People with celiac disease advised to consider pneumonia vaccine

Published May 27, 2016 Reuters

(Reuters Health) – Seniors are advised to get vaccinated against pneumonia, but that precaution is also a good idea for people of any age with celiac disease, according to a U.K. study.

Despite their greater risk for pneumonia, only about one quarter of celiac patients get a pneumonia vaccine after they are diagnosed, the study team writes in the journal Alimentary Pharmacology and Therapeutics.

To assess the link between pneumonia and celiac disease, the researchers used data on English patients collected between 1997 and 2011, including 9,803 with celiac disease and a comparison group of 101,755 people without celiac.

Overall people with and without celiac disease had pneumonia at similar rates, with 3.42 cases per 1,000 people per year among those with celiac and 3.12 per 1,000 people per year among those without the condition.

But among people under age 65 with a celiac diagnosis, those who didn’t get a pneumonia vaccine were 28 percent more likely to get pneumonia than those who were vaccinated, researchers found.

People under 65 with celiac disease were also 7 percent more likely to contract pneumonia than counterparts without celiac.

Only people under 65 years old showed a higher risk of pneumonia, probably because older age is an even greater risk factor for pneumonia than celiac disease, the study team speculates.

Only around 37 percent of celiac patients had ever had a pneumonia vaccine and only 26 percent of patients got a vaccine after their condition was diagnosed.

In people with celiac disease, the immune system attacks and damages the intestines when the gluten protein in wheat, barley or rye is consumed. The Celiac Disease Foundation estimates that one in 100 people worldwide suffer from the condition.

Colin Crooks, one of the study’s authors, offered a possible explanation for why celiac patients might be at greater risk of pneumonia.

“There is some evidence that in some patients with untreated celiac disease the spleen does not work as well, which is important in fighting certain infections,” he told Reuters Health by email.

Crooks, a researcher at the University of Nottingham, noted that when people with celiac begin a gluten-free diet, their spleen function will begin to improve, which may help them fight off infections.

Celiac disease can cause spleen issues for up to a third of patients and these people may be at greater risk for infections, said Dr. Shamez Ladhani of Public Health England in London, who was not involved in the study.

“It is important that they discuss their risk with their doctor and consider appropriate actions to reduce the risk, which may include vaccination, not only against pneumococcal disease but also other bacteria and viruses, such as influenza vaccination,” Ladhani said by email.

Getting a flu vaccine can also help protect against bacterial infections like pneumonia, he added.

Ladhani recommended that patients with spleen problems should get a flu vaccine every year and the pneumonia vaccine every five years.

“Bacterial pneumonia can be serious, but can be treated with common antibiotics. It is important that individuals with celiac disease seek medical advice early when they become unwell with fever or respiratory symptoms,” Ladhani said.

SOURCE: Alimentary Pharmacology and Therapeutics, online May 5, 2016.

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