More data on the risk of pancreatitis in the setting of celiac disease has been published (Clinical Gastroenterol Hepatol 2012; 10: 1136-1142).

In this medical records review study, 28,908 patients in Sweden with biopsy-proven celiac disease (1969-2008) were compared with a control population of 143,746 to determine the risk of pancreatitis due to celiac disease. The median age at study entry was 30 years and included patients as young as 10 years.

Among these cohorts, 406 pancreatitis patients with celiac disease were identified.  The expected number would have been 143, yielding a hazard ratio of 2.85.  The risk for any type of pancreatitis within 5 years of diagnosis was 2.76.  All types of pancreatitis were increased including acute pancreatitis with gallstones, non-gallstone acute pancreatitis, and chronic pancreatitis.

What are potential reasons for this association between pancreatitis and celiac disease?

1. Malnutrition may impair pancreas function
2. Associated papillary inflammation could increase risk of acute pancreatitis
3. The two diseases may share immunologic characteristics that increase the risk of both disorders
4. Elevated levels of asymptomatic pancreatic enzymes could lead to some false-positive cases

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