Increased Risk of Sarcoidosis among Patients with Celiac Disease: A Systematic Review and Meta-Analysis

Abstract

Background/Purpose: Several epidemiologic studies have suggested that patients with celiac disease may be at an increased risk of sarcoidosis but the results were inconsistent. This systematic review and meta-analysis was conducted with the aim to better characterize this risk by summarizing all available data.

Methods: A literature review was performed using MEDLINE and EMBASE database from inception to April 2018 using the search strategy that included the terms for sarcoidosis and celiac disease. Cohort studies or case-control studies that compared the risk of sarcoidosis among patients with celiac disease versus individuals without celiac disease were included. For cohort studies, cases must be patients with celiac disease, comparators must be individuals without celiac disease and the outcome of interest must be incident sarcoidosis. For case-control studies, cases must be patients with sarcoidosis, controls must be individuals without sarcoidosis and the exposure of interest must be celiac disease. Point estimates and standard errors of the included studies were extracted and the pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird.

Results: Of 375 retrieved articles, a total of 4 studies (2 cohort studies and 2 case-control studies) with 693,639 participants met the eligibility criteria and were included into the meta-analysis. The risk of sarcoidosis among patients with celiac disease was significantly higher than individuals without celiac disease with the pooled OR of 7.16 (95% CI, 1.48 – 34.56). The statistical heterogeneity of this study was high (I² = 95%). The forest plot of this meta-analysis is shown as figure 1.

Conclusion: This systematic review and meta-analysis found a significantly higher risk of sarcoidosis among patients with celiac disease.

Figure 1: Forest plot