic work-up disclosed no other cause of hepatotoxicity. Treatment with prednisolone 40 mg/day in tapering doses was ultimately added and the patient made a full recovery. Subsequent treatment with sildenafil and ambrisentan for pulmonary arterial hypertension was well tolerated and liver function tests have remained normal during 12 months' follow-up. A review of the literature revealed three other women with severe hepatotoxicity due to bosentan. Bosentan may cause severe liver injury, even after long uneventful therapy, and current recommendations on regular monitoring of liver function tests are reinforced. Ambrisentan may be a therapeutic alternative in patients with pulmonary arterial hypertension and hepatotoxicity by bosentan.
MeSH term(s)	Adult ; Antihypertensive Agents/adverse effects ; Antihypertensive Agents/therapeutic use ; Chemical and Drug Induced Liver Injury/etiology ; Female ; Humans ; Hypertension, Portal/drug therapy ; Hypertension, Pulmonary/drug therapy ; Sulfonamides/adverse effects ; Sulfonamides/therapeutic use
Chemical Substances	Antihypertensive Agents ; Sulfonamides ; bosentan (Q326023R30)
Language	English
Publishing date	2011-03
Publishing country	Romania
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2427021-0
ISSN	1842-1121 ; 1841-8724
ISSN (online)	1842-1121
ISSN	1841-8724
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Zs.A 3825: Show issues

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Article: Lack of effect of methotrexate in budesonide-refractory collagenous colitis.

Münch, Andreas / Bohr, Johan / Vigren, Lina / Tysk, Curt / Ström, Magnus

Clinical and experimental gastroenterology

2013 Volume 6, Page(s) 149–152

Abstract: Background: In most cases, collagenous colitis can be treated effectively with budesonide. However, some patients develop side effects or have chronic symptoms refractory to budesonide. This paper reports an open case series of patients intolerant or ... ...

Abstract	Background: In most cases, collagenous colitis can be treated effectively with budesonide. However, some patients develop side effects or have chronic symptoms refractory to budesonide. This paper reports an open case series of patients intolerant or refractory to budesonide who were treated with methotrexate (MTX). Methods and patients: Nine patients (seven women) with a median (range) age of 62 (44-77) years were studied. Bowel movements were registered during 1 week prior to baseline and after 6 and 12 weeks' treatment, enabling calculation of the mean bowel movements/day. All patients underwent colonoscopy with biopsies before inclusion to confirm diagnosis. Open treatment with MTX was given 15 mg subcutaneously weekly for 6 weeks and was increased to 25 mg for a further 6 weeks if symptoms were unresponsive to the first 6 weeks' treatment. The endpoint was clinical remission, which was defined as a mean <3 stools/day and mean <1 watery stool/day/week at Week 12. The Short Health Scale was used at baseline and Week 12 to assess health-related quality of life. Results: Five patients fulfilled the treatment according to the protocol and four patients discontinued the study after 3-6 weeks because of adverse events. No patient achieved clinical remission at Week 12. The mean stool frequency/day at baseline was 6.0 stools/day, thereof 5.4 watery stools/day and after 12 weeks treatment 6.4 stools/day, thereof 5.7 watery/day. No patient appreciated an improvement of health-related quality of life. Conclusion: Short-term treatment with MTX had no clinical effect in collagenous colitis patients intolerant or refractory to budesonide. Alternative therapies should be investigated in these patients.
Language	English
Publishing date	2013-08-30
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2520690-4
ISSN	1178-7023
ISSN	1178-7023
DOI	10.2147/CEG.S48201
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Article ; Online: Increased prevalence of antibodies against dietary proteins in children and young adults with cerebral palsy.

Stenberg, Reidun / Dahle, Charlotte / Magnuson, Anders / Hellberg, Dan / Tysk, Curt

Journal of pediatric gastroenterology and nutrition

2013 Volume 56, Issue 2, Page(s) 233–238

Abstract: Objectives: Undernourishment is common in children with cerebral palsy (CP), but the reasons are unknown. We previously reported elevated levels of immunoglobulin (Ig) A and IgG antibodies against gliadin (AGA) and tissue transglutaminase (tTG) in 99 ... ...

Abstract	Objectives: Undernourishment is common in children with cerebral palsy (CP), but the reasons are unknown. We previously reported elevated levels of immunoglobulin (Ig) A and IgG antibodies against gliadin (AGA) and tissue transglutaminase (tTG) in 99 children and young adults with CP without characteristic findings of gluten enteropathy in small bowel biopsies. Our aim was to perform a case-control study of IgG antibodies against other dietary antigens, AGA, anti-tTG, and IgE antibodies against wheat and gluten. Methods: Sera from 99 cases with CP and 99 healthy, age- and sex-matched controls were analysed with fluorescence enzyme-linked immunosorbent assay for detection of IgG antibodies against β-lactoglobulin, casein, egg white, IgG- and IgA-AGA, IgA-anti-tTG, and IgE antibodies against gluten and wheat. Results: Compared with controls, the odds ratio in cases with CP for having elevated levels of IgG antibodies against β-lactoglobulin was 17.0 (95% confidence interval [CI] 2.3-128), against casein 11.0 (95% CI 2.6-46.8), and against egg white 7.0 (95% CI 1.6-30.8). The IgE responses for wheat/gluten were generally low. The tetraplegic and dyskinetic CP subtypes had significantly higher frequencies of elevated levels for all of the tested antibodies except IgG against egg white, and IgA-anti-tTG. A significantly lower weight was seen in cases with CP with positive versus negative serology. Conclusions: Elevated levels of IgG against dietary antigens were more frequent in the CP group compared with controls, and particularly in the tetraplegic and dyskinetic CP subtypes with the most severe neurologic handicap and undernourishment. Hypothetically, malnourishment may cause increased intestinal permeability and thus immunization against dietary antigens.
MeSH term(s)	Adolescent ; Adult ; Antibodies/blood ; Autoantibodies/blood ; Body Weight ; Case-Control Studies ; Caseins/immunology ; Celiac Disease/complications ; Celiac Disease/immunology ; Cerebral Palsy/complications ; Cerebral Palsy/immunology ; Child ; Child, Preschool ; Dietary Proteins/immunology ; Egg White ; Female ; Glutens/immunology ; Humans ; Immunoglobulin A/blood ; Immunoglobulin E/blood ; Immunoglobulin G/blood ; Infant ; Lactoglobulins/immunology ; Male ; Malnutrition/etiology ; Malnutrition/immunology ; Transglutaminases/immunology ; Triticum/immunology ; Young Adult
Chemical Substances	Antibodies ; Autoantibodies ; Caseins ; Dietary Proteins ; Immunoglobulin A ; Immunoglobulin G ; Lactoglobulins ; Immunoglobulin E (37341-29-0) ; Glutens (8002-80-0) ; Transglutaminases (EC 2.3.2.13)
Language	English
Publishing date	2013-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603201-1
ISSN	1536-4801 ; 0277-2116
ISSN (online)	1536-4801
ISSN	0277-2116
DOI	10.1097/MPG.0b013e318272cbf4
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Zs.A 1728: Show issues

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