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. 2023 Nov 1;118(11):2041-2051.
doi: 10.14309/ajg.0000000000002318. Epub 2023 May 12.

Microscopic Colitis and Risk of Incident Acute Pancreatitis: A Nationwide Population-Based Matched Cohort Study

David Bergman  1 , Bjorn Roelstraete  1 , Ola Olén  2   3   4 , Björn Lindkvist  5 , Jonas F Ludvigsson  1   6   7
Affiliations

Microscopic Colitis and Risk of Incident Acute Pancreatitis: A Nationwide Population-Based Matched Cohort Study

David Bergman et al. Am J Gastroenterol. .

Abstract

Introduction: Several gastrointestinal diseases have been linked to acute pancreatitis, but the risk of acute pancreatitis in microscopic colitis (MC) has not been studied.

Methods: We conducted a nationwide, population-based, matched cohort study in Sweden of 12,140 patients with biopsy-verified MC (diagnosed in 2003-2017), 57,806 matched reference individuals, and 12,781 siblings without MC with a follow-up until 2021. Data on MC were obtained from all of Sweden's regional pathology registers (n = 28) through the ESPRESSO cohort. Data on acute pancreatitis were collected from the National Patient Register. Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) were calculated using Cox regression.

Results: During a mean follow-up of 9.9 years (SD = 4.3), 146 patients with MC and 437 reference individuals were diagnosed with acute pancreatitis (127.8 vs 80.1 per 100,000 person-years), corresponding to an aHR of 1.57 (95% CI = 1.30-1.90). Moreover, we found a positive association between MC and acute nongallstone-related pancreatitis (aHR 1.99 [95% CI = 1.57-2.51]), but not with acute gallstone-related pancreatitis (aHR 1.08 [95% CI = 0.78-1.49]). Comparing patients with MC with their unaffected siblings yielded an aHR of 1.28 (95% CI = 0.92-1.78). The risk of acute pancreatitis remained elevated also for patients with MC with a follow-up exceeding 10 years (aHR 1.75 [95% CI = 1.14-2.67]).

Discussion: This nationwide study of more than 12,000 patients with MC demonstrated an increased risk of acute pancreatitis after MC. Hence, clinicians should have a low threshold for the evaluation of acute pancreatitis in patients with MC. In addition, these patients should receive advice and care aimed at reducing the risk of acute pancreatitis.

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Figures

Figure 1.
Figure 1.
Flowchart of inclusion of patients with biopsy-confirmed microscopic colitis in the ESPRESSO Histopathology Cohort and matched general population controls from the Swedish Total Population Register 2003–2017. ESPRESSO, Epidemiology Strengthened by Histopathology Reports.
Figure 2.
Figure 2.
Kaplan-Meier failure estimates
Figure 3:
Figure 3:
Forest plot of main and secondary outcomes
See this image and copyright information in PMC

Comment in

References

    1. Burke KE, D’Amato M, Ng SC, Pardi DS, Ludvigsson JF, Khalili H. Microscopic colitis. Nat Rev Dis Primers 2021;7(1):39. - PubMed
    1. Mellander MR, Ekbom A, Hultcrantz R, Lofberg R, Ost A, Bjork J. Microscopic colitis: a descriptive clinical cohort study of 795 patients with collagenous and lymphocytic colitis. Scand J Gastroenterol 2016;51(5):556–62. - PubMed
    1. Bergman D, Clements MS, Khalili H, Agreus L, Hultcrantz R, Ludvigsson JF. A nationwide cohort study of the incidence of microscopic colitis in Sweden. Aliment Pharmacol Ther 2019;49(11):1395–400. - PubMed
    1. Forss A, Clements M, Bergman D, Roelstraete B, Kaplan GG, Myrelid P, et al. A nationwide cohort study of the incidence of inflammatory bowel disease in Sweden from 1990 to 2014. Aliment Pharmacol Ther 2022;55(6):691–9. - PubMed
    1. Weimers P, Ankersen DV, Lophaven S, Bonderup OK, Münch A, Løkkegaard ECL, et al. Incidence and prevalence of microscopic colitis between 2001 and 2016: A Danish nationwide cohort study. J Crohns Colitis 2020. - PubMed

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