Pulmonary embolism linked with auto-immune disorders such as Celiac

A research team from Malmo University Hospital in Sweden conducted a study to determine if there is a connection between auto-immune disorders (such as Celiac, Inflammatory Bowel Disease, Type 1 Diabetes, Hashimoto’s Thyroiditis, Lupus, Rheumatoid Arthritis … among others) and pulmonary embolism (PE), a sudden blockage in a lung artery. The researchers followed individuals who were never admitted to the hospital for venous thromboembolism (a blood clot that forms in a vein), and with a primary or secondary diagnosis of an autoimmune discover between January 1, 1964 and December 31, 2008, for admission to a hospital for pulmonary embolism. They obtained data from the MigMed2 database which contained information on all registered residents of Sweden. The reference population was the total population of Sweden. They then calculated standardized incidence ratios (SIRs) for pulmonary embolism, and adjusted the individual variables such as age and sex.

The Swedish researchers found that 535,538 individuals were admitted to a hospital because of an autoimmune disorder. Overall risk of pulmonary embolism during the first year after admission for an autoimmune disorder was 6·38 (95% confidence interval (CI), 6·19—6·57). All 33 different autoimmune disorders among the patients were associated with a significantly increased risk of pulmonary embolism during the first year after admission. However, some had a particularly high risk—eg, immune thrombocytopenic purpura (10·79, 95% CI, 7·98—14·28), polyarteritis nodosa (13·26, 95% CI, 9·33—18·29), polymyositis or dermatomyositis (SIR,16·44, 95% CI, 11·57—22·69), and systemic lupus erythematosus (SIR, 10·23, 95% CI, 8·31—12·45).  Rheumatoid arthritis (SIR, 5.99, 95% CI, 5.59-6.41) and Type I diabetes mellitus (SIR, 6.38, 95% CI, 3.28-11.18) also had high associations. Overall risk decreased over time, from 1·53 (95% CI, 1·48—1·57) at 1—5 years, to 1·15 (95% CI,1·11—1·20) at 5—10 years, and 1·04 (95% CI,1·00—1·07) at 10 years and later. The risk was increased for both sexes and all age groups.

What these findings suggest is that autoimmune disorders are associated with a high risk of pulmonary embolism in the first year after a hospital admission, and though there were some limitations in the study, the  researchers felt the associations were strong enough to indicate that autoimmune disorders are hypercoagulation disorders. Carani B. Sanjeevi, MD, PhD, of the Karolinska Institute in Stockholm, recommended that future studies should investigate the use of inflammatory markers to identify patients with autoimmune disorders so that preventative measures may be taken, in the form of anti-inflammatory agents to prevent a further complication of pulmonary embolism.

For more details about this study:

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2961306-8/abstract