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Infections are associated with increased risk of giant cell arteritis - a population-based case-control study from Southern Sweden

Stamatis, Pavlos LU orcid ; Turkiewicz, Aleksandra LU ; Englund, Martin LU orcid ; Jönsson, Göran LU ; Nilsson, Jan-Åke LU ; Turesson, Carl LU and Mohammad, Aladdin LU (2020) In Journal of Rheumatology 47(6).
Abstract
Objective To investigate the association of infections with the subsequent development of giant cell arteritis (GCA) in a large population-based cohort from a defined geographic area in Sweden.

Methods Patients diagnosed with biopsy-confirmed GCA between 2000 and 2016 were identified through the database of the Department of Pathology in Skåne, the southernmost region of Sweden. For each GCA case, 10 controls matched for age, sex, and area of residence were randomly selected from the general population. Using the Skåne Healthcare Register, we identified all infection events prior to the date of GCA diagnosis and index date of controls. With infection as exposure, a conditional logistic regression model was employed to estimate the... (More)
Objective To investigate the association of infections with the subsequent development of giant cell arteritis (GCA) in a large population-based cohort from a defined geographic area in Sweden.

Methods Patients diagnosed with biopsy-confirmed GCA between 2000 and 2016 were identified through the database of the Department of Pathology in Skåne, the southernmost region of Sweden. For each GCA case, 10 controls matched for age, sex, and area of residence were randomly selected from the general population. Using the Skåne Healthcare Register, we identified all infection events prior to the date of GCA diagnosis and index date of controls. With infection as exposure, a conditional logistic regression model was employed to estimate the odds ratio (OR) for developing GCA. The types of infections contracted nearest in time to the GCA diagnosis/index date were identified.

Results A total of 1005 patients with biopsy-confirmed GCA (71% female) and 10 050 controls were included in the analysis. Infections were more common among patients subsequently diagnosed with GCA compared to controls [51% vs. 41%, OR 1.78; 95% confidence interval (CI) 1.53–2.07]. Acute upper respiratory tract infection (OR 1.77; 95 %. CI 1.47–2.14), influenza and pneumonia (OR 1.72; 95 % CI 1.35–2.19), and unspecified infections (OR 5.35; 95 % CI 3.46–8.28) were associated with GCA. Neither skin nor gastrointestinal infections showed a correlation.

Conclusion Infections, especially those of the respiratory tract, were associated with subsequent development of biopsy-confirmed GCA. Our findings support the hypothesis that a range of infections may trigger GCA. (Less)
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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Rheumatology
volume
47
issue
6
publisher
Journal of Rheumatology Publishing Company Limited
external identifiers
  • pmid:32414956
  • scopus:85100181670
ISSN
0315-162X
DOI
10.3899/jrheum.200211
language
English
LU publication?
yes
id
855252db-d82c-470a-a117-2dc3f7ac549b
date added to LUP
2020-05-31 06:58:57
date last changed
2024-05-29 13:21:11
@article{855252db-d82c-470a-a117-2dc3f7ac549b,
  abstract     = {{Objective To investigate the association of infections with the subsequent development of giant cell arteritis (GCA) in a large population-based cohort from a defined geographic area in Sweden.<br/><br/>Methods Patients diagnosed with biopsy-confirmed GCA between 2000 and 2016 were identified through the database of the Department of Pathology in Skåne, the southernmost region of Sweden. For each GCA case, 10 controls matched for age, sex, and area of residence were randomly selected from the general population. Using the Skåne Healthcare Register, we identified all infection events prior to the date of GCA diagnosis and index date of controls. With infection as exposure, a conditional logistic regression model was employed to estimate the odds ratio (OR) for developing GCA. The types of infections contracted nearest in time to the GCA diagnosis/index date were identified.<br/><br/>Results A total of 1005 patients with biopsy-confirmed GCA (71% female) and 10 050 controls were included in the analysis. Infections were more common among patients subsequently diagnosed with GCA compared to controls [51% vs. 41%, OR 1.78; 95% confidence interval (CI) 1.53–2.07]. Acute upper respiratory tract infection (OR 1.77; 95 %. CI 1.47–2.14), influenza and pneumonia (OR 1.72; 95 % CI 1.35–2.19), and unspecified infections (OR 5.35; 95 % CI 3.46–8.28) were associated with GCA. Neither skin nor gastrointestinal infections showed a correlation.<br/><br/>Conclusion Infections, especially those of the respiratory tract, were associated with subsequent development of biopsy-confirmed GCA. Our findings support the hypothesis that a range of infections may trigger GCA.}},
  author       = {{Stamatis, Pavlos and Turkiewicz, Aleksandra and Englund, Martin and Jönsson, Göran and Nilsson, Jan-Åke and Turesson, Carl and Mohammad, Aladdin}},
  issn         = {{0315-162X}},
  language     = {{eng}},
  number       = {{6}},
  publisher    = {{Journal of Rheumatology Publishing Company Limited}},
  series       = {{Journal of Rheumatology}},
  title        = {{Infections are associated with increased risk of giant cell arteritis - a population-based case-control study from Southern Sweden}},
  url          = {{http://dx.doi.org/10.3899/jrheum.200211}},
  doi          = {{10.3899/jrheum.200211}},
  volume       = {{47}},
  year         = {{2020}},
}